Objective: We aimed to investigate the usefulness of abdominal adiposity and total body fat as predictors of cardiometabolic health, especially insulin sensitivity, in children and adolescents.
Methods: Participants were 479 children and adolescents with obesity (322 boys and 157 girls) aged 3 to 18 years attending the Children's Hospital at Zhejiang University School of Medicine (Hangzhou, China). Participants underwent a number of clinical assessments: anthropometry, sexual maturation, whole-body dual-energy x-ray absorptiometry (DXA) scan, carotid artery ultrasound, as well as an oral glucose tolerance test (OGTT). Insulin sensitivity was assessed using the Matsuda index. Participants were stratified into groups by sex and pubertal stage.
Results: Among the purbertal and pre-pubertal groups, Android/Gynoid ratio (A/G) was strong associated with most parameters of glucose homeostasis assessed. In striking contrast with A/G, Total body fat percentage (TBF%) only associated with fasting insulin in pubertal boys. For liver function, A/G was significantly associated with ALT and AST in pubertal girls and it was mainly correlated with ALT in boys, while TBF% only have a poor correlation with ALT in pubertal boys. A/G did not show a clear correlation with lipid profile with boys, but it was significantly in pubertal girls. None of them had correlation with Blood pressure changes and abnormal thickness in left carotid intima-media in all groups except TBF% had a low correlation with CIMT in pubertal boys. For adverse cardiometabolic outcome, The 0.1 increase in A/G was associated with a 44% and 42% increase in the risk of impaired glucose tolerance in purbetal boys and girls. The same increase in A/G was associated with an increase of 25% of abnormal glycaemia among pubertal boys and with a greater 77% risk of hyperuricaemia in pubertal girls. Every 0.1 increase in A/G was associated with a 19% increase in the risk of NAFLD in boy groups. In marked contrast with A/G, TBF% was only predictive of NAFLD in pubertal boys (aRR 1.05), and was not associated with the likelihood of any of other cardiometabolic outcomes assessed, irrespective of pubertal stage or sex.
Conclusions: Our study shows that A/G ratio is significantly associated with most cardiometabolic risk factors, especially glucose metabolic, in both purbertal and pre-pubertal children and adolescents, while TBF% had almost none significant correlation with these factors. Abdominal obesity can be a good predictor of cardiovascular metabolic risk factors in Chinese children.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology