HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Online-Only Appendix All Versions of this Article: db07-0932v1 db07-0932v2 57/2/367    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Taksali, S. E. Articles by Weiss, R. Search for Related Content PubMed PubMed Citation Articles by Taksali, S. E. Articles by Weiss, R. Social Bookmarking                What's this?

High Visceral and Low Abdominal Subcutaneous Fat Stores in the Obese Adolescent

A Determinant of an Adverse Metabolic Phenotype

¹ Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
² Yale Clinical Research Center, Yale University School of Medicine, New Haven, Connecticut
³ Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, Connecticut
⁴ Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
⁵ Department of Pediatrics, Hadassah-Hebrew University Medical School, Jerusalem, Israel

Address correspondence and reprint requests to Sonia Caprio, MD, Department of Pediatrics, Yale University School of Medicine, 333 Cedar Street, P.O. Box 208064, New Haven, CT 06520. E-mail: sonia.caprio{at}yale.edu

Abbreviations: ¹H-MRS, proton magnetic resonance spectroscopy; CRP, C-reactive protein; FFA, free fatty acid; HFF, hepatic fat fraction; IL, interleukin; IMCL, intramyocellular lipid; MRI, magnetic resonance imaging

OBJECTIVE— To explore whether an imbalance between the visceral and subcutaneous fat depots and a corresponding dysregulation of the adipokine milieu is associated with excessive accumulation of fat in the liver and muscle and ultimately with insulin resistance and the metabolic syndrome.

RESEARCH DESIGN AND METHODS— We stratified our multi-ethnic cohort of 118 obese adolescents into tertiles based on the proportion of abdominal fat in the visceral depot. Abdominal and liver fat were measured by magnetic resonance imaging and muscle lipid (intramyocellular lipid) by proton magnetic resonance spectroscopy.

RESULTS— There were no differences in age, BMI Z score, or fat-free mass across tertiles. However, as the proportion of visceral fat increased across tertiles, BMI and percentage of fat and subcutaneous fat decreased, while hepatic fat increased. In addition, there was an increase in 2-h glucose, insulin, c-peptide, triglyceride levels, and insulin resistance. Notably, both leptin and total adiponectin were significantly lower in tertile 3 than 1, while C-reactive protein and interleukin-6 were not different across tertiles. There was a significant increase in the odds ratio for the metabolic syndrome, with subjects in tertile 3 5.2 times more likely to have the metabolic syndrome than those in tertile 1.

CONCLUSIONS— Obese adolescents with a high proportion of visceral fat and relatively low abdominal subcutaneous fat have a phenotype reminiscent of partial lipodystrophy. These adolescents are not necessarily the most severely obese, yet they suffer from severe metabolic complications and are at a high risk of having the metabolic syndrome.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?