Measuring a variety of metabolites in plasma (called metabolic profiling) may be a more accurate way to assess cardiovascular risk than BMI. Abnormal metabolome (found in obesity) linked to ~5-fold increase in cardiovascular events when comparing people who were matched for BMI but had an opposing metabolome.
The metabolome includes measuring plasma metabolites such as amino acids, lipids, phospholipids, sphingolipids, uric acid, and many more.
While BMI correlates well with individual health outcomes, it does not have the sensitivity to identify outliers, some of which carry unique health consequences. The metabolome signature identified here appears to be a more sensitive biomarker for health because it is able to identify the metabolically healthy obese and unhealthy individuals with a normal BMI.