Table 6. Associations between normal weight obesity defined as high percent body fat^a with metabolic syndrome and insulin resistance, insulin sensitivity and β cell function, 1978/79 Ribeirão Preto birth cohort.

Normal weight obesity	%	Model 1b OR (95% CI)	P e	Model 2c OR (95% CI)	P e	Model 3d OR (95% CI)	P e
	Metabolic Syndrome – JISf
No	1.4	1		1		1
Yes	7.5	5.40 (2.21–13.22)	<0.001	5.66 (2.26–14.20)	<0.001	7.36 (2.65–20.45)	<0.001
	HOMA2- Insulin resistanceg
No	2.0	1		1		1
Yes	5.8	3.23 (1.26–8.22)	0.014	3.83 (1.32–8.68)	0.011	4.69 (1.65–13.32)	0.004
	Low HOMA2- Insulin sensitivityh
No	8.8	1		1		1
Yes	23.3	3.15 (1.90–5.24)	<0.001	3.28 (1.96–5.47)	<0.001	3.38 (1.96–5.83)	<0.001
	High HOMA2- β cell functioni
No	9.6	1		1		1
Yes	14.6	1.79 (0.98–3.25)	0.057	1.89 (1.03–3.45)	0.039	1.85 (1.01–3.49)	0.049

Abbreviations: OR, Odds ratio; CI, Confidence Interval; HOMA, Homeostasis Model Assessment. ^ahigh percent body fat>23% for males and >30% for females. Percent body fat was estimated based on the Slaughter's equations using the sum of triceps and subscapular skinfolds. ^badjusted for age, sex and skin color. ^cadjusted for age, sex, skin colour and early life variables (birth weight, gestational age at birth, maternal schooling, parity, type of delivery and maternal smoking during pregnancy). ^dadjusted for age, sex, skin colour, early and adult life variables (alcohol consumption, family income, schooling, marital status, smoking, percentage of fat in the diet and physical activity). ^eP value calculated by the log-likelihood ratio test. ^fdefined according to the Joint Interim Statement (JIS) of the IDF Task Force on Epidemiology and Prevention, National Heart, Lung and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society and International Association for the Study of Obesity. ^gBased on the Brazilian Metabolic Syndrome Study - BRAMS criterion (2009) - HOMA2- Insulin resistance >2.8. ^hHOMA2- Insulin sensitivity was considered to be low if <90th percentile and normal otherwise. ⁱHOMA2- β cell function was considered high if >90th percentile and normal otherwise.