Total and regional fat and serum cardiovascular disease risk factors in lean and obese children and adolescents

Objective: This study was conducted to evaluate the association of total and central adiposity with serum cardiovascular disease (CVD) risk factors in lean and obese Portuguese children and adolescents. Research Methods and Procedures: A total of 87 girls (13.2 +/-1.6 years old, 29.9 +/-6.4% body fat [mean SD]) and 72 boys (13.2 +/-1.6 years old, 20.8 +/-9.9% body fat) volunteered for the study. Whole-body composition and fat distribution, from DXA and anthropometry, and serum lipids, lipoproteins, and apolipoproteins were evaluated. Results: The sum of three trunk skinfolds (STS) was highly correlated with total trunk fat mass measured by DXA (p<0.001). Body mass index, DXA-measured percentage of body fat, trunk fat mass, STS, and the waist-to-height ratio were generally found to be associated with triacylglycerol, the ratio of total cholesterol (TC) to high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), and apolipoprotein B levels, (significant age-adjusted r between 0.16 and 0.27, p<0.05). Body mass index, STS, and the waist circumference were also associated with HDL-C (p<0.05), whereas no body composition variable significantly correlated with TC or apolipoproteins A-I. The STS was significantly correlated with HDL-C (p<0.01), TC/HDL-C (p<0.05), and apolipoproteins A-1 (p<0.05) independently of whole-body fatness. Obese subjects (n=73) had higher TC, LDL-C, TC/HDL-C, and apolipoprotein B than did non-obese subjects (n=86), and significant associations between central adiposity and some lipid variables (triacylglycerol and HDL-C) were found in obese children and adolescents that were not present in leaner individuals. Discussion: DXA- and anthropometry-based whole-body and central fat measures are associated with serum CVD risk factors in Portuguese boys and girls. Obese children and adolescents have a poorer lipid profile than do their leaner counterparts. Trunk skinfolds, which are easy to obtain even in large samples, predict CVD risk factors to the same extent as DXA-based variables, in some cases, independently of total fatness.