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VISCERAL FAT AND ARTERIAL STIFFNESS IN YOUTH WITH HEALTHY WEIGHT, OBESITY, AND TYPE 2 DIABETES

Abstract

Simon Higgins1, Babette S. Zemel2, Philip R. Khoury3, Elaine M. Urbina4,3, Joseph M. Kindler5. 1Elon University, Elon, NC. 2The Children’s Hospital of Philadelphia, Philadelphia, PA. 3Cincinnati Children’s Hospital Medical Center, Cincinnati, OH. 4University of Cincinnati, Cincinnati, OH. 5University of Georgia, Athens, GA.

BACKGROUND: Visceral fat is associated with increased cardiovascular risk in adults but studies in youth are limited. We assessed associations between visceral fat and arterial stiffness in youth with healthy weight, obesity, and type 2 diabetes, and determined whether relationships were independent of clinical estimates of body fatness (i.e., body mass index; BMI, and waist circumference). METHODS: This cross-sectional sample included youth ages 10 to 23 years (67% female, 56% non-black) with healthy weight (BMI=5th to 85th percentile, n=236), obesity (BMI>95th percentile, n=224), and type 2 diabetes (BMI>95th percentile, n=145). Visceral fat was assessed via dual-energy X-ray absorptiometry. Carotid-femoral pulse wave velocity (PWV) was assessed via applanation tonometry. Final analyses combined the obese and type 2 diabetes groups as there were no differences between these groups in associations between primary outcomes. All regression analyses accounted for age, sex, ancestry, and mean arterial pressure. RESULTS: Visceral fat and PWV were greater in youth with obesity vs. healthy weight (p<0.001). In youth with obesity, visceral fat was positively associated with PWV (B=0.14, SE=0.02, p<0.001), and was predictive of PWV beyond BMI and waist circumference. Adiposity measures were not associated with PWV in youth with healthy weight (all p>0.05). CONCLUSIONS: Visceral fat likely contributes to subclinical cardiovascular complications in youth. Since cardiovascular health tracks from adolescence to adulthood, longitudinal studies in youth with obesity are required to define the role of visceral fat in lifelong cardiovascular disease risk. FUNDING: Funding for this work was received from the Endocrine Fellows Foundation and University of Georgia Obesity Initiative. The original study was funded by the National Institutes of Health (R01-HL076269).

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