Metabolically obese normal weight (MONW) individuals are potentially at increased risk of developing metabolic syndrome. Serum zinc and copper concentrations were assessed in individuals with MONW to determine whether MONW is associated with altered serum zinc and/or copper status. Normal weight subjects (total n?=?2419; 1298 men and 1121 women), were recruited as part of Mashhad Stroke and Heart Association Disorder (MASHAD) Study cohort. They were divided into two groups according to the presence or absence of MetS, defined using IDF criteria. Serum zinc and copper concentrations were determined by atomic absorption. Of the 2419 normal weight adults, 377 had MetS. Of this group, 53.7% and 49.7% had a serum zinc 70?μg/dl (Q1) (p?=?0.001) or a serum copper 79?μg/dl (Q1) respectively. Furthermore, 27.3% had a serum copper 131?μg/dl (Q4) (p?=?0.034), and 18.8% had a serum zinc 95?μg/dl (Q4). Logistic regression analysis was performed to determine the odds ratio (OR) for an association of serum zinc, copper and zinc to copper ratio with MetS in normal weight subjects. The subjects with a serum zinc 95?μg/dl (Q4) had 0.386 [OR: 0.614(95%CI 0.457-0.823)] lower chance of MetS (p?=?0.001) and the subjects with a serum copper 131 (Q4) had OR 1.423 (95% CI: 1.09-1.857) higher chance of MetS (p?=?0.009). These data remained significant after adjustment for age and sex, for serum zinc and copper, respectively. Furthermore, our results strongly suggested that zinc and copper were the independent risk factor for metabolic syndrome in normal weight subjects. There is an imbalance between serum copper and zinc concentrations among individuals with MONW when compared with normal BMI individuals without MetS. This may increase the risk of individuals with MONW developing conditions associated with this imbalance, such as diabetes and cardiovascular disease.
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