title: Anthropometric measures of visceral and subcutaneous fat are important in the determination of metabolic dysregulation in boys and girls at risk for nonalcoholic fatty liver disease.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is increasing at alarming rates in obese children. The study aim was to describe body composition/somatotype and its interrelationships to biomarkers of liver disease, insulin resistance, and lipid and cytokine expression in youth with NAFLD.
  
  
  METHODS
  Somatotype and body composition of children (7-18 years) diagnosed with NAFLD (n= 18) were compared with obese (n = 11) and lean children (n = 17). Anthropometric variables assessed included weight, height, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHTR), and multiple skinfold thicknesses. Fat mass (FM) and somatotype analysis were measured using validated methodologies. Fasting liver biochemistries (aspartate aminotransferase [AST], alanine aminotransferase [ALT], γ-glutamyltransferase [GGT]), insulin, glucose, leptin, C-reactive protein (CRP), tumor necrosis factor-α, interleukin (IL) factors 6/10, apolipoproteins B-100/B-48 and C-III, triglycerides, and high-density lipoprotein (HDL)/low-density lipoprotein (LDL) cholesterol were measured. Insulin resistance was assessed by the homeostasis model of insulin resistance (HOMA-IR).
  
  
  RESULTS
  BMI z score, WC, FM, and somatotype did not differ between NAFLD and obese groups; however, lean children were lighter/leaner across all anthropometric measures (P < .001). Children with NAFLD had a higher sum-of-trunk to sum-of-extremity ratio (1.6 ± 0.4) than did obese (1.3 ± 0.2) and lean (1.1 ± 0.5) children (P < .001). Markers of central visceral (WC/WHTR) and subcutaneous fat (subscapular, abdominal, suprailiac skinfolds) were associated with elevated plasma concentrations of insulin, HOMA-IR, ALT, GGT, and AST and lower HDL cholesterol and IL-10 (P < .001).
  
  
  CONCLUSIONS
  Comprehensive assessment of body composition, including measurement of surrogate markers of subcutaneous and visceral fat, provides information regarding metabolic dysregulation and liver disease risk in obese children with NAFLD.
authors.affiliation: Department of Agriculture, Food and Nutritional Science, Department of Pediatrics,University of Alberta, 4-126 Li Ka Shing Centre for Research Innovation,Edmonton, AB T6G OK2, Canada. mager@ualberta.ca
authors.forename: Diana R
authors.initials: DR
authors.lastname: Mager
authors.forename: Jason
authors.initials: J
authors.lastname: Yap
authors.forename: Carla
authors.initials: C
authors.lastname: Rodriguez-Dimitrescu
authors.forename: Vera
authors.initials: V
authors.lastname: Mazurak
authors.forename: Geoff
authors.initials: G
authors.lastname: Ball
authors.forename: Susan
authors.initials: S
authors.lastname: Gilmour
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D000886:Anthropometry / Q000379:methods*; D001219:Aspartate Aminotransferases / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016753:Interleukin-10 / Q000097:blood; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D020738:Leptin / Q000097:blood; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D011446:Prospective Studies; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014463:Ultrasonography; D055105:Waist Circumference; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase