Associations of BMI and its fat-free and fat components with blood lipids in children: Project HeartBeat!

Abstract

Aim This study aimed to distinguish between the roles of the two components of BMI, the fat mass (FM) index and the fat-free mass (FFM) index, in BMI’s association with blood lipids in children and adolescents. Methods A total of 678 children (49.1% female, 79.9% non-black), initially aged 8, 11 and 14 years, were followed at 4-month intervals for up to 4 years (1991–1995). Total cholesterol (TC), LDL-C, HDL-C and triglycerides were determined in fasting blood samples. FFM index and FM index were calculated as FFM (kg)/height (m)2 and FM (kg)/height (m)2, respectively. Using a multilevel linear model, repeated measurements of blood lipids were regressed on concurrent measures of BMI or its components, adjusting for age, sex and race and, in a subsample, also for physical activity, energy intake and sexual maturity. Results Estimated regression coefficients for the relations of TC with BMI, FFM index and FM index were 1.539, −0.606 (p > 0.05) and 3.649, respectively. When FFM index and FM index were entered into the TC model simultaneously, regression coefficients were −0.855 and 3.743, respectively. An increase in BMI was related to an increase in TC; however, an equivalent increase in FM index was related to a greater increase in TC and, when FFM index was tested alone or with FM index, an increase in FFM index was related to a decrease in TC. Similar results were observed for LDL-C. FFM index and FM index were both inversely related to HDL-C and directly to triglycerides. Compared with FFM index, the equivalent increase in FM index showed a greater decrease in HDL-C. Conclusion Greater BMI was related to adverse levels of blood lipids in children and adolescents, which was mainly attributable to BMI’s fat component. It is important to identify weight management strategies to halt the childhood obesity epidemic and subsequently prevent heart disease in adulthood.

Temporal divergence of percent body fat and body mass index in pre‐teenage children: the LOOK longitudinal study

“…For example, its use as a surrogate of percent body fat (%BF) has been deemed inappropriate for normal‐weight children ; of low sensitivity ; and while appropriate for general screening, it was considered unsuitable for individual diagnosis . On the other hand, its involvement in pediatric studies has been supported on the basis of its ease of measurement, its significant moderate associations with %BF , the satisfactory sensitivity and specificity of BMI‐based obesity classifications when adjusted for age and sex , and its associations with cardiovascular risk factors in adolescents and children .…”

Quantity Does Not Reflect Quality- Musculoskeletal Health in Obese Peri- Pubertal Girls

“…In fact, in obese children, Weber et al [32] found that higher lean mass was associated with increased odds of abnormal BP, HDL cholesterol, and WC, even after adjustment for fat mass. Another smaller study [33] found similar associations between higher lean mass and cardiometabolic risk factors (reviewed in (15).…”

Association Between Serum Uric Acid and Triglycerides in Chinese Children and Adolescents With Short Stature

“…Overweight or obese children are prone to dyslipidaemia, and previous studies have reported that there is a positive association between BMI and TG in adults and children [35][36][37] . However, our study did not nd a relationship between BMI and TG in children and adolescents with short stature.…”