Evaluation of Different Adiposity Indices and Association with Metabolic Syndrome Risk in Obese Children: Is there a Winner?

Vizzuso, Sara; Brambilla, Paolo; Mameli, Chiara; Ravella, Simone; Amicis, Ramona De; Battezzati, Alberto; Zuccotti, Gian Vincenzo; Bertoli, Simona; Verduci, Elvira

doi:10.3390/ijms21114083

Cited by 28 publications

(29 citation statements)

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“…It further underlines the critical relationship between metabolic and cardiovascular alterations and waist circumference in obesity [ 24 , 25 ]. In the pediatric population of children with obesity and overweight, ABSI has been shown to have significant associations with in cardiometabolic risk markers [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Visceral Adiposity Index (VAI) in Children and Adolescents with Obesity: No Association with Daily Energy Intake but Promising Tool to Identify Metabolic Syndrome (MetS)

et al. 2021

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(1) Background. Visceral adiposity index (VAI) has been recently identified as a new cardiometabolic risk marker reflecting abdominal fat distribution and dyslipidaemia. The aim of the present paper was to evaluate the relationship between VAI, daily energy intake and metabolic syndrome (MetS) in a cohort of obese Caucasian children and adolescents, aged 8 to 15 years. (2) Methods. Consecutive Italian children and adolescents with obesity, according to World Health Organization were enrolled. Anthropometric parameters and blood pressure were measured. Fasting blood samples have been analyzed for lipids, insulin and glucose levels. MetS was diagnosed using identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) or International Diabetes Federation (IDF) criteria according to age. Homeostatic model assessment index (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), A body shape index (ABSI) and VAI were calculated. Multivariable logistic regression analyses with sex, age and each anthropometric parameter (body mass index (BMI) z-score, ABSI, waist-to-height ratio (WHR)) or VAI was performed to predict MetS. Receiver operation curve (ROC) analysis was used to define the optimal VAI cut-off to identify MetS. Multiple regression was performed to predict the BMI z-score and VAI from daily energy intake after adjusting for age and sex. (3) Results. Six hundred and thirty-seven (313 boys and 324 girls) children and adolescents with obesity with median age 11 (interquartile range 10–13) years were included in the analysis. MetS was diagnosed in 79 patients. VAI correlated with BMI, WHR, ABSI, HOMA-IR, QUICKI, systolic blood pressure, low- and high-density lipoprotein cholesterol, triglycerides and triglycerides-to-HDL ratio (p < 0.050). Optimal VAI cut-off (AUC) values to identify MetS were 1.775 (0.774), 1.685 (0.776) and 1.875 (0.797) in the whole population, boys and girls, respectively. Energy intake was positively associated with BMI z-score but no association was found with VAI. (4) Conclusion. VAI is a promising tool to identify MetS in children and adolescents with obesity and should be used in the management of abdominal obesity together with dietary assessment.

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Section: Introductionmentioning

confidence: 99%

Visceral Adiposity Index (VAI) in Children and Adolescents with Obesity: No Association with Daily Energy Intake but Promising Tool to Identify Metabolic Syndrome (MetS)

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“…Several factors are known to contribute to IR development in patients with obesity. Body composition, including distribution of body fat and accumulation of excess fat in certain depots is a crucial player in the development of IR to the extent that visceral fat accumulation has been shown to be a determinant of IR and cardiometabolic risk [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]41]. In pediatrics, pubertal changes in insulin sensitivity have been reported to contribute to IR [42].…”

Section: Discussionmentioning

confidence: 99%

“…Body mass index (BMI), waist circumference (WC) and or waist-to-height ratio (WHtR) are usually considered good markers of the dysmetabolic profile [16][17][18][19][20][21][22]. Recently, new indexes of obesity, including body shape index (ABSI), triponderal mass index (TMI), conicity index (ConI) and the visceral adiposity index (VAI) have been introduced to evaluate body-fat distribution and cardiometabolic risk [23][24][25][26][27][28][29][30][31][32].…”

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Sex-Specific Differences in the Relationship between Insulin Resistance and Adiposity Indexes in Children and Adolescents with Obesity

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New indexes of adiposity have been introduced to evaluate body-fat distribution and cardiometabolic risk. However, data on the correlation between Insulin Resistance (IR) and these new indexes are limited. We therefore evaluated the relationship between IR and adiposity indexes in children and adolescents with obesity, focusing on gender differences. We retrospectively enrolled 586 patients with obesity (10.80 ± 2.63; 306F/279M). As adiposity indexes we considered body mass index (BMI), BMI-z score, WC, waist-to-height ratio (WHtR), a body shape index (ABSI), triponderal mass index (TMI), visceral adiposity index (VAI) and conicity index (ConI). The homeostasis model assessment for insulin resistance (HOMA-IR), HOMA of percentage β-cell function (HOMA-β), quantitative insulin sensitivity check index (QUICKI), and triglyceride and glucose index (TyG-index) were measured and recorded as IR surrogates. In both sexes, WC and VAI significantly correlated with all IR measurements (p < 0.001). BMI significantly correlated (p < 0.001) with all IR parameters except for the TyG-index in females. Fat mass and TMI correlated with IR parameters only in females, BMI-z score with IR markers except for HOMA-β in males, WHtR with HOMA-β in both sexes (p < 0.05), free fat mass with HOMA-IR and QUICKI only in females (p < 0.01), ConI correlated with the TyG index in females (p = 0.01). Tryglicerides and SBP were correlated with all IR measurements (p < 0.001), in both sexes. Correlations between different sex parameters were significantly more evident in middle puberty. The relationship between IR surrogates and obesity indexes is influenced by gender in pediatrics. Sex-specific differences in obesity-related complications should be considered in preventive intervention decision-making.

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“…This is the reason for a renewed interest for anthropometry as a simple, portable and costless technique. Leone et al [20] compared the relationship between parameters of the metabolic syndrome and some anthropometric adiposity indices in obese children and adolescents, including BMI, waist circumference and the recently proposed body shape index (ABSI) [21], obtained by a mathematical combination of waist circumference, BMI and height. They found that the inclusion of ABSI in prediction models for metabolic syndrome improved the prediction compared to BMI alone in children >10 years of age and concluded that the combined ABSI-BMI can be a useful index for evaluating the relative contribution of central obesity to cardio-metabolic risk in the clinical management of obese children and adolescents.…”

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Cardiovascular Risk in Children: Focus on Pathophysiological Aspects

Genovesi

Parati

2020

IJMS

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Cardiovascular diseases are the leading cause of death, disability, and health care costs in industrialized countries. In general, cardiovascular diseases occur in adulthood, but cardiovascular damage, including stiffening of the arteries, begins very early. Already in the first decade of life, alterations that will favor the formation of atherosclerotic plaques may be present. Cardiovascular risk factors, associated with genetic predisposition, may trigger a sequence of pathophysiological changes which are associated with the progression of the atherosclerosis process. In this frame, the role of obesity has been increasingly emphasized. Different mechanisms linking obesity to cardiovascular disease have been postulated. Endothelial dysfunction and subclinical inflammation seem to be related to the worsening of cardiovascular risk factors in obese subjects and might have an essential role in the development of insulin resistance and the initiation and progression of atherosclerotic lesions. Excess weight, and in particular visceral adiposity, are associated with hypertrophy and hyperplasia of the adipocytes, increased secretion of adipokines and inflammatory cytokines and increase in serum uric acid levels. The list of obesity-related biomarkers associated with cardiovascular damage is rapidly expanding and their importance has already been described in children as well. Pathophysiological changes involved in determining early cardiovascular damage starting from childhood are discussed in this Special Issue.

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Evaluation of Different Adiposity Indices and Association with Metabolic Syndrome Risk in Obese Children: Is there a Winner?

Cited by 28 publications

References 58 publications

Visceral Adiposity Index (VAI) in Children and Adolescents with Obesity: No Association with Daily Energy Intake but Promising Tool to Identify Metabolic Syndrome (MetS)

Visceral Adiposity Index (VAI) in Children and Adolescents with Obesity: No Association with Daily Energy Intake but Promising Tool to Identify Metabolic Syndrome (MetS)

Sex-Specific Differences in the Relationship between Insulin Resistance and Adiposity Indexes in Children and Adolescents with Obesity

Cardiovascular Risk in Children: Focus on Pathophysiological Aspects

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