Background: Obesity in childhood is defined by age- and sex-specific BMI cut-off values. However, BMI does not disclose the distribution of fat mass. Increased abdominal adipose tissue is associated with a higher risk of cardio-metabolic disease in adulthood. Thus, precise measurements of abdominal adipose tissue in children may enable early prevention of disease.
Objective and hypotheses: To validate measurements of abdominal adipose tissue by anthropometry and Dual X-ray Absorptiometry (DXA) against Magnetic Resonance Imaging (MRI) in a cohort of healthy Danish children.
Method: A population-based cohort study of 197 children (83 girls) aged 1015 years. On the same day, a multi-slice MRI-abdomen (L1-L4), a DXA with determination of regional fat percentages and a clinical examination with measurement of height, weight, BMI, waist circumference (WC) and skinfolds and standard deviation scores (SDS) were calculated. Pubertal development was assessed. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) percentage of total abdominal volume was determined by MRI and android fat percentage by DXA.
Results: SAT was significantly higher in girls compared to boys (mean 20.1% vs 15.0%, B=4.3 (95% CI 1.96.6), P<0.001). VAT was similar in girls and boys (mean 6.7% in both genders, B=0.1 (95% CI −0.40.6), P=0.654). Analyses were adjusted for puberty. DXA android fat percentage, suprailiac skinfold, BMI-SDS and WC-SDS correlated positively with SAT (r=0.89, r=0.79 r=0.68 and r=0.57, all P< 0.001) and VAT (r=0.39, r=0.32, r=0.22 and r=0.22, all P<0.005). The best anthropometric predictor of both SAT and VAT was suprailiac skinfold, explaining 62.8 and 9.9% of the variance, respectively (both P<0.001).
Conclusion: Anthropometric measurements are good proxies for SAT determined by MRI in healthy non-obese children, reflecting that simple anthropometry can be used to determine obesity in childhood. However, prediction of VAT was less precise probably due to the sparse accumulation at this age.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology