Journal List > Korean J Pediatr Gastroenterol Nutr > v.13(2) > 1043469

Korean J Pediatr Gastroenterol Nutr. 2010 Sep;13(2):172-179. Korean.
Published online September 30, 2010.
Copyright © 2010 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Clinical Significance of Abdominal Fat Distribution in Korean Male Children and Adolescents
Yeoun Joo Lee, M.D., Kyung Mo Kim, M.D., Seak Hee Oh, M.D., Hye Soon Park, M.D.,* and Jun Pyo Myong, M.D.
Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan Medical School, Seoul, Korea.
*Department of Family Medicine, Asan Medical Center, University of Ulsan Medical School, Seoul, Korea.
Team of Health Promotion, Division of Health and Sanitation, Chungcheongbuk-do Provincial Government, Cheongju, Korea.

Corresponding author (Email: )
Received August 06, 2010; Revised August 10, 2010; Accepted September 08, 2010.



Visceral adipose tissue may be strongly linked to increased metabolic risks in adults. However, because little is known regarding the effect of visceral adipose tissue in children and adolescents, we performed this study to determine the association between abdominal fat distribution and metabolic risk factors in this population.


One hundred one children and adolescents (78 males and 23 females; mean age, 10.8±2.4 years) were enrolled. The anthropometric data and metabolic risk factors were evaluated. Theabdominal fat distribution was assessed according to the CT measurement. Age-adjusted, partial correlations were performed among the visceral adipose fat area (VFA), subcutaneous adiposefat area (SFA), metabolic risk factors, and anthropometrics.


The SFA increased more rapidly than the VFA with advancing years in both genders. In males, the VFA and SFA were positively correlated with anthropometrics. The VFA was correlated with low HDL-cholesterol and the SFA was correlated with diastolic blood pressure (DBP). However, there was no statistical significance between the VFA, SFA, anthropometrics, and other metabolic risk factors. The VFA and SFA were strongly linked to a number of metabolic risk factors, such as other anthropometrics.


This study investigated how a low HDL-C was correlated with VFA and how a high DBP was associated with SFA in Korean male children and adolescents. Our results suggest that the correlation between the VFA, SFA, and metabolic risk factors was relatively weak compared to that reported in previous adult studies.

Keywords: Obesity; Children; Adolescents; Abdominal fat; Visceral fat; Subcutaneous fat; Metabolic syndrome


Fig. 1
Scatter plots showed the visceral fat area (VFA) and subcutaneous fat area (SFA) according to age and gender (left, male right, female). The SFA increased more rapidly compared to the VFA with advancing years in both genders.
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Fig. 2
Scatter plots showed a negative linear association between the visceral fat area (VFA) and HDL-cholesterol. Age-adjusted multivariate regression model identified R2 as 0.322 and p-value as <0.001 between logVFA and HDL-cholesterol.
Click for larger image


Table 1
Clinical Characteristics, Plasma Biochemistry and Radiologic Assessment of the VFA and SFA Volume of the Participants
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Table 2
Partial Correlations Adjusted for Age between the VFA, SFA and Anthropometrics
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Table 3
Partial Correlations Adjusted for Age between Radiologic Assessment of the VFA, SFA, Anthropometric Data and Metabolic Risk Factors in 66 Males*
Click for larger image

1. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006;295:1549–1555.
2. Oh K, Jang MJ, Lee NY, Moon JS, Lee CG, Yoo MH, et al. Prevalence and trends in obesity among Korean children and adolescents in 1997 and 2005. Korean J Pediatr 2008;51:950–955.
3. Sinaiko AR, Donahue RP, Jacobs DR Jr, Prineas RJ. Relation of weight and rate of increase in weight during childhood and adolescence to body size, blood pressure, fasting insulin, and lipids in young adults. The Minneapolis Children's Blood Pressure Study. Circulation 1999;99:1471–1476.
4. Barton M. Screening for obesity in children and adolescents: US Preventive Services Task Force recommendation statement. Pediatrics 2010;125:361–367.
5. Lee S, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictor of insulin resistance in black and white youths. J Pediatr 2006;148:188–194.
6. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes 2007;8:299–306.
7. Park MJ, Boston BA, Oh M, Jee SH. Prevalence and trends of metabolic syndrome among Korean adolescents: from the Korean NHANES survey, 1998~2005. J Pediatr 2009;155:529–534.
8. Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 2000;21:697–738.
9. Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007;116:39–48.
10. Matsushita Y, Nakagawa T, Yamamoto S, Takahashi Y, Yokoyama T, Noda M, et al. Associations of visceral and subcutaneous fat areas with the prevalence of metabolic risk factor clustering in 6292 Japanese individuals: the Hitachi Health Study. Diabetes Care. 2010 May 11;
[Epub ahead of print].
11. Moon JS, Lee SY, Nam CM, Choi JM, Choe BK, Seo JW, et al. 2007 Korean National Growth Charts: review of developmental process and an outlook. Korean J Pediatr 2008;51:1–25.
12. Cole TJ, Green PJ. Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med 1992;11:1305–1319.
13. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–419.
14. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362–2374.
15. Bjorntorp P. "Portal" adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arteriosclerosis 1990;10:493–496.
16. Fontana L, Eagon JC, Trujillo ME, Scherer PE, Klein S. Visceral fat adipokine secretion is associated with systemic inflammation in obese humans. Diabetes 2007;56:1010–1013.
17. Caprio S, Hyman LD, McCarthy S, Lange R, Bronson M, Tamborlane WV. Fat distribution and cardiovascular risk factors in obese adolescent girls: importance of the intraabdominal fat depot. Am J Clin Nutr 1996;64:12–17.
18. Suliga E. Visceral adipose tissue in children and adolescents: a review. Nutr Res Rev 2009;22:137–147.
19. Kim JA, Park HS. Association of abdominal fat distribution and cardiometabolic risk factors among obese Korean adolescents. Diabetes Metab 2008;34:126–130.
20. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature 2006;444:840–846.
21. Fox KR, Peters DM, Sharpe P, Bell M. Assessment of abdominal fat development in young adolescents using magnetic resonance imaging. Int J Obes Relat Metab Disord 2000;24:1653–1659.
22. Kim JA, Ju SY, Yum KS. Cut-off value of visceral fat area at risk of obesity-related disorders in Korean adult population. J Korean Acad Fam Med 2006;27:208–214.
23. Jackson AS, Pollock ML, Graves JE, Mahar MT. Reliability and validity of bioelectrical impedance in determining body composition. J Appl Physiol 1988;64:529–534.
24. Kullberg J, Brandberg J, Angelhed JE, Frimmel H, Bergelin E, Strid L, et al. Whole-body adipose tissue analysis: comparison of MRI, CT and dual energy X-ray absorptiometry. Br J Radiol 2009;82:123–130.
25. Stolk RP, Wink O, Zelissen PM, Meijer R, van Gils AP, Grobbee DE. Validity and reproducibility of ultrasonography for the measurement of intra-abdominal adipose tissue. Int J Obes Relat Metab Disord 2001;25:1346–1351.
26. Blouin K, Boivin A, Tchernof A. Androgens and body fat distribution. J Steroid Biochem Mol Biol 2008;108:272–280.