ESPE Abstracts (2019) 92 P1-333

Abdominal Fat Distribution Assessed by Abdominal CT Scan in Adolescents with Type 2 Diabetes Mellitus

Yuriko Abe1, Tatsuhiko Urakami1, Mitsuhiko Hara2,3, Kei Yoshida1, Yusuke Mine1, Masako Aoki1, Junichi Suzuki1, Emiko Saito2,3, Fujihiko Iwata1, Tomoo Okada4,1, Ichiro Morioka1

1Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan. 2Department of Pediatrics, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan. 3Department of Human Nutrition, Tokyo Kasei Gakuin University, Tokyo, Japan. 4Department of Nutrition and Life Science, Kanagawa Institute of Technology, Atsugi, Japan

Background: Abdominal fat distributions are reportedly strongly associated with metabolic risks in type 2 diabetes mellitus. However, research on fat distribution in adolescents with type 2 diabetes mellitus has been limited.

Aim: To investigate fat distribution characteristics in adolescents with type 2 diabetes mellitus for comparison to those with simple obesity in Japan.

Design/Methods: Sixty-one adolescents 10 to 15 years of age with simple obesity or type 2 diabetes mellitus, who visited our outpatient clinics between 2002 and 2018, were enrolled in this study with ethics approval. Simple obesity was defined as a BMI ≥95%ile without. Serum lipids, ALT and HbA1c were measured without fasting. Visceral fat area (VFA) and subcutaneous fat area (SFA) were investigated using umbilical level CT scans. Subjects were classified into 2 subgroups: simple obesity group (n=38) or the type 2 diabetes mellitus group (n=23).

Results: Comparisons between the 2 groups are shown in Table 1. VFA and the ratio of VFA to SFA (V/S ratio) were significantly higher in the type 2 diabetes mellitus group than in the simple obesity group (VFA (cm2): 74 vs 89.2, P=0.0400, V/S ratio: 0.2 vs 0.32, P<0.0001). SFA was significantly lower in the type 2 diabetes mellitus group than in the simple obesity group (SFA (cm2) 357 vs 260, P= 0.0076). VFA and SFA correlated with systolic blood pressure (P=0.0009, 0.0099, respectively), ALT (P=0.0486, 0.0486, respectively), total cholesterol (P=0.0178, 0.0032, respectively), and non-HDL cholesterol (P=0.0065, 0.0010, respectively) in the type 2 diabetes mellitus group.

Conclusion: The abdominal fat distributions in type 2 diabetes mellitus differ from those in simple obesity, in adolescent subjects. VFA and SFA correlated with the metabolic parameters in adolescents with type 2 diabetes mellitus.

Table 1. Median (range) of Group Characteristics
Simple obesity
Type 2 diabetes mellitus
Age (years)12 (10-15)12 (10-15)0.6794
Sex (%Male)52520.9723
BMI %tile99.1 (95.6-99.9)97.9 (88.1-99.9)0.1348
Systolic blood pressure (mmHg)110 (93-146)116 (101-149)0.0692
Diastolic blood pressure (mmHg)63 (46-78)67 (54-89)0.0451*
ALT (U/L)32 (10-282)50.5 (13-251)0.0426*
Total cholesterol (mg/dL)163 (126-253)192.5 (125-230)0.0863
HDL cholesterol (mg/dL)47.5 (30-76)44 (26-49)0.0267*
non-HDL cholesterol (mg/dL)123 (73-207)146 (88-187)0.0344*
HbA1c (%)5.6 (5.3-6.1)8.3 (6.1-14.5)<0.0001*
VFA (cm2)74 (25-138)89.2 (33-206)0.0400*
SFA (cm2)357 (198-619)260 (94-605)0.0076*
V/S ratio0.20 (0.09-0.38)0.32 (0.20-0.76)<0.0001*
* P<0.05