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Body composition and metabolic factors in obese children and adolescents

Abstract

OBJECTIVE: Body composition is associated with metablic factors in adults; however, data are limited regarding obese children. This study was undertaken to assess body composition, regional fat distribution, and metabolic factors in obese 6–18-y-old children and adolescents.

DESIGN: Cross-sectional assessment.

SUBJECTS: Thirty-six obese children and adolescents, (mean±s.e.m.) age 11.8±0.5 y, BMI 34.1±1.2 kg/m2.

MEASUREMENTS: Body composition was assessed by dual energy X-ray absorptiometry and computerized tomography. Fasting insulin, glucose and leptin levels, and the homeostasis model assessment of insulin sensitivity (HOMA-IR) were assessed.

RESULTS: The girls had significantly lower glucose levels than the boys. The ethnic group differences (African American children vs white children) in fat mass, total CT fat, subcutaneous CT fat, insulin level, leptin level, and higher HOMA-IR were not significant after adjusting for age or pubertal stage. These differences in abdominal fat and subcutaneous abdominal fat were also not independent of total body fat or BMI. No ethnic group differences in visceral abdominal fat were noted. Insulin level and HOMA IR were associated with leptin level (independent of fat mass) and fat mass. Leptin level was associated with fat mass, total CT fat, and subcutaneous CT fat; however the associations between the CT fat measures and leptin were not independent of total body fat mass.

CONCLUSIONS: Neither visceral abdominal fat, subcutaneous abdominal fat, insulin levels, or insulin resistance differed by ethnic group when adjusted for age or pubertal status. This contrasts with findings in adults and non-obese children which suggest lower levels of visceral fat and higher insulin levels and insulin resistance in African American children and adolescents.

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References

  1. Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM & Johnson CL . Overweight prevalence and trends for children and adolescents. Arch Pediatric Adolescent Med 1995; 149: 1085–1091.

    Article  CAS  Google Scholar 

  2. Kuczmarski RJ, Flegal KM, Campbell SM & Johnson CL . Increasing prevalence of overweight among US adults. The National and Nutrition Examination Surveys, 1960–1991. JAMA 1994; 272: 205–239.

    Article  CAS  Google Scholar 

  3. Pinhas-Hamiel O, Dolan LM, Daniels SR, Standiford D, Khoury PR & Zeitler P . Increased incidence of non-insulin dependent diabetes mellitus among adolescents. J Pediat 1996; 128: 608–615.

    Article  CAS  Google Scholar 

  4. Anonymous. Type 2 diabetes in children and adolescents. Pediatrics 2000; 105: 671–680.

    Article  Google Scholar 

  5. Osei K, Schuster DP, Owusu S & Amoah AGV . Race and ethnicity determine serum insulin C-peptide concentrations and hepatic insulin extraction and insulin clearance: comparative studies of three populations of West African ancestry and white Americans. Metabolism 1997; 46: 53–58.

    Article  CAS  Google Scholar 

  6. Jiang X, Srinivasan SR, Radhakrishnamurthy B, Dalferes ER & Berenson GS . Racial (black–white) differences in insulin secretion and clearance in adolescents: The Bogalusa Heart Study. Pediatrics 1996; 97: 357–360.

    CAS  PubMed  Google Scholar 

  7. Arslanian S & Suprasongsin C . Differences in the in vivo insulin secretion and sensitivity of healthy black vs white adolescents. J Pediat 1996; 129: 440–443.

    Article  CAS  Google Scholar 

  8. Arslanian S . Insulin secretion and sensitivity in healthy African-American vs American white children. Clinical Pediat 1998; 37: 81–88.

    Article  CAS  Google Scholar 

  9. Gutin B, Islam S, Manos T, Cucuzzo N, Smith C & Stachura ME . Relation of percentage of body fat and maximal aerobic capacity to risk factors for atherosclerosis and diabetes in black and white seven-to eleven-year-old children. J Pediat 1994; 125: 847–852.

    Article  CAS  Google Scholar 

  10. Gower BA, Nagy TR, Trowbridge CA, Dezenberg C & Goran MI . Fat Distribution and insulin response in prepubertal African American and white children. Am J Clin Nutr 1998; 67: 821–827.

    Article  CAS  Google Scholar 

  11. Haffner SM, D'Agostino, Jr RB, Saad MF, Rewers M, Mykkanen L, Selby J, Howard G, Savage PJ, Hamman RF, Wagenknecht LE & Bergman RN . Increased insulin resistance and insulin secretion in nondiabetic African-Americans and Hispanics compared with Non-Hispanic whites: The Insulin Resistance Atherosclerosis Study. Diabetes 1996; 45: 742–748.

    Article  CAS  Google Scholar 

  12. Karter AJ, Mayer-Davis EJ, Selby J, D'Agostino, Jr RB, Haffner SM, Sholinsky P, Bergman R, Saad MF & Hamman RF . Insulin sensitivity and abdominal obesity in African-American, Hispanic, andNon-Hispanic white men and women: The Insulin Resistance Atherosclerosis Study. Diabetes 1996; 45: 1547–1555.

    Article  CAS  Google Scholar 

  13. Goran MI & Gower BA . Relation between visceral fat and disease risk in children and adolescents. Am J Clin Nutr 1999; 70 (Suppl): 149S–156S.

    Article  CAS  Google Scholar 

  14. Freedman DS, Srinivasan SR, Burke GL, Shear CL, Smoak CG, Harsha DW, Webber LS & Berenson GS . Relation of body fat distribution to hyperinsulinemia in children and adolescents: The Bogalusa Heart Study. Am J Clin Nutr 1987; 46: 403–410.

    Article  CAS  Google Scholar 

  15. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF & Turner RC . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–419.

    Article  CAS  Google Scholar 

  16. Lohman TG, Roche AF & Martorell R . Anthropometric standardization reference manual, Human Kinetics Books: Champaign, IL; 1988.

    Google Scholar 

  17. Marshall WA & Tanner JM . Variations in the pattern of pubertal changes in boys. Arch Dis Childhood 1970; 45: 13–23.

    Article  CAS  Google Scholar 

  18. Marshall WA & Tanner JM . Variations in pattern of pubertal changes in girls. Arch Dis Childhood 1969; 44: 291–303.

    Article  CAS  Google Scholar 

  19. Borkan GA, Gerzof SG, Robbins AH, Hults DE, Silbert CK & Silbert JE . Assessment of abdominal fat content by computed tomography. Am J Nutr 1982; 36: 172–177.

    Article  CAS  Google Scholar 

  20. Rosner B, Prineas RJ, Loggie J & Daniels SR . Percentiles for body mass index in US children 5 to 17 years of age. J Pediat 1998; 132: 211–222.

    Article  CAS  Google Scholar 

  21. Bonora E, Targher G, Alberiche M, Bonadonna RC, SAaffiani F, Zenere MB, Monauni T & Muggeo M . Homeostatsis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity. Diabetes Care 2000; 23: 57–63.

    Article  CAS  Google Scholar 

  22. Haffner SM, Gonzalez C, Miettinen H, Kennedy E & Stern MP . A prospective analysis of the HOMA model: The Mexico City Diabetes Study. Diabetes Care 1996; 19: 1138–1141.

    Article  CAS  Google Scholar 

  23. Boyko EJ, Leonett DL, Bergstom RW, Newell-Morris L & Fujimoto WY . Visceral adiposity, fasting plasma insulin, and lipid and lipoprotein levels in Japanese Americans. Int J Obes Relat Metab Disord 1996; 20: 801–808.

    CAS  Google Scholar 

  24. Caprio S, Hyman LD, McCarthy S, Lange R, Bronson M & Tamborlane WV . Fat distribution and cardiovascular risk factors in obese adolescent girls: importance of the intraabdominal fat depot. Am J Clin Nutr 1996; 64: 12–17.

    Article  CAS  Google Scholar 

  25. Charles MA, Eschwege E & Thibult N et al . The role of non-esterified fatty acids in the deterioration of glucose tolerance in caucasian subjects: results of the Paris Prosective Study. Diabetologia 1997; 40: 1101–1106.

    Article  CAS  Google Scholar 

  26. Tremblay AN . Nutritional determinants of the insulin resistance syndrome. Int J Obes Relat Metab Disord 1995; 19 (Suppl 1): S60–S68.

    PubMed  Google Scholar 

  27. Paolisso G, Tagliamonte MR & Riszzo MR et al . Lowering fatty acids potentiates acute insulin response in first degree relatives of people with type II diabetes. Diabetologia 1998; 41: 1127–1132.

    Article  CAS  Google Scholar 

  28. Bonora E . Relationship between regional fat distribution and insulin resistance. Int J Obes Relat Metab Disord 2000; 24 (Suppl 2): S32–S35.

    Article  CAS  Google Scholar 

  29. Lovejoy JC, de la Bretonne JA, Klemperer M & Tulley R . Abdominal fat distribution and metabolic risk ractors. effects of race. Metabolism 1996; 45: 1119–1124.

    Article  CAS  Google Scholar 

  30. Yanovski JA, Yanovski SZ, Filmer K, Hubbard VS, Avila N, Lewis B, Reynolds JC & Flood M . Differences in body composition of black and white girls. Am J Clin Nutr 1996; 64: 833–839.

    Article  CAS  Google Scholar 

  31. Osei K & Schuster DP . Ethnic differences in secretion, sensitivity, and hepatic extraction of insulin in black and white Americans. Diabetic Med 1994; 11: 755–762.

    Article  CAS  Google Scholar 

  32. Schuster DP, Kien CL & Osei K . Differential impact of obesity on glucose metabolism in black and white American adolescents. Am J Med Sci 1998; 316: 361–367.

    CAS  PubMed  Google Scholar 

  33. Campfield LA, Smith FJ & Burn P . The OB protein (leptin) pathway—a link between adipose tissue mass and central neural networks. Horm Metab Res 1996; 28: 619–632.

    Article  CAS  Google Scholar 

  34. Wong WW, Nicolson M, Stuff JE, Butte NF, Ellis KJ, Hergenroeder AC, Hill RB & Smith EO . Serum leptin concentrations in Caucasian and African-American girls. J Clin Endocrinol Metab 1998; 83: 3574–3577.

    CAS  PubMed  Google Scholar 

  35. Pelleymounter MA, Cullen MJ & Baker M . Effects of the obese gene product on body weight regulation in Ob/Ob mice. Science 1995; 269: 540–543.

    Article  CAS  Google Scholar 

  36. Hwa JJ, Ghibaudi L, Compton D, Fawzi AB & Strader CD . Intercerebroventricular injection of leptin increases thermogenesis and mobilizes fat metabolism in Ob/Ob mice. Horm Metab Res 1996; 28: 659–663.

    Article  CAS  Google Scholar 

  37. Perry HM, Morley JE, Horowitz M, Kaiser FE & Miller DK . Body composition and age in African-American and Caucasian women: relationship to plasma leptin levels. Metabolism 1997; 46: 1399–1405.

    Article  CAS  Google Scholar 

  38. Nagy TR, Gower BA, Trowbridge CA, Dezenberg C, Shewchuk RM & Goran MI . Effects of gender, ethnicity, body composition, and fat distribution on serum leptin concentrations in children. J Clin Endocrinol Metab 1997; 82: 2148–2152.

    CAS  Google Scholar 

  39. Nicklas BJ, Toth MJ, Goldberg AP & Poehlman ET . Racial differences in plasma leptin concentrations in obese postmenopausal women. J Clin Endocrinol Metab 1997; 82: 315–317.

    CAS  PubMed  Google Scholar 

  40. Jacob S, Machann J, Rett K, Brechtel K, Volk A, Renn W, Maerker E, Matthaei S, Schick F, Claussen CD & Haring HU . Association of increased intramyocellular lipid content with insulin resistance in lean nondiabetic offspring of type 2 diabetic subjects. Diabetes 1999; 48: 1113–1119.

    Article  CAS  Google Scholar 

  41. Goodpaster BH, Thaete FL & Kelley DE . Thigh adipose tissue distribution is associated with insulin resistance in obesity and in type 2 diabetes mellitus. Am J Clin Nutr 2000; 71: 885–892.

    Article  CAS  Google Scholar 

  42. Morrison JA, Barton B, Biro FM, Sprecher DL, Falkner F & Obarzanek E . Sexual maturation and obesity in 9- and 10-year-old black and white girls: The National Heart, Lung, and Blood Institute Growth and Health Study. J Pediat 1994; 124: 889–895.

    Article  CAS  Google Scholar 

  43. Kawabe H, Murata K, Shibata H, Hirose H, Tsujika M, Saito I & Saruta T . Participation in school sports clubs and related effects on cardiovascular risk factors in young males. Hypertens Res 2000; 23: 227–232.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This project was sponsored by The Children's Hospital of Philadelphia General Clinical Research Center (MO1RR00240). These results were partially presented at the 2001 Pediatric Academic Societies Annual Meeting.

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Correspondence to A M Tershakovec.

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Tershakovec, A., Kuppler, K., Zemel, B. et al. Body composition and metabolic factors in obese children and adolescents. Int J Obes 27, 19–24 (2003). https://doi.org/10.1038/sj.ijo.0802185

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