Relationships between cardiovascular risk profile, ultrasonographic measurement of intra-abdominal adipose tissue, and waist circumference in obese children.

Background & Aims: Ultrasonographic measurements have been proposed to assess intra-abdominal adipose tissue. The aim of this study was to compare the relationship between waist circumference (WC), ultrasonographic measurements of intra-abdominal adipose tissue (UMA), and cardiovascular risk factors (CRF).

Methods: We determined blood pressure (BP), fasting HDL-cholesterol, LDL-cholesterol, triglycerides, glucose, insulin resistance index HOMA, 2 h glucose in oral glucose tolerance test (oGTT), weight status (SDS-BMI), WC, and UMA in 89 obese children. Furthermore, we analyzed the changes of CRF, SDS-BMI, WC, and UMA in 29 obese children participating in a one-year lifestyle intervention.

Results: In stepwise multivariable regression analysis, waist circumference was significantly associated to LDL-cholesterol, triglycerides, HOMA, and systolic blood pressure (adjusted variance (AV) 0.05-0.17). SDS-BMI was significantly related to triglycerides, HDL-cholesterol, 2 h glucose in oGTT, and diastolic blood pressure (AV 0.12-0.15), while UMA was related significantly to HOMA (AV 0.04). The obese children participating in a lifestyle intervention significantly reduced their overweight, which was associated with a significant improvement of most CRF and a reduction of WC and UMA. Changes of WC were significantly correlated to changes of HDL-cholesterol (r=-0.45), HOMA (r=0.37), glucose tolerance (r=0.59), systolic BP (r=0.60), and diastolic BP (r=0.43), while change of SDS-BMI and UMA were not significantly related to any CRF.

Conclusions: Compared to UMA, WC was stronger related to CRF in obese children. Therefore, the simple measurement of WC seems preferable as an indirect marker of CRF.