Comparison of direct measures of adiposity with indirect measures for assessing cardiometabolic risk factors in preadolescent girls

Abstract

BackgroundChildhood overweight and obesity remains high, contributing to cardiometabolic risk factors at younger ages. It is unclear which measures of adiposity serve as the best proxies for identifying children at metabolic risk. This study assessed whether DXA-derived direct measures of adiposity are more strongly related to cardiometabolic risk factors in children than indirect measures.MethodsAnthropometric and DXA measures of adiposity and a comprehensive assessment of cardiometabolic risk factors were obtained in 288, 9–12 year old girls, most being of Hispanic ethnicity. Multiple regression models for each metabolic parameter were run against each adiposity measure while controlling for maturation and ethnicity. In addition, regression models including both indirect and direct measures were developed to assess whether using direct measures of adiposity could provide a better prediction of the cardiometabolic risk factors beyond that of using indirect measures alone.ResultsMeasures of adiposity were significantly correlated with cardiometabolic risk factors (p < 0.05) except fasting glucose. After adjusting for maturation and ethnicity, indirect measures of adiposity accounted for 29-34% in HOMA-IR, 10-13% in TG, 14-17% in HDL-C, and 5-8% in LDL-C while direct measures accounted for 29-34% in HOMA-IR, 10-12% in TG, 13-16% in HDL-C, and 5-6% in LDL-C. The addition of direct measures of adiposity to indirect measures added significantly to the variance explained for HOMA-IR (p = 0.04).ConclusionAnthropometric measures may perform as well as the more precise direct DXA-derived measures of adiposity for assessing most CVD risk factors in preadolescent girls. The use of DXA-derived adiposity measures together with indirect measures may be advantageous for predicting insulin resistance risk.Trial registration NCT02654262. Retrospectively registered 11 January 2016.

Metabolic Risk Factors Associated with Visceral and Subcutaneous Adipose Tissue in a Sex‐Specific Manner in Seven‐Year‐Olds

“…As a result, WC, BMI, and SAT showed a high impact on insulin resistance in both sexes, but VAT only showed this association in girls. This was contrary to a study in which DXA was used to measure body fat in preadolescent children, and this process did not add any significant predictive value to WC and WHtR for HOMA‐IR .…”

Anthropometry Versus Imaging for Prediction of Inflammation Among Hispanic Girls

“…Interestingly, the relationship between CRP and body composition (total and regional) was generally stronger than previously described for various metabolic biomarkers (i.e., insulin, triglycerides, high‐density lipoprotein, low‐density lipoprotein, glucose) and the same body composition and anthropometric measures used in this cohort . Nevertheless, similar to this analysis, any measure of total or regional adiposity performed equally well for predicting metabolic dysfunction in young Hispanic girls . The relatively higher strength of the correlations between CRP and body composition measures further supports their use in predicting cardiovascular disease risk among Hispanic girls, in addition to common lipid measurements already recommended by the American Academy of Pediatrics before and after puberty (at ages 9‐11 years and 17‐21 years, respectively) .…”

“…Interestingly, the relationship between CRP and body composition (total and regional) was generally stronger than previously described for various metabolic biomarkers (i.e., insulin, triglycerides, high‐density lipoprotein, low‐density lipoprotein, glucose) and the same body composition and anthropometric measures used in this cohort . Nevertheless, similar to this analysis, any measure of total or regional adiposity performed equally well for predicting metabolic dysfunction in young Hispanic girls .…”

“…Maturation was assessed via chronological age, Tanner stage, and maturity offset. In alignment with prior publication in this cohort , and because of limitations in age and Tanner stage to account for between‐subject variation in maturation , we selected maturity offset for the analyses herein. Maturity offset estimates physical maturity from chronological age and anthropometric measures (height, weight, sitting height, and leg length) using the Mirwald equation .…”

The Prevalence of Overfat Adults and Children in the US

“…Epidemiologic studies have demonstrated that increased abdominal fat, assessed through WC and waist-to-height ratio (WHtR), can predict adiposity-related risk ( 37 ). WHtR was more strongly related to cardiometabolic risk factors than BMI ( 29 , 44 ). In normal-weight non-obese children with a commonly used cutoff of WHtR ≥ 0.5, over 55% had one to three cardiometabolic health risk factors associated with increases in WC, triglycerides, and blood pressure ( 45 ).…”