Pennington Biomedical Research Center, Baton Rouge, LA, USA.
Am J Clin Nutr. 2022 Sep 2;116(3):780-785. doi: 10.1093/ajcn/nqac129.
Race and sex differences in adolescents' body fat are demonstrated in cross-sectional cohorts, yet a longitudinal design would better identify patterns of fat distribution over time.
The aim was to examine race and sex differences in adiposity between black and white adolescents over 2 y.
A cohort of adolescents aged 10-16 y (38% black; 52% girls; 15% overweight, 34% with obesity) underwent body composition measurements at baseline (n = 309) and 2 y later (n = 236), using DXA to quantify whole-body fat mass (FM) and MRI for abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) volumes. General linear models were used to examine race and sex differences in log-transformed FM, SAT, and VAT, adjusting for age, sexual maturation, extended BMI percentile, and race-by-sex interaction. SAT and VAT models in addition controlled for baseline FM and change in FM (for change models).
Mean (95% CI) baseline FM (kg) was higher among white [18.5 (17.9, 19.2) than among black adolescents [17.4 (16.6, 18.2), P = 0.03] and girls [19.5 (18.8, 20.3) than boys [16.5 (15.8, 17.2), P < 0.0001]. Mean (95% CI) baseline SAT (L) was higher among girls [4.4 (4.2, 4.6)] than among boys [3.9 (3.7, 4.1), P < 0.0001]. Mean (95% CI) baseline VAT (L) was higher among white [0.5 (0.5, 0.6)] than among black [0.3 (0.3, 0.4)] adolescents (P < 0.0001) and boys [0.5 (0.4, 0.5)] than girls [0.4 (0.4, 0.4), P = 0.04]. Over 2 y mean (95% CI) FM change (kg) was higher among white [3.7 (2.9, 4.5)] than among black adolescents [2.3 (1.3, 3.3), P = 0.04] and girls [4.0 (3.0, 4.9)] than boys [2.0 (1.1, 3.0), P = 0.007], but SAT change (L) did not differ by race or sex. VAT change (L) was higher among white [0.1 (0.1, 0.1)] than among black adolescents [0.0 (0.0, 0.1), P = 0.003] and boys [0.1 (0.1, 0.1)] than girls [0.0 (0.0, 0.1), P = 0.034].
Sex and race differences in the deposition and accumulation of excess fat are important considerations for understanding obesity prevalence and obesity-related disease risk among adolescents.This trial was registered at clinicaltrials.gov as NCT02784509.
横断面研究表明青少年的体脂肪在种族和性别之间存在差异，但纵向设计可以更好地识别随着时间的推移脂肪分布的模式。
本研究旨在观察黑人与白人青少年在 2 年内体脂肪的肥胖差异。
研究对象为年龄在 10-16 岁的青少年（38%为黑人；52%为女孩；15%超重，34%肥胖），在基线（n=309）和 2 年后（n=236）使用 DXA 对全身脂肪量（FM）进行测量，使用 MRI 对腹部皮下（SAT）和内脏脂肪组织（VAT）体积进行测量。使用一般线性模型，调整年龄、性成熟度、扩展 BMI 百分位数和种族-性别相互作用，来检验 log 转换的 FM、SAT 和 VAT 中的种族和性别差异。SAT 和 VAT 模型还控制了基线 FM 和 FM 的变化（对于变化模型）。
白人青少年的平均（95%CI）基线 FM（kg）[18.5（17.9，19.2）]高于黑人青少年[17.4（16.6，18.2），P=0.03]，女孩[19.5（18.8，20.3）]高于男孩[16.5（15.8，17.2），P<0.0001]。女孩的平均（95%CI）基线 SAT（L）[4.4（4.2，4.6）]高于男孩[3.9（3.7，4.1），P<0.0001]。白人青少年的平均（95%CI）基线 VAT（L）[0.5（0.5，0.6）]高于黑人[0.3（0.3，0.4）]青少年（P<0.0001）和男孩[0.5（0.4，0.5）]，女孩[0.4（0.4，0.4）]（P=0.04）。在 2 年内，白人青少年的平均（95%CI）FM 变化（kg）[3.7（2.9，4.5）]高于黑人青少年[2.3（1.3，3.3），P=0.04]和女孩[4.0（3.0，4.9）]，男孩[2.0（1.1，3.0），P=0.007]，但 SAT 变化（L）没有显示出种族或性别的差异。VAT 变化（L）在白人青少年[0.1（0.1，0.1）]中高于黑人青少年[0.0（0.0，0.1），P=0.003]和男孩[0.1（0.1，0.1）]，女孩[0.0（0.0，0.1）]（P=0.034）。
在了解青少年肥胖的流行率和与肥胖相关的疾病风险时，需要考虑性别和种族在多余脂肪的沉积和积累方面的差异。本试验在 clinicaltrials.gov 上注册为 NCT02784509。
