Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Horm Metab Res. 2020 Jul;52(7):527-531. doi: 10.1055/a-1159-4506. Epub 2020 Jun 2.
BMIz-score (BMIz) is commonly used to assess childhood obesity. Whether change in BMIz score predicts change in visceral fat remains unclear. The objective of the work was to study changes in visceral fat, cardiovascular fitness (CVF), and metabolic health over 6 months in children with stable/decreased-BMIz vs. increased-BMIz. Ninety children with obesity, referred for lifestyle intervention were studied (mean age 11±3.1 years, 50% girls, 22% Hispanic). Assessment included abdominal and total fat by dual X-ray absorptiometry (DXA), sub-maximal VO for CVF, anthropometrics, and fasting insulin, glucose, HDL-C, triglycerides, AST and ALT at 0 and 6 months. Sixty-three children (70%) showed a stable/decrease in BMIz over 6 months. There was no significant change in total body fat between groups (-1.3±2.9% in BMIz-stable/down vs. - 0.6 ± 2.6% BMIz-up, p=0.459); however, BMIz-stable/down group showed a decrease in visceral fat compared to the BMIz-up group (-258±650 g vs.+137±528 g, p=0.009). BMIz-stable/down group also demonstrated increased CVF (+1.2 ml/kg/min, p<0.001), not seen in the BMIz-up group. Neither group had significant changes in metabolic markers. Preventing BMIz increase in obese children predicts a significant decrease in visceral fat even if total body fat is unchanged. This is often associated with increased fitness. Thus, increasing fitness level and keeping BMI stable are strategic initial goals for obese children.
体重指数 z 分数（BMIz）常用于评估儿童肥胖。BMIz 评分的变化是否预测内脏脂肪的变化尚不清楚。本研究的目的是研究肥胖儿童在 BMIz 稳定/降低与 BMIz 增加相比，6 个月内内脏脂肪、心血管健康（CVF）和代谢健康的变化。90 名肥胖儿童接受生活方式干预，（平均年龄 11±3.1 岁，50%为女孩，22%为西班牙裔）。评估包括双能 X 射线吸收法（DXA）测量的腹部和总体脂肪、CVF 的亚最大 VO、人体测量学和空腹胰岛素、血糖、高密度脂蛋白胆固醇、甘油三酯、天冬氨酸转氨酶和丙氨酸转氨酶，分别在 0 和 6 个月时检测。63 名儿童（70%）在 6 个月内 BMIz 稳定/下降。两组间总身体脂肪无显著差异（BMIz 稳定/下降组为-1.3±2.9%，BMIz 增加组为-0.6±2.6%，p=0.459）；然而，BMIz 稳定/下降组的内脏脂肪较 BMIz 增加组减少（-258±650 g vs.+137±528 g，p=0.009）。BMIz 稳定/下降组的 CVF 也增加（+1.2ml/kg/min，p<0.001），而 BMIz 增加组未见变化。两组代谢标志物均无显著变化。肥胖儿童 BMIz 增加的预防可显著减少内脏脂肪，即使总身体脂肪不变。这通常与健康水平的提高有关。因此，增加肥胖儿童的健康水平并保持 BMI 稳定是肥胖儿童的初始策略性目标。
