Cardiometabolic Risk Factors and Fat Distribution in Children and Adolescents

Objectives To determine if cardiometabolic risk factors have differential associations with the proportion of fat distributed in the trunk, leg, and arm, in White and African American children and adolescents. Study design The sample included 391 White and African American 5- to 18 year-olds. Total and regional (trunk, leg, and arm) fat were measured by dual energy X-ray absorptiometry. Resting blood pressure and fasting triglycerides, high density lipoprotein cholesterol (HDL-C), glucose, insulin, and C-reactive protein were measured in a clinical setting. Insulin resistance was determined with the homeostatic model of insulin resistance. Multivariable linear and logistic regression models were used to examine associations between each cardiometabolic risk factor and proportion of fat (trunk, leg, or arm fat divided by whole body fat), with whole body fat, age, sex, race, sexual maturity status, and self-reported physical activity as covariates. Results Higher odds of low HDL-C, high triglycerides, insulin resistance, and high C-reactive protein were associated with% trunk fat. Lower odds of low HDL-C, high triglycerides, and insulin resistance were associated with% leg fat. No cardiometabolic risk factor was associated with % arm fat. Conclusions Cardiometabolic risk factors in children and adolescents were attenuated when a larger proportion of fat was distributed in the leg. The clinical assessment of children's fat distribution may be useful in determining cardiometabolic risk.