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Ultrasound measurement of pediatric visceral fat thickness: correlations with metabolic and liver profiles

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주제분류소아과학

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Purpose: Abdominal obesity is a fundamental factor underlying the development of metabolic syndrome. Because of radiation exposure and cost, computed tomography or dual-energy X-ray absorptiometry to evaluate abdominal adiposity are not appropriate in children. Authors evaluated whether ultrasound results could be an indicator of insulin resistance and nonalcoholic fatty liver disease (NAFLD). Methods: We enrolled 73 subjects (aged 6–16 years) who were evaluated abdominal adiposity by ultrasound. Subcutaneous fat thickness was defined as the measurement from the skin-fat interface to the linea alba, and visceral fat thickness (VFT) was defined as the thickness from the linea alba to the aorta. Anthropometric and biochemical metabolic parameters were also collected and compared. The subjects who met 2 criteria, radiologic confirmed fatty liver and alanine aminotransferase >40, were diagnosed with NAFLD. Results: There was a strong positive correlation between VFT and obesity. VFT was highly correlated with the homeostasis model assessment for insulin resistance score (r=0.403, P<0.001). The area under the curve for VFT as a predictor of NAFLD was 0.875 (95% confidence interval [CI], 0.787–0.964). VFT of 34.3 mm was found to be the discriminating cutoff for NAFLD (sensitivity, 84.6%; specificity, 71.2%, respectively). Conclusion: Ultrasound could be useful in measuring VFT and assessing abdominal adiposity in children. Moreover, increased VFT might be an appropriate prognostic factor for insulin resistance and NAFLD.

Abstract

Purpose: Abdominal obesity is a fundamental factor underlying the development of metabolic syndrome. Because of radiation exposure and cost, computed tomography or dual-energy X-ray absorptiometry to evaluate abdominal adiposity are not appropriate in children. Authors evaluated whether ultrasound results could be an indicator of insulin resistance and nonalcoholic fatty liver disease (NAFLD). Methods: We enrolled 73 subjects (aged 6–16 years) who were evaluated abdominal adiposity by ultrasound. Subcutaneous fat thickness was defined as the measurement from the skin-fat interface to the linea alba, and visceral fat thickness (VFT) was defined as the thickness from the linea alba to the aorta. Anthropometric and biochemical metabolic parameters were also collected and compared. The subjects who met 2 criteria, radiologic confirmed fatty liver and alanine aminotransferase >40, were diagnosed with NAFLD. Results: There was a strong positive correlation between VFT and obesity. VFT was highly correlated with the homeostasis model assessment for insulin resistance score (r=0.403, P<0.001). The area under the curve for VFT as a predictor of NAFLD was 0.875 (95% confidence interval [CI], 0.787–0.964). VFT of 34.3 mm was found to be the discriminating cutoff for NAFLD (sensitivity, 84.6%; specificity, 71.2%, respectively). Conclusion: Ultrasound could be useful in measuring VFT and assessing abdominal adiposity in children. Moreover, increased VFT might be an appropriate prognostic factor for insulin resistance and NAFLD.

참고문헌 (32)

  1. "Obesity: preventing and managing the global epidemic. Report of a WHO consultation", World Health Organ Tech Rep Ser, 894(i-xii), pp.1~253 (2000)
  2. Kim Y, "The Korea National Health and Nutrition Examination Survey (KNHANES): current status and challenges. Version 2", Epidemiol Health, 36, pp.e2014002~ (2014)
  3. Hedley AA, "Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002", JAMA, 291, pp.2847~2850 (2004)
  4. 박영신, "23년간 서울 지역 초·중·고등학생의 비만 추이", Korean Journal of Pediatrics, 47(3), pp.247~257 (2004), 대한소아과학회
  5. Lakka HM, "Abdominal obesity is associated with increased risk of acute coronary events in men", Eur Heart J, 23, pp.706~713 (2002)
  6. "Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults", WMJ, 97, pp.20~21 (1998)
  7. Hojgaard B, "Obesity related health care costs assessed from BMI or waist circumference: secondary publication", Ugeskr Laeger, 171, pp.3068~3071 (2009)
  8. Rössner S, "Adipose tissue determinations in cadavers--a comparison between cross-sectional planimetry and computed tomography", Int J Obes, 14, pp.893~902 (1990)
  9. Micklesfield LK, "Dual-energy X-ray performs as well as clinical computed tomography for the measurement of visceral fat", Obesity (Silver Spring), 20, pp.1109~1114 (2012)
  10. Armellini F, "Total and intra-abdominal fat measurements by ultrasound and computerized tomography", Int J Obes Relat Metab Disord, 17, pp.209~214 (1993)
  11. Meriño-Ibarra E, "Ultrasonography for the evaluation of visceral fat and the metabolic syndrome", Metabolism, 54, pp.1230~1235 (2005)
  12. Cucchi E, "Is echography an adequate method for assessing the thickness of intra-abdominal fat? A comparison with computed tomography", Radiol Med, 94, pp.329~334 (1997)
  13. Radikova Z, "Assessment of insulin sensitivity", resistance in epidemiological studies, 2003, pp.37, 189~194
  14. 문진수, "2007 한국 소아 청소년 성장도표 : 개발 과정과 전망", Korean Journal of Pediatrics, 51(1), pp.1~25 (2008), 대한소아과학회
  15. Barlow SE, "Obesity evaluation and treatment:Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services", Pediatrics, 102, pp.E29~ (1998)
  16. Tanda R, "The impact of the 2007 expert committee recommendations on childhood obesity preventive care in primary care settings in the United States", J Pediatr Health Care, 28, pp.241~250 (2014)
  17. Prentice AM, "Beyond body mass index", Obes Rev, 2, pp.141~147 (2001)
  18. Ribeiro-Filho FF, "Methods of estimation of visceral fat: advantages of ultrasonography", Obes Res, 11, pp.1488~1494 (2003)
  19. Daniels SR, "Obesity in the pediatric patient: cardiovascular complications", Prog Pediatr Cardiol, 12, pp.161~167 (2001)
  20. Morrison JA, "Overweight, fat patterning, and cardiovascular disease risk factors in black and white girls: The National Heart, Lung, and Blood Institute Growth and Health Study", J Pediatr, 135, pp.458~464 (1999)
  21. Miller J, "Childhood obesity", J Clin Endocrinol Metab, 89, pp.4211~4218 (2004)
  22. Daniels SR, "Association of body fat distribution and cardiovascular risk factors in children and adolescents", Circulation, 99, pp.541~545 (1999)
  23. Michelson PH, "Obesity, inflammation, and asthma severity in childhood:data from the National Health and Nutrition Examination Sur vey 2001-2004", Ann Allerg y Asthma Immunol, 103, pp.381~385 (2009)
  24. Hai Jin Kim, "Visceral Fat Thickness Predicts Fatty Liver in Koreans with Type 2 Diabetes Mellitus", Journal of Korean Medical Science, 23(2), pp.256~261 (2008), 대한의학회
  25. Hamagawa K, "Abdominal visceral fat thickness measured by ultrasonography predicts the presence and severity of coronary artery disease", Ultrasound Med Biol, 36, pp.1769~1775 (2010)
  26. Steinberger J, "Diagnosis of the metabolic syndrome inchildren", Curr Opin Lipidol, 14, pp.555~559 (2003)
  27. Kahn SE, "Mechanisms linking obesity to insulin resistance and type 2 diabetes", Nature, 444, pp.840~846 (2006)
  28. Motoshima H, "Differential regulation of adiponectin secretion from cultured human omental and subcutaneous adipocytes: effects of insulin and rosiglitazone", J Clin Endocrinol Metab, 87, pp.5662~5667 (2002)
  29. Cnop M, "The concurrent accumulation of intra-abdominal and subcutaneous fat explains the association between insulin resistance and plasma leptin concentrations : distinct metabolic effects of two fat compartments", Diabetes, 51, pp.1005~1015 (2002)
  30. Schwimmer JB, "Prevalence of fatty liver in children and adolescents", Pediatrics, 118, pp.1388~1393 (2006)
  31. Feldstein AE, "The natural history of nonalcoholic fatty liver disease in children: a follow-up study for up to 20 years", Gut, 58, pp.1538~1544 (2009)
  32. Saadeh S, "The utility of radiological imaging in nonalcoholic fatty liver disease", Gastroenterology, 123, pp.745~750 (2002)

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