Relationship of body fat distribution to metabolic complications in obese prepubertal boys: gender related differences

Our purpose was to assess the relationship of obesity and body fat distribution to serum glucose values, insulin concentration and insulin resistance in obese prepubertal boys. Thirteen obese and 15 control prepubertal boys were studied. Biceps, triceps, subscapular and suprailiac skin fold thicknesses were measured. Percentage of body fat and total body fat were calculated. Body fat distribution was assessed by analyzing the central (supra-iliac, subscapular)/peripheral (biceps, triceps) ratios. During an oral glucose tolerance test, serum glucose and insulin were measured and insulin/glucose was calculated. Body fat data and body fat distribution indices were significantly higher in the obese group. The obese population presented significantly elevated values of insulin and insulin/glucose. In the obese group insulin showed significant correlations with percentage of body fat, total body fat and subscapular skin fold thickness, whereas insulin/glucose had significant positive correlations with percentage of body fat, total body fat and supra-iliac skin fold thickness. In obese boys significant positive correlations were also shown by subscapular/supra-iliac with insulin and insulin/glucose, and by subscapular/triceps with insulin. In prepubertal boys obesity is centripetal and an upper central body fat distribution seems to be first associated with an abnormal glucose-insulin homeostasis.     

Ethnic differences in androgens, IGF-I and body fat in healthy prepubertal girls

OBJECTIVE: To examine ethnic differences in adrenal androgen production, IGF-I, and IGFBP-1 and -3 in relation to bone age, insulin, and body composition in healthy prepubertal girls. METHODS: Serum levels of DHEA-S, androstenedione, IGF-I, and IGFBP-1 and -3 were examined in relation to bone age, insulin, and body composition (determined by dual-energy X-ray absorptiometry) in 47 (19 Caucasian, 9 African-American, 19 Mexican-American) healthy prepubertal girls aged 7.5-9.0 years. RESULTS: Age, weight, height, bone age, androstenedione, insulin, glucose:insulin ratios, and IGFBP-3 levels were not statistically different among groups. Mexican-American girls had higher % body fat than African-Americans or Caucasians (P < 0.001). DHEA-S levels in African-Americans were twofold higher than in Caucasians (P = 0.024), although their % body fat was not significantly different (16.1% and 19.4%, respectively; P = 0.138). DHEA-S levels in Mexican-American girls were intermediate. Bone age and weight were significant covariates for DHEA-S levels. Plasma IGF-I levels were also higher in African-American than in Caucasian or Mexican-American girls (P = 0.009). Covariance analysis showed that IGF-I levels were influenced mainly by ethnicity (P = 0.009) and were independent of bone age. Despite similar insulin levels among groups, IGFBP-1 levels were higher in Caucasians than in Mexican-Americans or African-Americans (P < 0.001). CONCLUSIONS: In healthy prepubertal girls, DHEA-S concentrations are higher in African-Americans than in Caucasians or Mexican-Americans, even before any clinical evidence of adrenarche. Furthermore, IGF-I concentrations are higher in African-American girls than in Caucasian or Mexican-American girls which may contribute to the higher DHEA-S levels observed. Conversely, higher DHEA-S and IGF-I levels in African-American girls may be indicative of an influence not only of gonadal but also of adrenal androgens on the GH/IGF-I axis.     

Body fat, abdominal fat and body fat distribution related to cardiovascular risk factors in prepubertal children

Aim: We analysed whether total body fat (TBF), abdominal fat and body fat distribution are associated with higher composite risk factor scores for cardiovascular disease (CVD) in young children. Methods: Cross‐sectional study of 238 children aged 8–11 years. TBF and abdominal fat mass (AFM) were measured by Dual‐Energy X‐Ray Absorptiometry. TBF was expressed as a percentage of body weight (BF%). Body fat distribution was calculated as AFM/TBF. Maximal oxygen uptake (VO_2PEAK), systolic and diastolic blood pressure (SBP, DBP), and resting heart rate (RHR) were measured. Mean arterial pressure (MAP) and pulse pressure (PP) were calculated. Left atrial diameter (LA) was measured, and left ventricular mass (LVM) and relative wall thickness (RWT) were calculated. Z‐scores were calculated. Sum of z‐scores for SBP, DBP, MAP, PP, RHR, LVM, LA, RWT and ?VO_2PEAK was calculated in boys and girls, separately, and used as composite risk factor score. Results: Pearson correlations between ln BF%, ln AFM and AFM/TBF versus composite risk factor score for boys were r = 0.56, r = 0.59 and r = 0.48, all p < 0.001, and for girls r = 0.45, r = 0.50 and r = 0.48, all p < 0.001. Conclusion: Total body fat, abdominal fat and body fat distribution were all associated with higher composite risk factor scores for CVD in young children.     

Birth weight and body fat distribution in adolescent girls

OBJECTIVE: To examine the association between birth weight and body fat distribution in a group of adolescent girls. DESIGN: A total of 216 white girls who were born in Southampton had their heights, weights, waist and hip circumferences, and skinfold thicknesses measured when they were aged between 14 and 16 years. RESULTS: The girls who were smallest at birth, but who were fattest at time of measurement were the most centrally obese. In girls whose body mass index was above the median (21 kg/m2), the subscapular to triceps skinfold ratio rose by 9% for every kilogram decrease in birth weight. Among overweight girls, with a body mass index over 25, the ratio rose by 27% for every kilogram decrease in birth weight. CONCLUSION: In adolescent girls, the tendency to store fat on the trunk rather than the limbs, seems to be programmed by growth in fetal life, and is most evident in those who are overweight.     

Effect of weight loss on body fat distribution in obese children

The intra-abdominal visceral fat to subcutaneous fat ratio (V/S ratio) has been reported to be strongly related to disorders of glucose and lipid metabolism, and hypertension. It is a matter of concern as to whether weight loss causes an improvement of the V/S ratio or not in obese children. Changes in body fat distribution during weight loss in 23 obese children were quantified by weight, bioelectrical impedance analysis (BIA) and computed tomography (CT scan of the abdomen). Twenty-three patients were divided into two groups; six were in the inpatient group and 17 were in the outpatient group. Bodyweight, body fat percentage, subcutaneous fat and visceral fat were significantly higher in the inpatient group than in the outpatient group before weight loss. Whereas the V/S ratio was almost equal between the two groups before weight loss. Bodyweight, body fat percentage, subcutaneous fat and visceral fat were found to decrease significantly during weight loss in the two groups. The V/S ratio of the outpatient group did not change after weight loss. In contrast, the V/S ratio of the inpatient group decreased significantly during weight loss. These preliminary findings suggest that a large amount of body fat and a high obesity rate are not always accompanied by a high V/S ratio in obese children. The fat pattern changes during weight loss with strict dietary therapy and therapeutic exercise. A larger sample of obese children should be studied to test this conjecture.     

Aerobic fitness in prepubertal children according to level of body fat

Aim: The purpose of this study was to investigate the relationship between maximum oxygen uptake (VO_2PEAK) and body fat in young children on a population‐based level. Methods: Participants were 586 children (311 boys and 275 girls) aged 6.8 ± 0.4 years, recruited from a population‐based cohort. VO_2PEAK was measured by indirect calorimetry during a maximal exercise test. Percent body fat (BF%) was estimated from skinfold measurements. Results: Significant relationships existed between BF% and absolute values of VO_2PEAK (mL/min), VO_2PEAK scaled by body weight (mL/min/kg) and VO_2PEAK by allometric scaling (mL/min/kg^0.71), whereas no relationships were detected for VO_2PEAK scaled to fat‐free mass (FFM) (mL/min/FFM). Person correlation coefficients for boys were 0.26, ?0.38, ?0.19 and ?0.01 NS and for girls 0.33, ?0.42, ?0.21 and ?0.03 NS, respectively. Significant differences in VO_2PEAK existed between different quartiles of BF%, with the exception when VO_2PEAK was scaled to FFM. Conclusion: Our findings document the coexistence of two known risk factors for disease at a young age on a population‐base and confirms that VO_2PEAK was scaled to FFM represents a body fat independent way of expressing fitness.     

Vulvovaginitis in prepubertal girls

This retrospective study evaluated the clinical features and findings in bacterial cultures and in microscopic examination of vaginal secretions in 80 prepubertal girls, aged 2-12 years, with vulvovaginitis. Vaginal secretions were obtained directly from the vagina with a sterile catheter carefully inserted into the vagina. Pathogenic bacteria were isolated in 36% of cases. In 59% of these cases the isolated pathogen was group A beta-haemolytic streptococcus. Candida was not found in any of the patients. The finding of leucocytes in vaginal secretions as an indicator for growth of pathogenic bacteria had a sensitivity of 83% and a specificity of 59%. Antimicrobial treatment should therefore be based on bacteriological findings of vaginal secretions and not on the presence of leucocytes alone.     

Milk intake is inversely related to body mass index and body fat in girls

Dairy foods comprise a range of products with varying nutritional content. The intake of dairy products (DPs) has been shown to have beneficial effects on body weight and body fat. This study aimed to examine the independent association between DP intake, body mass index (BMI), and percentage body fat (%BF) in adolescents. A cross-sectional, school-based study was conducted with 1,001 adolescents (418 boys), ages 15-18?years, from the Azorean Archipelago, Portugal. Anthropometric measurements were recorded (weight and height), and %BF was assessed using bioelectric impedance analysis. Adolescent food intake was measured using a self-administered, semiquantitative food frequency questionnaire. Data were analyzed separately for girls and boys, and separate multiple linear regression analysis was used to estimate the association between total DP, milk, yogurt, and cheese intake, BMI, and %BF, adjusting for potential confounders. For boys and girls, respectively, total DP consumption was 2.6?±?1.9 and 2.9?±?2.5 servings/day (P?=?0.004), while milk consumption was 1.7?±?1.4 and 2.0?±?1.7 servings/day (P?=?0.001), yogurt consumption was 0.5?±?0.6 and 0.4?±?0.7 servings/day (P?=?0.247), and cheese consumption was 0.4?±?0.6 and 0.5?±?0.8 servings/day (P?=?0.081). After adjusting for age, birth weight, energy intake, protein, total fat, sugar, dietary fiber, total calcium intake, low-energy reporters, parental education, pubertal stage, and physical activity, only milk intake was negatively associated with BMI and %BF in girls (respectively, girls: β?=?-0.167, P?=?0.013; boys: β?=?-0.019, P?=?0.824 and girls: β?=?-0.143, P?=?0.030; boys: β?=?-0.051, P?=?0.548). Conclusion: We found an inverse association between milk intake and both BMI and %BF only in girls.     

Vulvovaginitis in prepubertal girls.

This retrospective study evaluated the clinical features and findings in bacterial cultures and in microscopic examination of vaginal secretions in 80 prepubertal girls, aged 2-12 years, with vulvovaginitis. Vaginal secretions were obtained directly from the vagina with a sterile catheter carefully inserted into the vagina. Pathogenic bacteria were isolated in 36% of cases. In 59% of these cases the isolated pathogen was group A beta-haemolytic streptococcus. Candida was not found in any of the patients. The finding of leucocytes in vaginal secretions as an indicator for growth of pathogenic bacteria had a sensitivity of 83% and a specificity of 59%. Antimicrobial treatment should therefore be based on bacteriological findings of vaginal secretions and not on the presence of leucocytes alone.     

Isolated menses in prepubertal girls

Seventeen prepubertal girls 1 to 8 years of age were studied for the complaint of vaginal bleeding of apparent uterine origin. The bleeding was considered as isolated menses because it lasted two to five days and no other signs of sexual development or any detectable vaginal or uterine abnormalities were found. Eleven girls had two or more apparent menstrual periods, six experienced only one period. Height and bone age were not significantly different from normal. Laparoscopy or ultrasonography showed normal prepubertal uterine size, with either prepubertal ovaries or ovaries containing follicular cysts. Plasma gonadotrophins and their response to luteinizing hormone-releasing hormone were at prepubertal levels. Plasma estradiol level was significantly above the normal prepubertal range, suggesting transient ovarian activity and instability of the pituitary-gonadal axis in these girls. Isolated menses occurred mainly during the months of September to January, thus leading us to speculate about possible seasonal variations of hormonal regulation.     

Gardnerella vaginalis in prepubertal girls

A prospective study was established to determine the significance of the isolation of Gardnerella vaginalis from the vagina in prepubertal children. Two hundred fifty-six children were enrolled. Group 1 consisted of 137 children who had been victims of sexual abuse; group 2, forty-eight children with genitourinary complaints and no history of sexual abuse; and group 3, seventy-one children with no genitourinary complaints and no history of sexual abuse. Gardnerella vaginalis was isolated from 20 patients (14.6%) in group 1 and five (4.2%) of 119 control patients from groups 2 and 3. Within group 1, G vaginalis was more likely to be isolated from children with a history of multiple episodes of sexual abuse than those with a single episode. Gardnerella vaginalis was not associated with any other historical, physical, or laboratory findings, including vaginal erythema or vaginal discharge.     

Postprandial triglyceridemia in obese and non-obese adolescents. Importance of body composition and fat distribution

BACKGROUND: It has recently been shown that obese adults have a disturbed metabolism of postprandial lipoproteins, resulting in postprandial hypertriglyceridemia. To the best of our knowledge, there are no data about postprandial triglyceridemia in obese and non-obese children and adolescents. SUBJECTS: 12 obese and 12 non-obese adolescents, aged 11.0 to 13.8 years. METHODS: Body composition and fat distribution (waist-to-hip circumference ratio and triceps/ subscapular skinfold thickness ratio) were assessed by anthropometry. An oral fat tolerance test was carried out, and fasting and postprandial lipid-lipoprotein serum concentrations were measured. RESULTS: We observed a significant increase in triglyceride serum concentrations 2 and 4 hours after the oral fat load, in both obese and non-obese adolescents. In obese and non-obese adolescents there were significant correlations between some variables of postprandial lipemia and the studied indices of body fat distribution. When we compare postprandial lipemia in adolescents having a central pattern of fat distribution with those having a peripheral pattern of fat distribution, we observed higher variables related to postprandial lipemia in those having a central pattern of fat distribution compared with those with a peripheral pattern (sum of serum triglyceride concentrations: 6.06 vs 4.41, p = 0.0243). CONCLUSIONS: We present a protocol to study postprandial lipemia in children and adolescents that allowed us to observe significant changes after an oral fat load. Results obtained indicate that the pattern of distribution of adipose tissue may be more important for lipid metabolism disturbances than total adipose tissue per se.     

女童全身体脂比率与性早熟的关系

目的 既往研究提示体重指数（BMI）与女童发育年龄有关,但是否与女童全身脂肪比率相关尚不清楚。该研究旨在分析全身脂肪比率与性早熟的关联性。方法 依据中枢性性早熟诊断与治疗共识将2017年7~8月收治的128例性早熟患儿分为中枢性性早熟组（CPP组,87例）和外周性性早熟组（PPP组,41例）,同时纳入51例未发育女童作为对照组。利用双能X线吸收测量法检测上肢组织、腿部组织、躯干组织、男性区、女性区和全身组织的脂肪比率,结合研究对象的年龄、BMI、BMI-Z值、骨龄、卵巢体积、激素水平等实验室检查结果,综合分析脂肪比率和性早熟的相关性。结果 与对照组比较,CPP组和PPP组患儿上肢、腿部、躯干、男性区、女性区和全身组织的体脂率参数以及腿部/全身脂肪比和（上肢+腿部）/躯干脂肪比均显著升高（均P < 0.05）,而上述所有体脂率和脂肪分布指标在CPP组和PPP组间比较差异均无统计学意义（均P > 0.05）。在性早熟女童中,高体脂率组的黄体生成素（LH）基础值及黄体生成素释放激素（LHRH）激发试验的LH峰值、LH/卵泡刺激素峰值均显著高于低体脂率组,差异均有统计学意义（均P < 0.05）。同时高体脂率组和低体脂率组LH基础值相比于对照组均显著升高（均P < 0.05）。结论 体脂含量的增加可能是诱发女童性早熟的因素,但具体机制尚有待进一步研究。     

Leptin is closely related to body fat in prepubertal children aged 8-11 years

BACKGROUND: In adults and obese children, serum leptin concentrations are closely related to body fat. AIM: To investigate whether such a relationship between leptin concentrations and body fat is also evident in children with a relatively normal body composition. METHODS: The study was a cross-sectional population study in 170 Caucasian children (91 boys and 79 girls), with a mean age of 9.9+/-0.6 y (range 8.5-10.9 y) and a mean BMI of 17.4+/-2.6 (range 12.8-28.1). Serum leptin was measured and compared to total body fat as determined by dual-energy X-ray absorptiometry. RESULTS: In the whole population, serum leptin concentrations were highly correlated with total body fat (r=0.83, p<0.001). A stepwise forward multi-regression analysis revealed that the inclusion of other anthropometrical data did not add any significance to the model. Leptin concentrations were significantly higher in girls (5.2 ng/ml) than in boys (3.2 mg/ml; p=0.003). Gender differences still prevailed (p=0.007) after adjusting for number of kilograms of fat tissue. CONCLUSION: This study shows that, already at the young age of 9-11 y, an adult-like pattern of regulation of leptin exists. This indicates similar risk factor dependency of leptin across all age groups.     

Vaginal opening measurement in prepubertal girls

Normative, age-indexed data regarding the size of the vaginal opening in prepubertal girls have not been previously reported, to our knowledge. Measurement of the apparent transverse diameter of the vaginal opening was done in 273 prepubertal girls as part of their routine health assessment. Vaginal opening diameter tended to enlarge with age and to be larger in the supine knee-chest position than in the supine frog-leg position. An opening greater than 4 mm was distinctly rare.     

Calcified ovarian fibromas in prepubertal girls

Ovarian fibromas in prepubertal girls are rare. We describe two girls aged 8 and 11 years with extensively calcified ovarian fibromas. One patient had a single unilateral fibroma with metaplastic bone formation in the calcified area. The other patient had bilateral nodular fibromas suggesting the possibility of naevoid basal-cell carcinoma syndrome although broader manifestations are lacking at present.     

Microbiological aspects of vulvovaginitis in prepubertal girls

This study aimed to establish the vaginal introitus microbial flora in girls with and without symptoms of vulvovaginitis, and to present the distribution of isolated microorganisms by age groups in girls with vulvovaginitis. We enrolled 500 girls with vulvovaginitis symptoms, aged 2-12 years, referred by their pediatricians for microbiological examination of the vaginal introitus swabs, and 30 age-matched asymptomatic girls. Similar microbial flora was isolated in both groups, but the symptomatic girls had significantly more common positive microbiological findings compared to controls (p?相似文献