Reyes Marcela, Espinoza Aníbal, Rebollo M Jesús, Moraga Francisco, Mericq Verónica, Castillo-Durán Carlos
Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2010 Feb;138(2):152-9. Epub 2010 Mar 30.
Cardiovascular risk factors are commonly present in obese children.
To evaluate the association among radiological measurements of intra-abdominal adipose tissue, and cardiovascular risk factors, in prepuberal obese children.
We evaluated 30 obese (body mass index > p95) children aged 6 to 12 years (15 males). Anthropometry and blood pressure were measured. Subcutaneous and intra-abdominal fat thickness and fat area were measured by ultrasound (US) and computed tomography. Serum insulin, glucose and lipid profile were measured in a fasting blood sample. Homeostasis model assessment (HOMA) was calculated as an index of insulin resistance.
There was a significant correlation between US intra-abdominal fat thickness and HOMA (r = 0.47, p < 0.01), serum triglycerides (r = 0.46, p < 0.05) and with positive criteria for metabolic syndrome (r = 0.66, p < 0.01). A receiver operating curve (ROC) analysis showed that, above a cut-off of 45 mm for intra-abdominal fat thickness, US was able to identify insulin resistance with a sensibility and specificity of 79 and 69% respectively and metabolic syndrome with sensibility and specificity of 100 and 67% respectively. US and computed tomography measurements for intra-abdominal fat thickness were significantly correlated (r= 0.62, p < 0.01).
US measurements of intra-abdominal fat thickness identify obesity-associated damage in childhood. Age-specific measurements of intra-abdominal adipose tissue may improve the detection power of this approach.
心血管危险因素在肥胖儿童中普遍存在。
评估青春期前肥胖儿童腹部内脂肪组织的放射学测量值与心血管危险因素之间的关联。
我们评估了30名6至12岁的肥胖(体重指数>第95百分位数)儿童(15名男性)。测量了人体测量学指标和血压。通过超声(US)和计算机断层扫描测量皮下和腹部内脂肪厚度及脂肪面积。在空腹血样中测量血清胰岛素、葡萄糖和血脂谱。计算稳态模型评估(HOMA)作为胰岛素抵抗指数。
超声测量的腹部内脂肪厚度与HOMA(r = 0.47,p < 0.01)、血清甘油三酯(r = 0.46,p < 0.05)以及代谢综合征阳性标准(r = 0.66,p < 0.01)之间存在显著相关性。受试者工作特征曲线(ROC)分析表明,腹部内脂肪厚度超过45 mm时,超声能够分别以79%的敏感性和69%的特异性识别胰岛素抵抗,以100%的敏感性和67%的特异性识别代谢综合征。超声和计算机断层扫描测量的腹部内脂肪厚度显著相关(r = 0.62,p < 0.01)。
超声测量腹部内脂肪厚度可识别儿童期肥胖相关损害。针对特定年龄的腹部内脂肪组织测量可能会提高这种方法的检测能力。