Department of Pediatrics, Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT, 06520, USA.
Department of the Woman, the Child, of General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Int J Obes (Lond). 2019 Apr;43(4):673-682. doi: 10.1038/s41366-018-0227-6. Epub 2018 Oct 18.
The relative proportion of visceral fat (VAT) to subcutaneous fat (SAT) has been described as a major determinant of insulin resistance (IR). Our study sought to evaluate the effect of body fat distribution on glucose metabolism and intrahepatic fat content over time in a multiethnic cohort of obese adolescents.
SUBJECTS/METHODS: We examined markers of glucose metabolism by oral glucose tolerance test, and body fat distribution by abdominal MRI at baseline and after 19.2 ± 11.4 months in a cohort of 151 obese adolescents (88 girls, 63 boys; mean age 13.3 ± 3.4 years; mean BMI z-score 2.15 ± 0.70). Hepatic fat content was assessed by fast-gradient MRI in a subset of 93 subjects. We used the median value of VAT/(VAT + SAT) ratio within each gender at baseline to stratify our sample into high and low ratio groups (median value 0.0972 in girls and 0.118 in boys).
Female subjects tended to remain in their VAT/(VAT + SAT) category over time (change over follow-up P = 0.14 among girls, and P = 0.04 among boys). Baseline VAT/(VAT + SAT) strongly predicted the hepatic fat content, fasting insulin, 2-h glucose, and whole-body insulin sensitivity index at follow-up among girls, but not in boys.
The VAT/(VAT + SAT) ratio is a major determinant of impaired glucose metabolism and hepatic fat accumulation over time, and its effects are more pronounced in girls than in boys.
内脏脂肪（VAT）与皮下脂肪（SAT）的相对比例已被描述为胰岛素抵抗（IR）的主要决定因素。我们的研究旨在评估肥胖青少年的多民族队列中，随着时间的推移，体脂分布对葡萄糖代谢和肝内脂肪含量的影响。
受试者/方法：我们通过口服葡萄糖耐量试验检查了葡萄糖代谢标志物，通过腹部 MRI 检查了体脂分布，在肥胖青少年队列中，在基线和 19.2±11.4 个月后进行了检查（88 名女孩，63 名男孩；平均年龄 13.3±3.4 岁；平均 BMI z 评分 2.15±0.70）。在 93 名受试者中，通过快速梯度 MRI 评估了肝内脂肪含量。我们使用每个性别在基线时的 VAT/（VAT+SAT）比值的中位数将我们的样本分为高比值组和低比值组（女孩的中位数为 0.0972，男孩的中位数为 0.118）。
女性受试者随着时间的推移倾向于保持其 VAT/（VAT+SAT）分类（女孩的随访变化超过 0.14，男孩的随访变化超过 0.04）。基线 VAT/（VAT+SAT）强烈预测了女孩在随访时的肝内脂肪含量、空腹胰岛素、2 小时血糖和全身胰岛素敏感性指数，但在男孩中则没有。
VAT/（VAT+SAT）比值是随着时间推移葡萄糖代谢和肝内脂肪堆积受损的主要决定因素，其影响在女孩中比男孩中更为明显。
