title: Reference values and early determinants of intra-abdominal fat mass in primary school children.
abstract: BACKGROUND
  Intra-abdominal fat (IAF) is a valuable predictor of cardiovascular morbidity. However, neither reference values nor determinants are known in children.
  
  
  METHODS
  IAF was assessed as sonographically measured intra-abdominal depth in 1,046 children [median age 7.6 years, interquartile range (IQR) 7.2-7.9; 54% boys] of the URMEL-ICE study.
  
  
  RESULTS
  The intraclass correlation coefficient for intraobserver agreement was 0.93. The median IAF showed a significant gender difference (boys: 54.6 mm, IQR 50.1-59.3, vs. girls: 51.7 mm, IQR 46.3-56.4; p < 0.001). Age- and gender-specific centiles were generated. IAF showed a positive correlation to systolic blood pressure [regression coefficient (β) = 0.24 mm Hg/mm; p < 0.001] and a negative correlation to HDL cholesterol (β = -0.01 mmol/l/mm; p < 0.001). IAF showed a positive association with increased paternal and maternal BMI (β = 0.28 mm/kg/m(2) and 0.27 mm/kg/m(2); p < 0.001), increased weight gain in the first 2 years of life (β = 3.04 mm; p < 0.001), and maternal smoking during pregnancy (β = 2.4 mm; p = 0.001). Increased parental education was negatively associated with IAF (maternal: β = -0.65 mm/degree; p = 0.004, and paternal: β = -0.61 mm/degree; p = 0.002).
  
  
  CONCLUSIONS
  Sonography was a reliable tool to estimate IAF. Factors influencing IAF included rapid infant weight gain, smoking during pregnancy, and parental BMI and education. Since IAF showed an association with cardiovascular risk factors even in prepubertal children, it might become a valuable predictor of cardiovascular vulnerability.
authors.affiliation: Divisions of Paediatric Endocrinology and Diabetes, Ulm University, Ulm, Germany.
authors.forename: J
authors.initials: J
authors.lastname: von Schnurbein
authors.forename: J
authors.initials: J
authors.lastname: Klenk
authors.forename: C
authors.initials: C
authors.lastname: Galm
authors.forename: S
authors.initials: S
authors.lastname: Berg
authors.forename: P
authors.initials: P
authors.lastname: Gottmann
authors.forename: J M
authors.initials: JM
authors.lastname: Steinacker
authors.forename: W
authors.initials: W
authors.lastname: Kratzer
authors.forename: S
authors.initials: S
authors.lastname: Brandstetter
authors.forename: O
authors.initials: O
authors.lastname: Wartha
authors.forename: R
authors.initials: R
authors.lastname: Peter
authors.forename: S
authors.initials: S
authors.lastname: Weiland
authors.forename: M
authors.initials: M
authors.lastname: Wabitsch
mesh_terms: D001724:Birth Weight; D015992:Body Mass Index; D001942:Breast Feeding; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002648:Child; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008297:Male; D015999:Multivariate Analysis; D050177:Overweight / Q000453:epidemiology*; D012016:Reference Values; D012307:Risk Factors; D014463:Ultrasonography; D015430:Weight Gain