Anthropometric Assessment of Abdominal Obesity and Health Risk in Children and Ad

描述(由申请人提供)：本申请涉及广泛的挑战领域(04)临床研究，以及特定的挑战主题06-DK-106：确定儿科中心性肥胖的标准人体测量方法。腹部脂肪，特别是腹内内脏脂肪组织被认为是人体内最具血脂紊乱和致动脉粥样硬化作用的脂肪库。使用先进的成像技术，可以在实验室环境下准确、可靠地测量腹内内脏脂肪组织和全身脂肪；然而，儿科腹内内脏脂肪组织和全身脂肪的可靠临床测量尚未开发出来。早期识别对于解决日益扩大的儿童肥胖和代谢性疾病问题至关重要。因此，这项研究的具体目的是：1)确定可靠的标志和方法，用于测量与非裔美国人和高加索儿童和青少年的腹内内脏脂肪组织和全身脂肪有关的儿童和青少年的腹内内脏脂肪组织和总体脂，以及非裔美国人和高加索儿童和青少年的生物成熟度范围；2)确定腰围与其他人体测量学指标相结合是否能更好地预测腹内内脏脂肪组织和总体脂，3)开发和确定儿童种族-性别特定腰围阈值的临床实用性，以识别儿童年龄、全身肥胖和成熟范围内升高的慢性病危险因素。我们将通过对100名5至18岁的非洲裔美国男孩、100名高加索男孩、100名非洲裔美国女孩和100名高加索女孩进行横断面研究来实现这些目标。腰围将在儿科研究中常用的四个解剖部位测量：1)髂骨上缘，2)髂骨与最低肋骨之间的中点，3)脐，4)最小腰围。将获得额外的身体尺寸，以确定将腰围与其他测量相结合在预测腹内内脏脂肪组织和全身脂肪方面的临床效用，这将使用先进的成像技术进行评估。确定最合适的腰围标志和测量技术对于临床识别肥胖相关健康风险升高的儿童以及在国家内部和国家之间实现肥胖监测战略的标准化非常重要。 公共卫生相关性(由申请者提供)：儿童肥胖是一个主要的公共卫生问题，识别因肥胖而面临更高健康问题风险的儿童是现代卫生保健的优先事项。腹部脂肪被认为是身体中最有害的，制定可靠的里程碑和程序来评估儿童的腹内内脏脂肪组织和全身脂肪将对以下方面产生重大影响：1)及早发现健康风险较高的儿童；2)适当优先安排卫生保健资源；3)国家内部和国家之间的肥胖监测程序标准化。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (04) Clinical Research, and Specific Challenge Topic 06- DK-106: Identifying a Standard Anthropometric Measure for Pediatric Central Adiposity. Abdominal fat, in particular intra-abdominal visceral adipose tissue is considered to be the most dyslipidemic and atherogenic fat depot in the human body. Intra-abdominal visceral adipose tissue and total body fat can be measured precisely and reliably in a laboratory setting using advanced imaging techniques; however, reliable clinical measurements of pediatric intra-abdominal visceral adipose tissue and total body fat are yet to be developed. Early identification is essential to addressing the expanding problem of pediatric obesity and metabolic disease. Thus, the specific aims of this study are to 1) identify reliable landmarks and methodology for the measurement of pediatric waist circumference that are associated with intra-abdominal visceral adipose tissue and total body fat across the pediatric age (5 to 18 years of age), total body adiposity, and biological maturity range among African American and Caucasian children and adolescents, 2) determine if waist circumference in combination with other anthropometric indices is a better predictor of intra-abdominal visceral adipose tissue and total body fat than waist circumference alone across the pediatric age, total body adiposity, and maturation range, and 3) develop and determine the clinical utility of pediatric race-sex-specific waist circumference thresholds for the identification of elevated chronic disease risk factors across the pediatric age, total body adiposity, and maturation range. We will accomplish these aims by conducting a cross-sectional study of 100 African American boys, 100 Caucasian boys, 100 African American girls, and 100 Caucasian girls 5 to 18 years of age. Waist circumference will be measured at the four common anatomic sites used in pediatric research: 1) superior border of the iliac crest, 2) midpoint between the iliac crest and the lowest rib, 3) umbilicus, and 4) minimal waist. Additional body dimensions will be obtained in order to determine the clinical utility of combining waist circumference with other measurements in predicting intra-abdominal visceral adipose tissue and total body fat, which will be assessed using advanced imaging techniques. The identification of the most appropriate waist circumference landmarks and measurement techniques is important for the clinical identification of children at elevated obesity-related health risk and for the standardization of obesity surveillance strategies within and between countries. PUBLIC HEALTH RELEVANCE (provided by applicant): Childhood obesity is a major public health issue, and the identification of children who are at increased risk of health problems due to their obesity is a priority for modern health care. Abdominal fat is considered to be the most harmful in the body, and the development of reliable landmarks and procedures for the assessment of intra-abdominal visceral adipose tissue and total body fat in children will have a major impact on 1) the early identification of children at elevated health risk, 2) the proper prioritization of health care resources, and 3) the standardization of obesity surveillance procedures within and between countries.