Lin TY, Wu PH, Lin YT, et al. - Given that gut microbiota was implicated in the regulation of host metabolism and can play important roles in the development of normal weight obesity (NWO), defined by a normal body mass index (BMI) but increased body fat percentage (BF%), in chronic kidney disease, researchers conducted this case-control study to investigate the gut microbial diversity and taxonomy in 96 hemodialysis patients with normal weight (BMI < 25 kg/m² and BF% ≤ 25% for men or ≤ 35% for women, n = 32), NWO (BMI < 25 kg/m² and BF% > 25% for men or > 35% for women, n = 32), and overweight/obesity (BMI ≥ 25 kg/m², n = 32), matched for age, gender, and diabetes. Using bioimpedance spectroscopy device, BF% was measured. The authors observed that α-diversity among the 3 adiposity phenotypes was significantly different, with NWO being the least diverse. It was noted that α-diversity was positively correlated with BMI, subjective global assessment score, and physical activity, but negatively related to interleukin-6 and tumor necrosis factor-α. The findings support associations in hemodialysis patients with NWO, between gut dysbiosis and a proinflammatory and catabolic state.