Premium
Truncal‐to‐leg fat ratio and cardiometabolic disease risk factors in US adolescents: NHANES 2003‐2006
Author(s) -
Cioffi Catherine E.,
Alvarez Jessica A.,
Welsh Jean A.,
Vos Miriam B.
Publication year - 2019
Publication title -
pediatric obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.226
H-Index - 69
eISSN - 2047-6310
pISSN - 2047-6302
DOI - 10.1111/ijpo.12509
Subject(s) - medicine , national health and nutrition examination survey , insulin resistance , obesity , blood pressure , cohort , logistic regression , risk factor , endocrinology , metabolic syndrome , demography , population , environmental health , sociology
Summary 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.