Association of body fat distribution and cardiovascular risk factors in children and adolescents

Background-Obesity is associated with increased risk of cardiovascular dise ase in adults and less favorable cardiovascular risk factor status in child ren and adolescents. In adults, fat distribution has been shown to be relat ed to lipid and lipoprotein concentrations, blood pressure levels, and left ventricular mass. These relationships have not been extensively studied in young subjects. Methods and Results-This was a cross-sectional study of 127 children and ad olescents 9 to 17 years of age. Dual-energy x-ray absorptiometry was used t o measure total and regional fat mass. The dependent variables were fasting lipid and lipoprotein concentrations, systolic and diastolic blood pressur es, and left ventricular mass. There were significant (P<0.05) univariate c orrelations between fat distribution and log triglycerides (r=0.27), log HD L cholesterol (r=-0.23), systolic blood pressure (r=0.26), and left ventric ular mass (r=0.37). Multiple regression analysis showed that the significan t independent correlates for triglycerides and HDL cholesterol were age and fat distribution; for systolic blood pressure, height and fat distribution ; and for left ventricular mass, height, race, sex, and fat distribution. Conclusions-These results demonstrate that fat distribution is a more impor tant independent correlate of cardiovascular risk factors than percent body fat in children and adolescents. Greater deposition of central fat (an and roid fat pattern) is associated with less favorable plasma lipid and lipopr otein concentrations, blood pressure, and left ventricular mass.