Objectives: Abdominal fat has been strongly linked to increased cardiometabolic risk and impaired glucose regulation in adults. Owing to the lack of detailed body composition phenotyping in most previous child cohort studies, the temporal links between abdominal fat accumulation and impaired glucose regulation have not been well established. In this study, we evaluated the associations of abdominal fat assessed by MRI at early infancy (≤21 days after birth) and at 4.5 years, as well as the rate of fat accumulation during this interval with glucose regulation assessed at 6 years.
Methods: The participants were from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study, a prospective mother-offspring cohort comprising 1176 children. Abdominal fat MRI was performed on 331 children within the first 2 weeks after birth, and on 316 children at 4.5y (128 children had MRIs at both ages). Abdominal fat was further segmented into deep subcutaneous adipose tissue (DSAT), superficial subcutaneous adipose tissue (SSAT) and intra-abdominal adipose tissue (IAT). The individual depot volumes at both time points were standardized using z-scores. The relative gain in abdominal fat in each depot was calculated as the difference between the z-scores at 4.5y and at early infancy. Fasting plasma glucose was obtained from 543 children at age 6y, and its associations with abdominal fat z-scores at both time points were analyzed after adjusting for ethnicity, sex, maternal education, maternal BMI at recruitment in the first trimester, maternal antenatal fasting glucose, rate of gestational weight gain, and breastfeeding duration.
Results: Higher DSAT and SSAT volumes at 4.5y were associated with higher fasting glucose concentrations (DSAT: adjusted difference (AD) per SD=0.062 mmol/L, 95%CI: 0.010, 0.114, SSAT: AD=0.07 mmol/L, 95%CI: 0.016, 0.123). Higher gain in all the abdominal fat depots between early infancy and 4.5y also showed associations with higher fasting glucose (DSAT: AD=0.109 mmol/L, 95%CI: 0.041, 0.178, SSAT: AD=0.103 mmol/L, 95%CI: 0.023, 0.184, IAT: AD=0.072 mmol/L, 95%CI: 0.006, 0.137). No associations were observed between any of the neonatal abdominal fat compartments or IAT at 4.5y and fasting glucose at 6y.
Conclusions: A higher rate of abdominal fat accumulation during early childhood and higher subcutaneous fat levels at 4.5y were associated with higher levels of fasting glucose at 6y in Asian children. Our findings highlight the importance of characterizing the dynamic aspects of abdominal fat accumulation in early life for predicting later metabolic health.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology