Abstract
(1) Background. Visceral adiposity index (VAI) has been recently identified as a new cardiometabolic risk marker reflecting abdominal fat distribution and dyslipidaemia. The aim of the present paper was to evaluate the relationship between VAI, daily energy intake and metabolic syndrome (MetS) in a cohort of obese Caucasian children and adolescents, aged 8 to 15 years. (2) Methods. Consecutive Italian children and adolescents with obesity, according to World Health Organization were enrolled. Anthropometric parameters and blood pressure were measured. Fasting blood samples have been analyzed for lipids, insulin and glucose levels. MetS was diagnosed using identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) or International Diabetes Federation (IDF) criteria according to age. Homeostatic model assessment index (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), A body shape index (ABSI) and VAI were calculated. Multivariable logistic regression analyses with sex, age and each anthropometric parameter (body mass index (BMI) z-score, ABSI, waist-to-height ratio (WHR)) or VAI was performed to predict MetS. Receiver operation curve (ROC) analysis was used to define the optimal VAI cut-off to identify MetS. Multiple regression was performed to predict the BMI z-score and VAI from daily energy intake after adjusting for age and sex. (3) Results. Six hundred and thirty-seven (313 boys and 324 girls) children and adolescents with obesity with median age 11 (interquartile range 10–13) years were included in the analysis. MetS was diagnosed in 79 patients. VAI correlated with BMI, WHR, ABSI, HOMA-IR, QUICKI, systolic blood pressure, low- and high-density lipoprotein cholesterol, triglycerides and triglycerides-to-HDL ratio (p < 0.050). Optimal VAI cut-off (AUC) values to identify MetS were 1.775 (0.774), 1.685 (0.776) and 1.875 (0.797) in the whole population, boys and girls, respectively. Energy intake was positively associated with BMI z-score but no association was found with VAI. (4) Conclusion. VAI is a promising tool to identify MetS in children and adolescents with obesity and should be used in the management of abdominal obesity together with dietary assessment.
Highlights
In terms of prevalence and economic significance [1,2] pediatric obesity is considered one of the most important public health problems of the 21st century [3]
Prevalence in the whole cohort and in prespecified subpopulations according to sex, age, Body mass index (BMI) z-score and presence of metabolic syndrome (MetS) are shown in Tables 1 and 2 and Supplementary Table S1
MetS was diagnosed in 79 patients (12.4%); MetS patients were significantly younger and shorter, had higher, homeostatic model assessment for insulin resistance (HOMA-IR), HOMA of percent β-cell function (HOMA-β), TyG index, total cholesterol (TC), TG, low-density lipoprotein cholesterol (LDL-C), triglyceridesto-HDL ratio, Visceral adiposity index (VAI) and Systolic blood pressure (SBP), and a lower BMI, Waist circumference (WC), HDL-C and quantitative insulin sensitivity check index (QUICKI) (p < 0.050)
Summary
In terms of prevalence and economic significance [1,2] pediatric obesity is considered one of the most important public health problems of the 21st century [3] Both during childhood and adolescence, children with obesity can often present glucose metabolism disorders such as insulin resistance, dyslipidemia or hypertension, all classic signs of the metabolic syndrome (MetS) [4,5]. Most of these metabolic disorders are driven by excess central (intra-abdominal) body fat distribution [6]. The use of age- and sex-adjusted BMI z-score has been recommended in pediatric age instead of BMI alone; the association between cardio metabolic-risk and pediatric BMI z-score is not linear [13]
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