Pediatrics Research Group, Girona Institute for Biomedical Research, Girona, Spain.
Pediatrics, Dr JosepTrueta Hospital, Girona, Spain.
Int J Obes (Lond). 2018 Apr;42(4):641-647. doi: 10.1038/ijo.2017.236. Epub 2017 Sep 25.
BACKGROUND/OBJECTIVES: It is well known that increased abdominal fat is associated with cardiovascular (CV) risk. Perirenal fat has been recently associated with CV risk in adults. However, studies with children are lacking. We investigated the relationship of perirenal fat and other abdominal fat depots (including preperitoneal, intra-abdominal and subcutaneous fat) with carotid intima-media thickness (cIMT-a surrogate marker of CV risk) in prepubertal children, so as to identify novel markers that can be easily assessed and used in the early prevention of cardiovascular disease.
SUBJECTS/METHODS: Subjects were 702 asymptomatic prepubertal Caucasian children (418 lean, 142 overweight and 142 obese) who were recruited in a primary care setting. Ultrasound measurements (perirenal, preperitoneal, intra-abdominal and subcutaneous fat and cIMT), clinical (body mass index (BMI) and systolic blood pressure) and metabolic parameters (insulin resistance (HOMA-IR), high molecular weight (HMW) adiponectin and serum lipids) were assessed.
Perirenal fat was associated with diverse metabolic and CV risk factors in all the studied subjects. However, in overweight and obese children, perirenal fat was mostly associated with cIMT (P<0.001) and was the only fat depot that showed independent associations with cIMT in multivariate analyses (overweight chidren: β=0.250, P=0.003, r=12.8%; obese children: β=0.254, P=0.002, r=15.5%) after adjusting for BMI, gender, age and metabolic parameters. Perirenal fat was also the only fat depot that showed independent associations with HMW-adiponectin in obese children (β=-0.263, P=0.006, r=22.8%).
Perirenal fat is the main abdominal fat depot associated with cIMT, especially in overweight and obese children, and may thus represent a helpful parameter for assessing CV risk in the pediatric population.
背景/目的：众所周知，腹部脂肪增加与心血管（CV）风险相关。最近，研究表明肾周脂肪与成年人的 CV 风险相关。然而，针对儿童的研究还很缺乏。我们调查了肾周脂肪和其他腹部脂肪（包括腹膜前、腹腔内和皮下脂肪）与颈动脉内膜中层厚度（cIMT-心血管风险的替代标志物）在青春期前儿童中的关系，以确定可以容易评估和用于心血管疾病早期预防的新型标志物。
受试者/方法：受试者为 702 名无症状的青春期前白种人儿童（418 名瘦，142 名超重和 142 名肥胖），他们是在初级保健环境中招募的。进行了超声测量（肾周、腹膜前、腹腔内和皮下脂肪以及 cIMT）、临床（体重指数（BMI）和收缩压）和代谢参数（胰岛素抵抗（HOMA-IR）、高分子量（HMW）脂联素和血清脂质）的评估。
肾周脂肪与所有研究对象的多种代谢和 CV 危险因素相关。然而，在超重和肥胖儿童中，肾周脂肪主要与 cIMT 相关（P<0.001），并且是在多元分析中与 cIMT 具有独立关联的唯一脂肪沉积（超重儿童：β=0.250，P=0.003，r=12.8%；肥胖儿童：β=0.254，P=0.002，r=15.5%），调整 BMI、性别、年龄和代谢参数后。肾周脂肪也是与肥胖儿童的 HMW 脂联素具有独立关联的唯一脂肪沉积（β=-0.263，P=0.006，r=22.8%）。
肾周脂肪是与 cIMT 相关的主要腹部脂肪沉积，特别是在超重和肥胖儿童中，因此可能是评估儿科人群 CV 风险的有用参数。
