Truncal-to-leg fat ratio and cardiometabolic disease risk factors in US adolescents: NHANES 2003-2006

• Type of Material: Article
• Authors: Catherine E. Cioffi, Emory University; Jessica Alvarez, Emory University; Jean Welsh, Emory University; Miriam Vos, Emory University
• Language: English
• Date: 2019-07-01
• Publisher: Wiley
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 John Wiley & Sons, Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1111/ijpo.12509
• Title of Journal or Parent Work: Pediatric Obesity
• Volume: 14
• Issue: 7
• Start Page: e12509
• End Page: e12509
• Grant/Funding Information: The doctoral training of C.E.C. was supported by an institutional training grant from the National Institute of Diabetes, Digestive and Kidney Disease (NIDDK) no. T32-DK007734.; J.A.A. is supported by NIDDK grant no. K01-DK102851. M.B.V. is supported by National Institute of Child Health and Human Development (NICHD) grant no. R21-HD089056.
• Keywords: Body fat; Sex differences; adolescence; leg fat; Life Sciences & Biomedicine; Pediatrics; Blood pressure; Model assessment; Cardiovascular risk; Prevalence; Insulin resistance; Metabolic syndrome; Central adiposity; cardiometabolic disease; trunk fat; Science & Technology
• Research Categories: Health Sciences, Human Development; Health Sciences, Public Health; Health Sciences, Epidemiology; Health Sciences, Nutrition

Abstract

Background: This study aims to describe patterns of truncal versus peripheral fat deposition measured by truncal-to-leg fat ratio (TLR) in adolescents and examine associations of TLR with cardiometabolic (CMD) risk factors. Methods: Data were from 3810 adolescents (12-19 years old) in the National Health and Examination Survey (NHANES) 2003-2006. Body fat was assessed by dual-energy X-ray absorptiometry, and CMD risk factors were determined by blood samples and physical examination. Linear and logistic regressions adjusted for BMI z-score and other covariates were used to examine associations of TLR with CMD risk factors as continuous and dichotomized outcomes, respectively. Results: Adolescents who were Mexican American, who have lower income, and with obesity had the highest mean TLR (all p < 0.05). In linear regression, increasing TLR was associated positively with homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, total cholesterol, systolic blood pressure (BP), c-reactive protein, and alanine aminotransferase (ALT), and negatively with high-density lipoprotein (HDL) cholesterol in both sexes (p < 0.05). TLR was also associated with diastolic BP in boys and low-density lipoprotein cholesterol in girls (p < 0.05). A similar pattern of findings resulted from logistic regression. When further stratified by race/ethnicity, TLR was positively associated with high triglycerides, total cholesterol, and ALT for White and/or Mexican American (p < 0.05), but not Black adolescents, while associations with HOMA-IR and HDL were significant for all race/ethnicities. Conclusions: In this cohort of adolescents, TLR was associated with several risk factors independent of BMI z-score, although some findings were sex or race/ethnicity specific. Body fat distribution may be an important determinant of future CMD.