Measurement site of visceral adipose tissue and prediction of metabolic syndrome in youth

Lee, So Jung; Kuk, Jennifer L.; Kim, YoonMyung; Arslanian, Silva

doi:10.1111/j.1399-5448.2010.00705.x

Cited by 40 publications

(43 citation statements)

References 22 publications

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“…Ethnic-specific MRI measurement sites of VAT have been recommended in adolescents to best predict total VAT and risk for the metabolic syndrome. 86 Understanding which specific depots and regions of fat yield the most harm is necessary to tailor physical activity and weight-reduction efforts.…”

Section: Challenges and Future Directionsmentioning

confidence: 99%

Ethnic and sex differences in body fat and visceral and subcutaneous adiposity in children and adolescents

2012

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Body fat and the specific depot where adipose tissue (AT) is stored can contribute to cardiometabolic health risks in children and adolescents. Imaging procedures including magnetic resonance imaging and computed tomography allow for the exploration of individual and group differences in pediatric adiposity. This review examines the variation in pediatric total body fat (TBF), visceral AT (VAT) and subcutaneous AT (SAT) due to age, sex, maturational status and ethnicity. TBF, VAT and SAT typically increase as a child ages, though different trends emerge. Girls tend to accumulate more TBF and SAT during and after puberty, depositing fat preferentially in the gynoid and extremity regions. In contrast, pubertal and postpubertal boys tend to deposit more fat in the abdominal region, particularly in the VAT depot. Sexual maturation significantly influences TBF, VAT and SAT. Ethnic differences in TBF are mixed. VAT tends to be higher in white and Hispanic youth, whereas SAT is typically higher in African American youth. Asian youth typically have less gynoid fat but more VAT than whites. Obesity per se may attenuate sex and ethnic differences. Particular health risks are associated with high amounts of TBF, VAT and SAT, including insulin resistance, hepatic steatosis, metabolic syndrome and hypertension. These risks are affected by genetic, biological and lifestyle factors including physical activity, nutrition and stress. Synthesizing evidence is difficult as there is no consistent methodology or definition to estimate and define depot-specific adiposity, and many analyses compare SAT and VAT without controlling for TBF. Future research should include longitudinal examinations of adiposity changes over time in representative samples of youth to make generalizations to the entire pediatric population and examine variation in organ-specific body fat.

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Section: Challenges and Future Directionsmentioning

confidence: 99%

Ethnic and sex differences in body fat and visceral and subcutaneous adiposity in children and adolescents

2012

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“…MRI was obtained with a 3.0 Tesla MR scanner (Siemens, Magnetom Trio, Erlangen, Germany) as discussed previously (Lee et al 2011). To quantify total VAT, five axial images (10 mm thickness) were acquired every 50 mm over the span of 200 mm, extending from 5 cm below to 15 cm above L4-L5 (e.g., L4-L5 − 5 cm, L4-L5, L4-L5 + 5 cm, L4-L5 + 10 cm, L4-L5 + 15 cm).…”

Section: Total Vat By Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

Associations between visceral fat and liver fat with insulin sensitivity and metabolic risk in obese adolescents

Brown

Kuk

Libman

et al. 2015

Biochem. Cell Biol.

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We examined the joint and independent associations between VAT and LF with insulin sensitivity (IS) and lipids in seventy-one obese adolescents (BMI ≥ 95th, 14.9 ± 1.8 years). VAT was assessed by magnetic resonance imaging, and LF was quantified by proton magnetic resonance spectroscopy. IS was evaluated by a 3 -h hyperinsulinemic (80 mU·m(-2)·min(-1)) euglycemic clamp. Independent associations between VAT and LF on metabolic variables were assessed in mutually adjusted multivariate models. The joint association between VAT and LF on metabolic variables was assessed by categorizing participants into a low VAT + low LF group (n = 35), high VAT + low LF group (n = 26), or high VAT + high LF group (n = 10), based on a VAT median split (1.17 kg) and high (≥5%) and low (<5%) LF. Both VAT and LF were independently associated with fasting insulin, 2 h insulin, insulin AUC, IS, and triglycerides (P < 0.05). Adolescents with high VAT + high LF had higher 2 h glucose, glucose AUC, 2 h insulin, triglycerides, and lower insulin sensitivity compared to adolescents with high VAT only (P < 0.025 for all). In obese adolescents, VAT and LF were independently associated with insulin sensitivity and dyslipidemia, and the concomitant presence of VAT and LF is strongly associated with metabolic risk factors.

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“…To our knowledge, only two other studies 19,20 have researched the best single-slice location in children. Lee et al 19 found that VAT measurements 5 cm (R 2 5 0.93) and 10 cm (R 2 5 0.93) above L4-L5 best correlated with overall abdominal VAT mass (p , 0.05) in white-American children aged 8-18 years (N 5 54).…”

Section: 46-12mentioning

confidence: 99%

“…Lee et al 19 found that VAT measurements 5 cm (R 2 5 0.93) and 10 cm (R 2 5 0.93) above L4-L5 best correlated with overall abdominal VAT mass (p , 0.05) in white-American children aged 8-18 years (N 5 54). Our findings were similar in a comparable age group (9-16 years) but more specific in location as we assessed more slices at each intervertebral level from T12 to S1.…”

Section: 46-12mentioning

confidence: 99%

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Best single-slice location to measure visceral adipose tissue on paediatric CT scans and the relationship between anthropometric measurements, gender and VAT volume in children

O’Connor

Ryan

Foley

2015

BJR

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Objective: Visceral adipose tissue (VAT) is a significant risk factor for obesity-related metabolic diseases. This study investigates (1) the best single CT slice location for predicting total abdominal VAT volume in paediatrics and (2) the relationship between waist circumference (WC), sagittal diameter (SD), gender and VAT volume. Methods: A random sample of 130 paediatric abdomen CT scans, stratified according to age and gender, was collected. Three readers measured VAT area at each intervertebral level between T12 and S1 using ImageJ analysis (National Institute of Health, Bethesda, MD) software by thresholding 2190 to 230 HU and manually segmenting VAT. Single-slice VAT measurements were correlated with total VAT volume to identify the most representative slice. WC and SD were measured at L3-L4 and L4-L5 slices, respectively. Regression analysis was used to evaluate WC, SD and gender as VAT volume predictors. Results: Interviewer and intraviewer reliability were excellent (intraclass correlation coefficient 5 0.99). Although VAT measured at multiple slices correlated strongly with abdominal VAT, only one slice in females at L2-L3 and two slices in males at L1-L2 and L5-S1 were strongly correlated across all age groups. Linear regression analysis showed that WC was strongly correlated with VAT volume (beta 5 0.970, p , 0.001). Conclusion: Single-slice VAT measurements are highly reproducible. Measurements performed at L2-L3 in females and L1-L2 or L5-S1 in males were most representative of VAT. WC is indicative of VAT. Advances in knowledge: VAT should be measured at L2-L3 in female children and at either L1-L2 or L5-S1 in males. WC is a strong indicator of VAT in children. INTRODUCTIONThe prevalence of obesity has increased dramatically over the past 30 years and was recently described by the World Health Organization as a "global epidemic".1 In 1980, 7% of children aged 6-11 years were obese compared with nearly 18% in 2012. Similarly, the percentage of adolescents aged 12-19 years who were obese increased from 5% to almost 21% over the same period.2 The Centers for Disease Control (CDC) and Prevention classifies overweight children as those with a body mass index (BMI) over the 85th percentile and obese children as those with BMI over the 95th percentile relative to a child's age and sex. Currently, more than one-third of children and adolescents are overweight or obese, related to the sex-specific CDC BMI-for-age growth charts from 2000.

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Measurement site of visceral adipose tissue and prediction of metabolic syndrome in youth

Cited by 40 publications

References 22 publications

Ethnic and sex differences in body fat and visceral and subcutaneous adiposity in children and adolescents

Ethnic and sex differences in body fat and visceral and subcutaneous adiposity in children and adolescents

Associations between visceral fat and liver fat with insulin sensitivity and metabolic risk in obese adolescents

Best single-slice location to measure visceral adipose tissue on paediatric CT scans and the relationship between anthropometric measurements, gender and VAT volume in children

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