Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical characteristics of obese boys and girls in a high school: focused on abdominal fat indices, fatty liver and carotid intima-media thickness

  • Oh, Jung-Eun (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Jung, Ji-Young (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Kim, Hae-Soon (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Hong, Young-Mi (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Yoo, Jung-Hyun (Department of Radiology, Ewha Womans University School of Medicine) ;
  • Song, Young-Whan (Department of Pediatrics, Inje University College of Medicine) ;
  • Jung, Jo-Won (Department of Pediatrics, Ajou University School of Medicine) ;
  • Kim, Nam-Su (Department of Pediatrics, Han Yang University College of Medicine) ;
  • Noh, Chung-Il (Department of Pediatrics, Seoul National University College of Medicine)
  • Received : 2010.10.16
  • Accepted : 2011.05.13
  • Published : 2011.07.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Our study aimed to evaluated sex differences in clinical features of obese high school students. Methods: One hundred three obese high school students (body mass index [BMI]${\geq}$85th percentile) and 51 control students (BMI<85th percentile) were enrolled in this study. Anthropometric measurements were performed. Fasting serum glucose, insulin, aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and high-sensitive C-reactive protein were measured. Abdominal fat thickness, degree of fatty liver, and carotid intima-media thickness were measured by ultrasound. Results: In control and obese groups, waist circumference was significantly longer in boys but body fat mass was Significantly higher in girls. In the control group, total cholesterol and LDL-C were higher in girls. In the obese group, however, aspartate aminotransferase, alanine aminotransferase and triglyceride were higher and HDL-C was lower in boys. Preperitoneal fat thickness was significantly higher in obese girls. In obese group, the degree of fatty liver was significantly higher in boys. Carotid intima-media thickness was not significantly different between boys and girls. Conclusion: Obese adolescents had distinguishable sex differences in body measurements, metabolic abnormalities, abdominal fat thickness and fatty liver. We can infer that these characteristics may extend into adult obesity.

Keywords

References

  1. Moller DE, Flier JS. Insulin resistance-- mechanisms, syndromes, and implications. N Engl J Med 1991;325:938-48. https://doi.org/10.1056/NEJM199109263251307
  2. Beauloye V, Zech F, Tran HT, Clapuyt P, Maes M, Brichard SM. Determinants of early atherosclerosis in obese children and adolescents. J Clin Endocrinol Metab 2007;92:3025-32. https://doi.org/10.1210/jc.2007-0619
  3. Tershakovec AM, Kuppler KM, Zemel BS, Katz L, Weinzimer S, Harty MP, et al. Body composition and metabolic factors in obese children and adolescents. Int J Obes Relat Metab Disord 2003;27:19-24. https://doi.org/10.1038/sj.ijo.0802185
  4. Moran A, Jacobs DR Jr, Steinberger J, Hong CP, Prineas R, Luepker R, et al. Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes 1999;48:2039-44. https://doi.org/10.2337/diabetes.48.10.2039
  5. Travers SH, Jeffers BW, Bloch CA, Hill JO, Eckel RH. Gender and Tanner stage differences in body composition and insulin sensitivity in early pubertal children. J Clin Endocrinol Metab 1995;80:172-8. https://doi.org/10.1210/jc.80.1.172
  6. Rumack CM, Wilson SR, Charbonean JW. Diagnostic ultrasound. 3rd ed. St. Louis: Elsevier Mosby, 2005:95-7.
  7. Geer EB, Shen W. Gender differences in insulin resistance, body composition, and energy balance. Gend Med 2009;6 Suppl 1:60-75. https://doi.org/10.1016/j.genm.2009.02.002
  8. Garaulet M, Pérex-Llamas F, Fuente T, Zamora S, Tebar FJ. Anthropometric, computed tomography and fat cell data in an obese population: relationship with insulin, leptin, tumor necrosis factor-alpha, sex hormonebinding globulin and sex hormones. Eur J Endocrinol 2000;143:657-66. https://doi.org/10.1530/eje.0.1430657
  9. Seidell JC, Cigolini M, Charzewska J, Ellsinger BM, Deslypere JP, Cruz A. Fat distribution in European men: a comparison of anthropometric measurements in relation to cardiovascular risk factors. Int J Obes Relat Metab Disord 1992;16:17-22.
  10. Pouliot MC, Després JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994;73:460-8. https://doi.org/10.1016/0002-9149(94)90676-9
  11. Janssen I, Heymsfield SB, Allison DB, Kotler DP, Ross R. Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat. Am J Clin Nutr 2002;75:683-8.
  12. Björntorp P. "Portal" adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arteriosclerosis 1990;10:493-6. https://doi.org/10.1161/01.ATV.10.4.493
  13. Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 2000;21:697-738. https://doi.org/10.1210/er.21.6.697
  14. Ritchie SA, Connell JM. The link between abdominal obesity, metabolic syndrome and cardiovascular disease. Nutr Metab Cardiovasc Dis 2007;17:319-26. https://doi.org/10.1016/j.numecd.2006.07.005
  15. Huang TT, Johnson MS, Figueroa-Colon R, Dwyer JH, Goran MI. Growth of visceral fat, subcutaneous abdominal fat, and total body fat in children. Obes Res 2001;9:283-9. https://doi.org/10.1038/oby.2001.35
  16. Machann J, Thamer C, Schnoedt B, Stefan N, Stumvoll M, Haring HU, et al. Age and gender related effects on adipose tissue compartments of subjects with increased risk for type 2 diabetes: a whole body MRI/MRS study. MAGMA 2005;18:128-37. https://doi.org/10.1007/s10334-005-0104-x
  17. Leung KC, Johannsson G, Leong GM, Ho KK. Estrogen regulation of growth hormone action. Endocr Rev 2004;25:693-721. https://doi.org/10.1210/er.2003-0035
  18. Wanless IR, Lentz JS. Fatty liver hepatitis (steatohepatitis) and obesity: an autopsy study with analysis of risk factors. Hepatology 1990;12:1106-10. https://doi.org/10.1002/hep.1840120505
  19. Jang HO, Lee CG, Kang YJ. The prevalent rates of abnormal serum aminotransferase levels and total cholesterol levels among adolescents with obesity. J Korean Pediatr Soc 2002;45:1484-90.
  20. Wiegand S, Keller KM, Röbl M, L'Allemand D, Reinehr T, Widhalm K, et al. Obese boys at increased risk for nonalcoholic liver disease: evaluation of 16,390 overweight or obese children and adolescents. Int J Obes (Lond) 2010;34:1468-74. https://doi.org/10.1038/ijo.2010.106
  21. Clark JM, Brancati FL, Diehl AM. Nonalcoholic fatty liver disease. Gastroenterology 2002;122:1649-57. https://doi.org/10.1053/gast.2002.33573
  22. Schwimmer JB, McGreal N, Deutsch R, Finegold MJ, Lavine JE. Influence of gender, race, and ethnicity on suspected fatty liver in obese adolescents. Pediatrics 2005;115:e561-5. https://doi.org/10.1542/peds.2004-1832
  23. Shimizu I, Inoue H, Yano M, Shinomiya H, Wada S, Tsuji Y, et al. Estrogen receptor levels and lipid peroxidation in hepatocellular carcinoma with hepatitis C virus infection. Liver 2001;21:342-9. https://doi.org/10.1034/j.1600-0676.2001.210507.x
  24. Anezaki Y, Ohshima S, Ishii H, Kinoshita N, Dohmen T, Kataoka E, et al. Sex difference in the liver of hepatocyte-specific Pten-deficient mice: a model of nonalcoholic steatohepatitis. Hepatol Res 2009;39:609-18. https://doi.org/10.1111/j.1872-034X.2009.00494.x
  25. Strauss RS, Barlow SE, Dietz WH. Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents. J Pediatr 2000; 136:727-33.
  26. Lavine JE, Schwimmer JB. NAFLD/NASH in children. In: Farrell G, George J, Hall P, McCollough AJ, editors. Fatty liver disease: NASH and related disorders. Oxford: Blackwell Publishing, 2004:229-40.
  27. Bacon BR, Farahvash MJ, Janney CG, Neuschwander-Tetri BA. Nonalcoholic steatohepatitis: an expanded clinical entity. Gastroenterology 1994;107:1103-9.
  28. Gnasso A, Irace C, Mattioli PL, Pujia A. Carotid intima-media thickness and coronary heart disease risk factors. Atherosclerosis 1996;119:7-15. https://doi.org/10.1016/0021-9150(95)05625-4
  29. Raitakari OT, Juonala M, Kähönen M, Taittonen L, Laitinen T, Mäki- Torkko N, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA 2003;290:2277-83. https://doi.org/10.1001/jama.290.17.2277
  30. Caserta CA, Pendino GM, Amante A, Vacalebre C, Fiorillo MT, Surace P, et al. Cardiovascular risk factors, nonalcoholic fatty liver disease, and carotid artery intima-media thickness in an adolescent population in southern Italy. Am J Epidemiol 2010;171:1195-202. https://doi.org/10.1093/aje/kwq073
  31. Lee YJ, Nam CM, Kim HC, Hur NW, Suh I. The association between obesity indices in adolescence and carotid intima-media thickness in young adults: Kangwha Study. J Prev Med Public Health 2008;41:107-14. https://doi.org/10.3961/jpmph.2008.41.2.107
  32. Kim SK, Kim HJ, Hur KY, Choi SH, Ahn CW, Lim SK, et al. Visceral fat thickness measured by ultrasonography can estimate not only visceral obesity but also risks of cardiovascular and metabolic disease. Am J Clin Nutr 2004;79:593-9.