Background: Obesity is associated with increased risk of cardiovascular disease in adults and less favorable cardiovascular risk factor status in children and adolescents. In adults, the distribution of fat has been shown to be related to metabolic alterations which increase the risk of cardiovascular disease. An android fat pattern with increased central adiposity is associated with less favorable cardiovascular risk than a gynoid pattern with greater peripheral adiposity. These relationships have not been extensively studied in young subjects.
Methods and Results: This was a cross-sectional study of 127 normal children and adolescents, age 9-17 years, 68 male and 55 black. Dual energy x-ray absorptiometry was used to measure total and regional fat mass. The distribution of fat was calculated as the fat mass in the subscapular and waist region divided by fat mass in the hip and thigh region. The dependent variables were fasting lipid and lipoprotein concentrations, systolic and diastolic blood pressure (BP), and left ventricular mass (LVM) measured by echocardiography. There were significant (p<0.05) univariate correlations between the distribution of fat and log triglycerides (r=0.27), log HDL-cholesterol (r=-0.23), systolic BP (r=0.26) and LVM (r=0.37). Multiple regression analysis showed that age and fat distribution were the independent predictors of log triglycerides (R2= 0.09) and HDL-cholesterol(R2=0.13). The significant predictors of systolic BP were height and fat distribution (R2=0.18). The predictors of LVM were height, race, sex and fat distribution (R2=0.63). The distribution of fat entered the multiple regression models prior to any other measure of adiposity.
