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The Usefulness of the Abdominal Computerized Tomography for the Diagnosis of Childhood Obesity and Its Correlation with Various Parameters of Obesity  

Shim, Yoon Hee (Department of Pediatrics, College of Medicine, Ewha Womans University)
Cho, Su Jin (Department of Pediatrics, College of Medicine, Ewha Womans University)
Rhyu, Jung Hyun (Department of Diagnositic Radiology, College of Medicine, Ewha Womans University)
Hong, Young Mi (Department of Pediatrics, College of Medicine, Ewha Womans University)
Publication Information
Clinical and Experimental Pediatrics / v.48, no.10, 2005 , pp. 1082-1089 More about this Journal
Abstract
Purpose : Abdominal obesity is encountered as a risk factor for cardiovascular diseases. However, the anthropometric cut-off value to estimate the cardiovascular risk, has not been suggested. This study was designed to find the relationship between the abdominal fat and various parameters of obesity to find the cardiovascular risk factors related to abdominal obesity and to establish practical methods to measure them. Methods : Twenty seven obese Korean adolescents of moderate to severe degree and 22 healthy adolescents were enrolled. The body mass index(BMI), arm circumference and skinfold thickness were measured. Furthermore, blood lipid, sugar, insulin and four different cytokines' levels were checked and the distribution of body composition was measured by bioelectrical impedance analysis. The subcutaneous and intra-abdominal fat thickness by abdominal ultrasonography(US) and the total and intra-abdominal fat area by abdominal computerized tomography(CT) were measured in the obese group. Results : The most accurate method to measure abdominal fat in children is abdominal CT and the fat mass measured by bioelectrical impedance was strongly correlated with it(r=0.954). It was also correlated with arm circumference, fat thickness measured by abdominal US, BMI, aspartate aminotransferase(AST), alanine aminotransferase(ALT) and triglyceride level. Conclusion : Abdominal CT is the most accurate method to measure intra-abdominal fat, and it can be replaced by abdominal US for cost effectiveness. The screening methods that can be used at school or in outpatient basis include bioelectrical impedance, waist/hip ratio, and arm circumference. The cardiovascular risk factors include leptin, triglyceride and insulin level.
Keywords
Obesity; Abdominal CT; Abdominal US; Bioelectrical impedance;
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1 Armellini F, Zamboni M, Robbi R, Todesco T, Rigo L, Bergamo-Andreis IA, et al. Total and intra-abdominal fat measurements by ultrasound and computerized tomography. Int J Obes Relat Metab Disor 1993;17:209-14
2 Armellini F, Zamboni M, Rigo L, Bergamo-Andreis IA, Robbi R, Marchi M, et al. Sonography detection of small intra-abdominal fat variations. Int J Obesity 1991;15:847-52
3 Daniels SR. Obesity in the pediatric patient : cardiovascular complications. Prog Pediatr Cardiol 2001;12:161-7   DOI   PUBMED   ScienceOn
4 Steinberger J. Diagnosis of the metabolic syndrome in children. Curr Opin Lipidol 2003;14:555-9   DOI   PUBMED   ScienceOn
5 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;23;99:1471-6   DOI   ScienceOn
6 Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents : the Bogalusa Heart Study. Pediatrics 1999;103:1175-82   DOI   PUBMED   ScienceOn
7 Faria AN, Ribeiro Filho FF, Gouveia Ferreira SR, Zanella MT. Impact of visceral fat on blood pressure and insulin sensitivity in hypertensive obese women. Obes Res 2002;10:1203-6   DOI   ScienceOn
8 Rossner S, Bo WJ, Hiltbrandt E, Hinson W, Karstaedt N, Santiago P, et al. Adipose tissue determinations in cadavers: a comparison between cross-sectional planimetry and computed tomography. Int J Obes 1990;14:893-902
9 Hall JE, Zappe D, Kassab S. Mechanism of obesity induced hypertension News Physiol Sci 1994;23:381-94
10 Nemet D, Wang P, Funahashi T, Matsuzawa U, Tanaka S, Engelman L, et al. Adipocytokines, body composition, and fitness in children. Pediatr Res 2003;53:148-52   DOI   ScienceOn
11 Steinberger J. Insulin resistance and cardiovascular risk in the pediatric patient. Prog Pediatr Cardiol 2001;12:169-75   DOI   PUBMED   ScienceOn
12 Hong YM, Moon KR, Seo JW, Shim JG, Yoo KH, Jeong BJ, et al. Guideline of diagnosis and treatment in childhood obesity. J Korean Pediatr Soc 1999;42:1338-45
13 Eckel RH, Krauss RM. American Heart Association call to action : obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation 1998;97:2099-100   DOI   ScienceOn
14 Wilson DM, Wang Y, Cullen KW, Baranowski T, Himes JH, Gross M, et al. Assessing weight-related biochemical cardiovascular risk factors in African-American girls. Obes Res 2004;12 Suppl:73S-83S   DOI
15 Fujioka S, Matsuzawa Y, Tokunaga K, Tarui S. Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metabolism 1987;36:54-7   DOI   ScienceOn
16 Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin endocrinol Metab 2004;89:108-13   DOI   ScienceOn
17 Ribeiro-Filho FF, Faria AN, Azjen S, Zanella MT, Ferreira SR. Methods of estimation of visceral fat : advantages of ultrasonography. Obes Res 2003;11:1488-94   DOI   ScienceOn
18 Cucci E, Piatti PM, Orena C, Pontiroli AE, Martino E, Paesano PL, et al. Is echocardiography an adequate method for assessing the thickness of intra-abdominal fat? : a comparison with computed tomography. Radiol Med 1997;94:329-34
19 Morrison JA, Sprecher DL, Barton BA, Waclawiw MA, Daniels SR. Overweight, fat patterning and cardiovascular disease risk factors in black and white girls : the National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 1999;135:458-64   DOI   ScienceOn
20 Bonora E, Formentini G, Calceterra F, Lombardi S, Marini F, Zenari L, et al. HOMA-estimated insulin resistance is an independent predictor of cardiovascular disease in type 2 diabetic subjects : prospective data from Verona diabetes complications study. Diabetes Care 2002;25:1135-41   DOI   ScienceOn
21 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;350:2362-74   DOI   ScienceOn
22 Miller J, Rosenbloom A, Silverstein J. Childhood obesity. J Clin Endocrinol Metab 2004;89:4211-8   DOI   ScienceOn
23 Cook S. The metabolic syndrome : antecedent of adult cardiovascular disease in pediatrics. J Pediatr 2004;145:427-30   DOI   PUBMED   ScienceOn
24 Gus M, Fuchs SC, Moreira LB, Moraes RS, Wiehe M, Silva AF, et al. Association between different measurements of obesity and the incidence of hypertension. Am J Hypertens 2004;17:50-3   DOI   ScienceOn
25 Ribeiro-Filho FF, Faria AN, Kohlmann O Jr, Ajzen S, Ribeiro AB, Zanella MT, et al. Ultrasonography for the evaluation of visceral fat and cardiovascular risk. Hypertension 2001;38:713-7   DOI   ScienceOn
26 Lakka HM, Lakka TA, Tuomilehto J, Salonen JT. Abdominal obesity is associated with increased risk of acute coronary events in men. Eur Heart J 2002;23:706-13   DOI   ScienceOn
27 Armellini F, Zamboni M, Rigo L, Todesco T, Bergamo-Andreis IA, Procacci C, et al. The contribution of sonography to the measurement of intra-abdominal fat. J Clin Ultrasound 1990;18:563-7   DOI   ScienceOn
28 Esposito K, Nicoletti G, Giugliano D. Obesity, cytokines and endothelial dysfunction : A link for the raised cardiovascular risk associated with visceral obesity. J Endocrinol Invest 2002;25:646-9