Abstract
Background: Body mass index (BMI) is commonly used as a proxy to determine excess adiposity, though this may underestimate fat mass (FM) in individuals of South Asian (SA) heritage. SA tend to have greater central adiposity than white people, which is associated with a higher risk of cardiometabolic disease. In this cross-sectional study, we aimed to determine the differences in total and regional FM using Dual-energy X-ray absorptiometry (DXA), and to see if any differences in FM varied by BMI category in UK-born white and SA children aged ~9 years. Methods: Anthropometric measurements and DXA scans were undertaken from 225 white and 269 SA children from the Born in Bradford cohort study. Linear regression was used to assess ethnic differences in total body fat percent and total and regional FM. Results: Although the mean BMI was similar, compared to white children, the proportion of SA children who were overweight or obese was ~20% higher, they had a median of 2kg more total FM, and the proportion with > 35% total body fat (TBF) was 22% and 16% higher in boys and girls respectively. Mean TBF% was greater in each BMI category, as was truncal, android and gynoid FM, with the greatest differences between ethnic groups observed in the healthy and overweight categories. Conclusions: Greater TBF% and total and regional FM in the healthy- and overweight BMI categories observed in SA children suggests they may be at greater risk of future cardiometabolic disease at a BMI level below obesity threshold. However, our sample size was small, and results may be influenced by selection bias and confounding; our findings need to be replicated in a larger study.
Highlights
Greater adiposity has been shown to increase the risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in adults[1,2,3] and children[4,5,6,7,8]
We have demonstrated some evidence of ethnic differences in the distribution and amount of directly measured total and regional adiposity, and their relationship with established categories of body mass index (BMI)
A previous study of the Born in Bradford (BiB) cohort at 4–5 years found that triceps skinfolds – an indicator of peripheral fat – was lower in South Asian (SA) boys and girls compared to white children[27]; this contrasts with the higher arm and leg fat mass (FM) observed in SA boys in the present study, which may indicate that in addition to greater central adiposity, SA boys may be susceptible to increased peripheral adiposity as they grow
Summary
Greater adiposity has been shown to increase the risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in adults[1,2,3] and children[4,5,6,7,8]. Risk of cardiometabolic disease is greater among those of South Asian (SA) heritage, who for a given body mass index (BMI) have greater total and central adiposity and are more likely to be insulin resistant and have CVD risk factors compared to White European adults[9,10,11] and children[12,13,14,15] It is visceral fat mass (FM), which is located in the trunk, rather than subcutaneous FM, that has been consistently associated with a higher risk of cardiometabolic disease independently of total FM16. Our sample size was small, and version 2 (revision)
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