Specific Fat Depots and Cardiometabolic Risk and Insulin Resistance in Children With Obesity

BACKGROUND: In children, the impact of specific fat depots, particularly ectopic depots, on cardiometabolic health has been scarcely investigated. Therefore, we aimed to investigate the associations of various specific fat depots with cardiometabolic risk and insulin resistance in children with overweight/obesity. METHODS: One hundred fourteen children with overweight/obesity (54.4% girls, 10.6 ± 1.1 years) were included. Fat depots including abdominal visceral (VAT), subcutaneous (ASAT), and intermuscular (IMAAT) adipose tissue, lumbar spine bone marrow, hepatic and pancreatic fat were measured using magnetic resonance imaging. Cardiometabolic risk factors (blood pressure, triglycerides, high-density lipoprotein cholesterol, glucose and insulin) were assessed, and age- and sex-reference based cardiometabolic risk score and insulin resistance were calculated. RESULTS: In univariate analysis, VAT, ASAT, IMAAT and hepatic fat were significantly associated with cardiometabolic risk score (β = 0.308-0.526, p ≤ 0.001) and insulin resistance (β = 0.227-0.412, p < 0.05). However, after adjusting for other fat variables, VAT was the only fat depot independently associated with cardiometabolic risk score (β = 0.450, p < 0.001), while ASAT was the only fat depot independently associated with insulin resistance (β = 0.393, p < 0.001). Hepatic fat did not show an independent association with either cardiometabolic risk score or insulin resistance (p ≥ 0.256). CONCLUSION: In this population, VAT and ASAT appear to be independent predictors of cardiometabolic risk and insulin resistance, respectively.