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Insulin Sensitivity Is Correlated with Subcutaneous but Not Visceral Body Fat in Overweight and Obese Prepubertal Children

Department of Mother and Child (C.M., S.S., M.S., T.B.), Biology-Genetics, Section of Pediatrics; Department of Radiology (R.M.), Section of Radiology; and Department of Biomedical and Surgical Sciences (M.T., R.C.B.), Section of Endocrinology, University of Verona, 37134 Verona, Italy

Address all correspondence and requests for reprints to: Claudio Maffeis, M.D., Department of Mother and Child, Biology-Genetics, Section of Pediatrics, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy. E-mail: claudio.maffeis{at}univr.it.

Aim: Our aim was to explore the relationship between insulin sensitivity, body fat distribution, ectopic (liver and skeletal muscle) fat deposition, adipokines (leptin and adiponectin), and inflammation markers (highly sensitive C-reactive protein, IL-6, IL-10, and TNF-) in prepubertal children.

Subjects and Methods: Thirty overweight and obese children (16 males and 14 females with body mass index z-score range of 1.1–3.2) were recruited. Body fat distribution and fat accumulation in liver and skeletal muscle were measured using magnetic resonance imaging. Insulin sensitivity was assessed by iv glucose tolerance test.

Results: Insulin sensitivity was associated with sc abdominal adipose tissue (SAT) (r = –0.52; P < 0.01) and liver fat content (r = –0.44; P < 0.02) but not with visceral abdominal adipose tissue (VAT) (r = –0.193; P value not significant) and fat accumulation in skeletal muscle (r = –0.210; P value not significant). Adipokines, but not inflammation markers, were significantly correlated to insulin sensitivity. VAT correlated with C-reactive protein (r = 0.55; P < 0.01) as well as adiponectin (r = –0.53; P <0.01). Multiple regression analysis showed that only SAT and liver fat content were independently correlated to insulin sensitivity (P < 0.01; 20 and 16% of explained variance, respectively).

Conclusions: In overweight and moderately obese prepubertal children, insulin sensitivity was negatively correlated with SAT and liver fat content. Furthermore, contrary to adults, VAT and inflammation markers were not correlated with insulin sensitivity in children.

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