Measuring abdominal adiposity in 6 to 7-year-old children

Background/Objectives: Both intra-abdominal adipose tissue (IAAT) and subcutaneous abdominal adipose tissue (SAAT) are associated with cardiovascular risk factors, even in childhood. Currently, the gold standard in assessing IAAT and SAAT is computed tomography (CT), which is not widely applicable. The aim of this study was to estimate abdominal fat using anthropometry, dual-energy X-ray absorptiometry (DEXA) and ultrasound, and compare these estimates with the amounts of IAAT and SAAT determined by CT in 6 to 7-year-old children. Subjects/Methods: In 31 healthy children, weight, height, circumferences, skinfolds, DEXA, abdominal ultrasound and CT were performed. Measurements were compared by simple correlations and receiver operating characteristic analyses. Results: Total abdominal fat on CT did not differ between boys and girls (86.5 versus 89.8 cm(3), P = 0.84). Boys had a higher IAAT to SAAT ratio than girls (0.56 versus 0.37, P = 0.03). The sum of supra-iliac and abdominal skinfolds was most strongly correlated with SAAT on CT (r = 0.93, P < 0.001), and the abdominal skinfold with IAAT on CT (r = 0.72, P < 0.001). Diagnosis of subcutaneous abdominal and intra-abdominal adiposity can also be made using skinfolds. The associations with circumferences, body mass index and DEXA were less pronounced; however, these techniques can also be used to classify children according to SAAT and IAAT. Ultrasound can be used to diagnose subcutaneous adiposity, although it was not superior to skinfold measurements. Conclusion: Skinfold measurements are the best non-invasive technique in predicting subcutaneous as well as intra-abdominal fat in our population of 6 to 7-year-old children. European Journal of Clinical Nutrition (2009) 63, 835-841; doi:10.1038/ejcn.2008.57; published online 7 January 2009