School of Medicine and Health Sciences Poster Presentations

Title

Increased Visceral Adiposity in Obese Adolescents with Hyperglycemia Compared to Normoglycemic Obese Peers

Document Type

Poster

Keywords

visceral adiposity; glucose tolerance; adolescents; obesity

Publication Date

Spring 2017

Abstract

Background: The increase in pediatric obesity in recent decades has led to an increase in the prevalence of type 2 diabetes (T2DM) in children and adolescents. Obesity increases insulin resistance, a known risk factor for T2DM. However, not all adolescents with insulin resistance go on to develop T2DM. Other risk factors, such as family history, also play a role. Excess visceral fat as opposed to subcutaneous fat has been associated with increased metabolic abnormalities.

Objective: To investigate the relationship between visceral adiposity and abnormal glucose tolerance in obese adolescents.

Methods: This observational cohort study enrolled pubertal children (Tanner stage >1), ages 12 -19 years, BMI 95%ile, and compared those with abnormal glucose tolerance by oral glucose tolerance test (OGTT) or previous diagnosis of T2DM (n=34) (Abnl Gluc Tol), to those with normal glucose tolerance by OGTT (n=80) (Nl Gluc Tol). Visceral fat area (VFAT) was measured by dual x-ray absorptiometry (DXA). VFAT was square root transformed to achieve a normal distribution.

Results: Groups were similar in age (14.51 years ± 1.41 (Abnl Gluc Tol) vs 14.49 years ± 1.41 (Nl Gluc Tol), p= 0.94), sex (50% male vs 39% male, p = 0.27), and race (79% African American vs 80% African American, p = 0.77). VFAT was significantly higher in the Abnl Gluc Tol group compared to the Nl Gluc Tol group (90.68 ± 25.22 vs 76.54 ± 25.41, respectively, p = 0.009) by t-test. Linear regression analysis demonstrated that this difference persisted after adjusting for BMI Z-score, age, sex, and race (β =0.892 =p=0.000). Greater BMI z-score, age and male sex were also associated with increased visceral adiposity.

Conclusions: Obese adolescents with abnormal glucose tolerance have significantly greater visceral adiposity compared to normoglycemic obese peers, even after adjustment for BMIz-score, sex and age. Future longitudinal studies are needed to determine whether increased visceral adiposity predicts conversion to abnormal glucose tolerance among obese adolescents.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Poster to be presented at GW Annual Research Days 2017.

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Increased Visceral Adiposity in Obese Adolescents with Hyperglycemia Compared to Normoglycemic Obese Peers

Background: The increase in pediatric obesity in recent decades has led to an increase in the prevalence of type 2 diabetes (T2DM) in children and adolescents. Obesity increases insulin resistance, a known risk factor for T2DM. However, not all adolescents with insulin resistance go on to develop T2DM. Other risk factors, such as family history, also play a role. Excess visceral fat as opposed to subcutaneous fat has been associated with increased metabolic abnormalities.

Objective: To investigate the relationship between visceral adiposity and abnormal glucose tolerance in obese adolescents.

Methods: This observational cohort study enrolled pubertal children (Tanner stage >1), ages 12 -19 years, BMI 95%ile, and compared those with abnormal glucose tolerance by oral glucose tolerance test (OGTT) or previous diagnosis of T2DM (n=34) (Abnl Gluc Tol), to those with normal glucose tolerance by OGTT (n=80) (Nl Gluc Tol). Visceral fat area (VFAT) was measured by dual x-ray absorptiometry (DXA). VFAT was square root transformed to achieve a normal distribution.

Results: Groups were similar in age (14.51 years ± 1.41 (Abnl Gluc Tol) vs 14.49 years ± 1.41 (Nl Gluc Tol), p= 0.94), sex (50% male vs 39% male, p = 0.27), and race (79% African American vs 80% African American, p = 0.77). VFAT was significantly higher in the Abnl Gluc Tol group compared to the Nl Gluc Tol group (90.68 ± 25.22 vs 76.54 ± 25.41, respectively, p = 0.009) by t-test. Linear regression analysis demonstrated that this difference persisted after adjusting for BMI Z-score, age, sex, and race (β =0.892 =p=0.000). Greater BMI z-score, age and male sex were also associated with increased visceral adiposity.

Conclusions: Obese adolescents with abnormal glucose tolerance have significantly greater visceral adiposity compared to normoglycemic obese peers, even after adjustment for BMIz-score, sex and age. Future longitudinal studies are needed to determine whether increased visceral adiposity predicts conversion to abnormal glucose tolerance among obese adolescents.