Association Between Early Life Weight Gain and Abdominal Fat Partitioning at 4.5 Years is Sex, Ethnicity, and Age Dependent

Abstract

Objective To investigate the independent associations between age-specific annual weight gain from birth to age 4 years and fat deposition in metabolically distinct compartments at age 4.5 years in a South Asian longitudinal birth cohort. Methods Volumetric abdominal MRI with comprehensive segmentation of deep (DSAT) and superficial subcutaneous (SSAT), and visceral adipose tissues (VAT) was performed in 316 children (150 boys, and 166 girls in three ethnic groups: 158 Chinese, 94 Malay, and 64 Indian) aged 4.5 years. Associations between fat volumes and annual relative weight gain conditional on past growth were assessed overall and stratified by sex and ethnicity. Results Conditional relative weight gain had stronger associations with greater SAT and VAT at age 4.5 years in girls than boys, and in Indians compared with Malay and Chinese. Overall, the magnitude of association was the largest during 2-3 years for SAT, and 1-2 years for VAT. Despite similar body weight, Indian children, and girls had the highest DSAT and SSAT volumes at age 4.5 years (all p-interaction<0.05). No significant sex or ethnic differences were observed in VAT. With increasing BMI, Indian children had the highest tendency to accumulate VAT, and girls accumulated more fat than boys in all depots (all p-interaction<0.001). Conclusions Indian ethnicity and female sex predisposed children to accumulate more fat in the visceral adipose depot with increasing conditional relative weight gain in the second year of life. Thus, 1-2 years age may be a critical window for interventions to reduce visceral fat accumulation.

Brown Adipose Tissue, Adiposity, and Metabolic Profile in Preschool Children

“…The underlying mechanism for this observation is not known. However, our findings of ethnic differences in adiposity and IMCL is consistent with previous findings in the GUSTO cohort ( 21 , 27 ). We have previously shown interethnic variations in insulin sensitivity.…”

“…Abdominal MRI was performed to quantify the volumes of abdominal adipose tissue compartments and superficial subcutaneous (SSAT), deep subcutaneous (DSAT), and visceral (VAT) adipose tissue using a fully automated graph theoretic segmentation algorithm and quantified as described elsewhere ( 20 , 21 ). Liver fat (fat content per unit of liver weight, expressed as percentage) and intramyocellular lipids (IMCL) of the soleus muscle (expressed as a percentage of tissue water content) were assessed by proton magnetic resonance spectroscopy as previously described.…”

Trunk Fat Estimation According To Gender In Childhood Through Basic Somatic Readings. An Opportunity for Improving Girl’S Evaluation

“…Present techniques allow the measurement of abdominal fat separately from subcutaneous fat in children (51,52), but these could not be the available method for better evaluation of the growing heavier section of double burden malnutrition in Low-and Middle-Income Countries (LMIC), so it is natural to look for by-proxy estimators. Further, they are useful even where DXA is available but cannot be justi ed in every follow-up visit.…”

Seeing the fetus from a DOHaD perspective: discussion paper from the advanced imaging techniques of DOHaD applications workshop held at the 2019 DOHaD World Congress

“…136 This ethnic patterning of abdominal fat persisted at age 4.5 years, with the highest SSAT and DSAT levels in Indian children and the lowest levels in Chinese children. 145 No significant sex or ethnic differences were observed in VAT. Skeletal muscle insulin resistance plays a role in the pathophysiology of type 2 diabetes, and cytosolic accumulation of lipid droplets within myocytes, referred to as intramyocellular lipids (IMCLs), has been implicated in the early pathogenesis of insulin resistance.…”

“…142,143 With the aim of determining the individual fat depot volumes, a fully automated algorithm based on graph cuts and level sets to segment and quantify the volume of SAT, SSAT, and VAT depots has been developed. 141 Pediatric MRI protocols and data processing pipeline had been established to assess body fat partitioning in infancy and early childhood [144][145][146] through the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) study, which investigated maternal and early-life determinants of metabolic health and disease later in life. 147 MRI provides a feasible, reliable, and safe approach to longitudinally track the changes in fat accumulation as the children age.…”