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Updated: Nov 19, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Cardiometabolic Profile of Different Body Composition Phenotypes in Children
Yi Ying Ong1, Jonathan Y Huang2, Navin Michael2
1Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Insights
Higher lean mass may protect against cardiometabolic risks associated with high fat mass in children, particularly girls. Fat mass index appears more influential than lean mass index in young children's cardiometabolic health.
Area of Science:
- Pediatric Endocrinology
- Body Composition Analysis
- Metabolic Health
Background:
- Cardiometabolic health in children is influenced by body composition, with high adiposity being a known risk factor.
- The specific role of lean mass in modulating cardiometabolic risk in conjunction with fat mass in early childhood remains unclear.
Purpose of the Study:
- To investigate the hypothesis that greater lean mass can mitigate cardiometabolic risks in children with elevated fat mass.
- To characterize cardiometabolic profiles across different body composition phenotypes in 6-year-old children.
Main Methods:
- Quantitative magnetic resonance was used to measure whole-body composition in 377 children from the GUSTO cohort.
- Four body composition phenotypes were defined based on fat mass index (FMI) and lean mass index (LMI): LF-LL, LF-HL, HF-LL, and HF-HL.
Main Results:
- Children with high FMI (HF-HL, HF-LL) exhibited higher BMI z-scores and metabolic syndrome risk scores compared to those with low FMI and high LMI (LF-HL).
- The high FMI-high LMI (HF-HL) group showed increased fatty liver index.
- In girls, the HF-HL group had lower fasting glucose and diastolic blood pressure than the HF-LL group; these associations were not observed in boys.
Conclusions:
- Lean mass may offer some protection against adiposity-related cardiometabolic risk markers, but this effect was primarily observed in girls within this Asian cohort.
- Fat mass index appears to be a more significant determinant of cardiometabolic profiles in young children than lean mass index.
Context:
Cardiometabolic profiles of different body composition phenotypes are poorly characterized in young children, where it is well established that high adiposity is unfavorable, but the role of lean mass is unclear.
Objective:
We hypothesized that higher lean mass attenuates cardiometabolic risk in children with high fat mass.
Methods:
In 6-year-old children (n = 377) from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) prospective birth cohort, whole-body composition was measured by quantitative magnetic resonance, a novel validated technology. Based on fat mass index (FMI) and lean mass index (LMI), 4 body composition phenotypes were derived: low FMI-low LMI (LF-LL), low FMI-high LMI (LF-HL), high FMI-low LMI (HF-LL), high FMI-high LMI (HF-HL).
Main Outcome Measures:
Body mass index (BMI) z-score, fasting plasma glucose, insulin resistance, metabolic syndrome risk score, fatty liver index, and blood pressure.
Results:
Compared with the LF-HL group, children in both high FMI groups had increased BMI z-score (HF-HL: 1.43 units 95% CI [1.11,1.76]; HF-LL: 0.61 units [0.25,0.96]) and metabolic syndrome risk score (HF-HL: 1.64 [0.77,2.50]; HF-LL: 1.28 [0.34,2.21]). The HF-HL group also had increased fatty liver index (1.15 [0.54,1.77]). Girls in HF-HL group had lower fasting plasma glucose (-0.29 mmol/L [-0.55,-0.04]) and diastolic blood pressure (-3.22 mmHg [-6.03,-0.41]) than girls in the HF-LL group. No similar associations were observed in boys.
Conclusion:
In a multi-ethnic Asian cohort, lean mass seemed to protect against some cardiometabolic risk markers linked with adiposity, but only in girls. The FMI seemed more important than lean mass index in relation to cardiometabolic profiles of young children.
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