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  • Original Article
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Measuring abdominal adiposity in 6 to 7-year-old children

European Journal of Clinical Nutrition volume 63, pages 835–841 (2009)Cite this article

Abstract

Background/Objectives:

Both intra-abdominal adipose tissue (IAAT) and subcutaneous abdominal adipose tissue (SAAT) are associated with cardiovascular risk factors, even in childhood. Currently, the gold standard in assessing IAAT and SAAT is computed tomography (CT), which is not widely applicable. The aim of this study was to estimate abdominal fat using anthropometry, dual-energy X-ray absorptiometry (DEXA) and ultrasound, and compare these estimates with the amounts of IAAT and SAAT determined by CT in 6 to 7-year-old children.

Subjects/Methods:

In 31 healthy children, weight, height, circumferences, skinfolds, DEXA, abdominal ultrasound and CT were performed. Measurements were compared by simple correlations and receiver operating characteristic analyses.

Results:

Total abdominal fat on CT did not differ between boys and girls (86.5 versus 89.8 cm3, P=0.84). Boys had a higher IAAT to SAAT ratio than girls (0.56 versus 0.37, P=0.03). The sum of supra-iliac and abdominal skinfolds was most strongly correlated with SAAT on CT (r=0.93, P<0.001), and the abdominal skinfold with IAAT on CT (r=0.72, P<0.001). Diagnosis of subcutaneous abdominal and intra-abdominal adiposity can also be made using skinfolds. The associations with circumferences, body mass index and DEXA were less pronounced; however, these techniques can also be used to classify children according to SAAT and IAAT. Ultrasound can be used to diagnose subcutaneous adiposity, although it was not superior to skinfold measurements.

Conclusion:

Skinfold measurements are the best non-invasive technique in predicting subcutaneous as well as intra-abdominal fat in our population of 6 to 7-year-old children.

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References

  • Arfai K, Pitukcheewanont PD, Goran MI, Tavare CJ, Heller L, Gilsanz V (2002). Bone, muscle, and fat: sex-related differences in prepubertal children. Radiology 224, 338–344.

    Article  PubMed  Google Scholar 

  • Black D, Vora J, Hayward M, Marks R (1988). Measurement of subcutaneous fat thickness with high frequency pulsed ultrasound: comparisons with a caliper and a radiographic technique. Clin Phys Physiol Meas 9, 57–64.

    Article  CAS  PubMed  Google Scholar 

  • Blalock HM (1972). Social Statistics. McGraw-Hill: Tokyo, 407pp.

    Google Scholar 

  • Borkan GA, Gerzof SG, Robbins AH, Hults DE, Silbert CK . (1982). Assessment of abdominal fat content by computed tomography. Am J Clin Nutr 36, 172–177.

    Article  CAS  PubMed  Google Scholar 

  • Brambilla P, Bedogni G, Moreno LA, Goran MI, Gutin B, Fox KR et al. (2006). Crossvalidation of anthropometry against magnetic resonance imaging for the assessment of visceral and subcutaneous adipose tissue in children. Int J Obes (Lond) 30, 23–30.

    Article  CAS  Google Scholar 

  • Brambilla P, Manzoni P, Sironi S, Simone P, Del MA, di Natale B et al. (1994). Peripheral and abdominal adiposity in childhood obesity. Int J Obes Relat Metab Disord 18, 795–800.

    CAS  PubMed  Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000). Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 320, 1240–1243.

    Article  CAS  Google Scholar 

  • Fox K, Peters D, Armstrong N, Sharpe P, Bell M (1993). Abdominal fat deposition in 11-year-old children. Int J Obes Relat Metab Disord 17, 11–16.

    CAS  PubMed  Google Scholar 

  • Fredriks AM, van BS, Wit JM, Verloove-Vanhorick SP (2000). Body index measurements in 1996–7 compared with 1980. Arch Dis Child 82, 107–112.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Freedman DS, Serdula MK, Srinivasan SR, Berenson GS (1999). Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 69, 308–317.

    Article  CAS  PubMed  Google Scholar 

  • Garnett SP, Hogler W, Blades B, Baur LA, Peat J, Lee J et al. (2004). Relation between hormones and body composition, including bone, in prepubertal children. Am J Clin Nutr 80, 966–972.

    Article  CAS  PubMed  Google Scholar 

  • Goran MI (1999). Visceral fat in prepubertal children: influence of obesity, anthropometry, ethnicity, gender, diet, and growth. Am J Hum Biol 11, 201–207.

    Article  PubMed  Google Scholar 

  • Goran MI, Gower BA (1999). Relation between visceral fat and disease risk in children and adolescents. Am J Clin Nutr 70, 149S–156S.

    Article  CAS  PubMed  Google Scholar 

  • Goran MI, Gower BA, Treuth M, Nagy TR (1998). Prediction of intra-abdominal and subcutaneous abdominal adipose tissue in healthy pre-pubertal children. Int J Obes Relat Metab Disord 22, 549–558.

    Article  CAS  PubMed  Google Scholar 

  • Goran MI, Nagy TR, Treuth MS, Trowbridge C, Dezenberg C, McGloin A et al. (1997). Visceral fat in white and African American prepubertal children. Am J Clin Nutr 65, 1703–1708.

    Article  CAS  PubMed  Google Scholar 

  • Gower BA, Nagy TR, Trowbridge CA, Dezenberg C, Goran MI (1998). Fat distribution and insulin response in prepubertal African American and white children. Am J Clin Nutr 67, 821–827.

    Article  CAS  PubMed  Google Scholar 

  • Greenfield JR, Samaras K, Chisholm DJ, Campbell LV (2002). Regional intra-subject variability in abdominal adiposity limits usefulness of computed tomography. Obes Res 10, 260–265.

    Article  PubMed  Google Scholar 

  • Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM (2004). Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 291, 2847–2850.

    Article  CAS  PubMed  Google Scholar 

  • L'Abée C, Visser GH, Liem ET, Kok DEG, Sauer PJJ, Stolk RP . Submitted.

  • Lobstein T, Frelut ML (2003). Prevalence of overweight among children in Europe. Obes Rev 4, 195–200.

    Article  CAS  PubMed  Google Scholar 

  • Pietrobelli A, Boner AL, Tato L (2005). Adipose tissue and metabolic effects: new insight into measurements. Int J Obes (Lond) 29 (Suppl 2), S97–S100.

    Article  Google Scholar 

  • Potretzke AM, Schmitz KH, Jensen MD (2004). Preventing overestimation of pixels in computed tomography assessment of visceral fat. Obes Res 12, 1698–1701.

    Article  PubMed  Google Scholar 

  • Reilly JJ, Methven E, McDowell ZC, Hacking B, Alexander D, Stewart L et al. (2003). Health consequences of obesity. Arch Dis Child 88, 748–752.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rossner S, Bo WJ, Hiltbrandt E, Hinson W, Karstaedt N, Santago P et al. (1990). Adipose tissue determinations in cadavers—a comparison between cross-sectional planimetry and computed tomography. Int J Obes 14, 893–902.

    CAS  PubMed  Google Scholar 

  • Shen W, Wang Z, Punyanita M, Lei J, Sinav A, Kral JG et al. (2003). Adipose tissue quantification by imaging methods: a proposed classification. Obes Res 11, 5–16.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stolk RP, Wink O, Zelissen PM, Meijer R, van Gils AP, Grobbee DE (2001). Validity and reproducibility of ultrasonography for the measurement of intra-abdominal adipose tissue. Int J Obes Relat Metab Disord 25, 1346–1351.

    Article  CAS  PubMed  Google Scholar 

  • Teixeira PJ, Sardinha LB, Going SB, Lohman TG (2001). Total and regional fat and serum cardiovascular disease risk factors in lean and obese children and adolescents. Obes Res 9, 432–442.

    Article  CAS  PubMed  Google Scholar 

  • Tornaghi G, Raiteri R, Pozzato C, Rispoli A, Bramani M, Cipolat M et al. (1994). Anthropometric or ultrasonic measurements in assessment of visceral fat? A comparative study. Int J Obes Relat Metab Disord 18, 771–775.

    CAS  PubMed  Google Scholar 

  • Weiss R, Caprio S (2005). The metabolic consequences of childhood obesity. Best Pract Res Clin Endocrinol Metab 19, 405–419.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was performed within the Groningen Expert Center for Kids with Obesity, supported by Hutchison Whampoa Ltd. and by the University Medical Center Groningen. Additional support was provided by the Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands.

We would like to thank Wim GJ Tukker, Annemieke HM Stiekema, Sharon Jonkman, Piet L Jager, Mark Haagmans, Mireille A Edens and Dieuwertje EG Kok for their valuable contribution.

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Authors and Affiliations

  1. Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    E T Liem, C L'Abée & P J J Sauer

  2. Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    E T Liem, E De Lucia Rolfe, C L'Abée & R P Stolk

  3. Medical Research Council Epidemiology Unit, Cambridge, UK

    E De Lucia Rolfe & K K Ong

  4. Department of Paediatrics, University of Cambridge, Cambridge, UK

    K K Ong

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  1. E T Liem
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  2. E De Lucia Rolfe
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  3. C L'Abée
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  4. P J J Sauer
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  5. K K Ong
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  6. R P Stolk
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Corresponding author

Correspondence to E T Liem.

Additional information

Guarantor: RP Stolk.

Contributors: ETL, CA and RPS contributed to the design of the study; ETL and CA to recruitment of the participants; ETL, EDLR and CA collected data; ETL, PJJS, KKO, and RPS contributed to data analysis; and ETL, CA, PJJS, KKO and RPS participated in writing of the paper.

Supplementary Information accompanies the paper on European Journal of Clinical Nutrition website (http://www.nature.com/ejcn)

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Liem, E., De Lucia Rolfe, E., L'Abée, C. et al. Measuring abdominal adiposity in 6 to 7-year-old children. Eur J Clin Nutr 63, 835–841 (2009). https://doi.org/10.1038/ejcn.2008.57

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