Ethnicity Strongly Influences Body Fat Distribution Determining Serum Adipokine Profile and Metabolic Derangement in Childhood Obesity

Abstract

Background: Body fat content and distribution in childhood is influenced by sex and puberty, but interethnic differences in the percentage and distribution of body fat also exist. The abdominal visceral/subcutaneous fat ratio has been the main feature of body fat distribution found to associate with the serum adipokine profile and metabolic derangement in adulthood obesity. This has also been assumed for childhood obesity despite the known singularities of this disease in the pediatric age in comparison to adults. Objective: We aimed to investigate the effect of ethnicity, together with sex and pubertal status, on body fat content and distribution, serum adipokine profile, metabolic impairment and liver steatosis in children and adolescents with obesity. Patients and Methods: One hundred and fifty children with obesity (50% Caucasians/50% Latinos; 50% males/50% females) were studied. Body fat content and distribution were studied by whole body DXA-scan and abdominal magnetic resonance, and their relationships with liver steatosis (as determined by ultrasonography), glycemia, insulinemia, lipid metabolism, uric acid, total and HMW-adiponectin, leptin, leptin-receptor, and sex steroid levels were explored. Results: Latino patients had more severe truncal obesity (higher trunk/lower limb fat ratio, odds ratio 10.00; p < 0.05) and higher prevalence of liver steatosis than Caucasians regardless of sex or pubertal status, but there were no difference in the visceral/subcutaneous abdominal fat ratio, except for pubertal females. A higher trunk/lower limb fat ratio, but not the visceral/subcutaneous abdominal fat ratio, was associated with adipokine profile impairment (higher free leptin index and lower adiponectin levels), insulin resistance and dyslipidemia, and was further enhanced when liver steatosis was present ( p < 0.05). A higher abdominal visceral/subcutaneous fat ratio was observed in prepubertal children ( p < 0.01), except for Latino females, whereas predominant subcutaneous fat deposition was observed in adolescents. Conclusion: Ethnicity is one of the main determinants of increased trunk body fat accumulation in Latino children with obesity, which is best estimated by the trunk/lower limb fat ratio and related to the development of metabolic derangement and liver steatosis.

Conservative Treatment for Childhood and Adolescent Obesity: Real World Follow-Up Profiling and Clinical Evolution in 1300 Patients

“…More importantly, our data indicate that during childhood, being classified as metabolically healthily obese is dynamic and mainly dependent on the evolution of the patient's BMI throughout childhood and adolescence. Additionally, the lower prevalence of metabolically healthy individuals in the Latino patients in our cohort, previously already shown to present higher insulin resistance, triglyceride levels and prevalence of liver steatosis when using our populational standards [12,41], should lead us to consider whether homogeneous standards are valid for every patient, or whether ethnic specific standards for these parameters should be advised.…”

Impact of short-term change of adiposity on risk of high blood pressure in children: Results from a follow-up study in China

“…(3) For children with GOB or AOB at baseline, we also categorized their adiposity parameter (BMI or WHtR) change during the follow-up as ten equal groups (Group 1: �P 10 , Group 2: P 10~P20 , Group 3: P 20~P30 , Group 4: P 30~P40 , Group 5: P 40~P50 , Group 6: P 50~P60 , Group 7: P 60~P70 , Group 8: P 70~P80 , Group 9: P 80~P90 and Group 10: >P 90 ) and compared the risk of HBP in different groups with multivariate logistic models. (4) We used an international definition of child obesity developed by the International Obesity Task Force (IOTF) and the World Health Organization (WHO) standard of obesity for 5-19 years old children to test the associations [18][19][20][21][22][23][24]. (5) We also used BMI standard deviation score (BMI SDS) instead of BMI to compare the risk of HBP in different groups with multivariate logistic models.…”

Genetic risk score prediction of leg fat and insulin sensitivity differs by race/ethnicity in early pubertal children

“…Similar findings have been reported previously in Latino and HA children. A study in 150 Latino and Caucasian children found that the trunk/lower limb fat ratio was higher in Latinos, and this ratio was positively associated with both homeostatic model assessment (HOMA) and liver steatosis 29 . Hetherington et al 30 reported that in HA girls with a wide range of body fat levels, both gynoid and leg fat (calculated as a percentage of total body fat) were negatively correlated with HOMA‐insulin resistance (IR).…”

“…In a longitudinal study conducted in HA children and young adults, increases in hepatic fat over a 2‐year period were associated with higher fasting glucose, higher HbA1c values and a 10.5% decrease in beta‐cell function 45 . Compared to Caucasians, individuals of Mexican or Latino ancestry are prone to increased deposition of liver fat and have a higher prevalence of non‐alcoholic fatty liver disease 9,29 . Greater liver fat may be due in part to a polymorphism at the PNPLA3 gene 10 .…”