High visceral and low abdominal subcutaneous fat stores in the obese adolescent - A determinant of an adverse metabolic phenotype
High visceral and low abdominal subcutaneous fat stores in the obese adolescent - A determinant of an adverse metabolic phenotype
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DOI：
10.2337/db07-0932
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发表时间：
2008-02-01
期刊：
影响因子：
7.7
通讯作者：
Weiss, Ram
中科院分区：
文献类型：
--
作者：
Taksali, Sara E.;Caprio, Sonia;Weiss, Ram
目的：探讨内脏脂肪和皮下脂肪是否失衡。脂肪储存和相应的脂肪因子环境失调与肝脏和肌肉中脂肪的过度积累有关，最终与胰岛素抵抗和代谢综合征有关。研究设计和方法-我们根据腹部脂肪在内脏储存中的比例将118名肥胖青少年的多种族队列分成三组。腹部和肝脏的脂肪用磁共振成像测量，肌脂(心肌细胞内的脂质)用质子磁共振波谱测量。结果：年龄、BMI Z评分和脱脂质量在三者之间没有差异。然而，随着内脏脂肪比例的增加，体重指数、脂肪和皮下脂肪的百分比下降，而肝脏脂肪增加。此外，2-h血糖、胰岛素、C-肽、甘油三酯水平和胰岛素抵抗均有增加。值得注意的是，瘦素和总脂联素在三个孩子中都显著低于第一个孩子，而C-反应蛋白和白细胞介素6在三个孩子之间没有差异。代谢综合征的优势比显著增加，三分位数3的人患代谢综合征的几率是三分位数1的5.2倍。结论内脏脂肪比例高、腹部皮下脂肪相对较低的肥胖青少年具有部分性脂营养不良的表型。这些青少年不一定是最严重的肥胖者，但他们患有严重的代谢并发症，患有代谢综合征的风险很高。
OBJECTYVE-To explore whether an imbalance between the visceral and subcutaneous fat. depots and a corresponding dysregulation of the adipokine milieu is associated with excessive accumulation of fat in the liver and muscle and ultimately with insulin resistance and the metabolic syndrome.RESEARCH DESIGN AND METHODS-We stratified our multi-ethnic cohort of 118 obese adolescents into tertiles based on the proportion of abdominal fat in the visceral depot. Abdominal and liver fat were measured by magnetic resonance imaging and muscle lipid (intramyocellular lipid) by proton magnetic resonance spectroscopy.RESULTS-There were no differences in age, BMI Z score, or fat-free mass across tertiles. However, as the proportion of visceral fat increased across tertiles, BMI and percentage of fat and subcutaneous fat decreased, while hepatic fat increased. In addition, there was an increase in 2-h glucose, insulin, c-peptide, triglyceride levels, and insulin resistance. Notably, both leptin and total adiponectin were significantly lower in tertile 3 than 1, while C-reactive protein and interleukin-6 were not different across tertiles. There was a significant increase in the odds ratio for the metabolic syndrome, with subjects in tertile 3 5.2 times more likely to have the metabolic syndrome than those in tertile 1.CONCLUSIONS-Obese adolescents with a high proportion of visceral fat and relatively low abdominal subcutaneous fat have a phenotype reminiscent of partial lipodystrophy. These adolescents are not necessarily the most severely obese, yet they suffer from severe metabolic complications and are at a high risk of having the metabolic syndrome.