Exploring Visceral Fat as a Screening Marker for Cardiometabolic Risk in Children and Adolescents

Area of Science:

• Pediatrics
• Cardiology
• Metabolic Health

Background:

• Cardiometabolic risk (CMR) is a growing concern in children and adolescents.
• Visceral fat area (VFA) is a key indicator of CMR, but standardized screening cutoffs are lacking.
• Accurate identification of CMR is crucial for timely intervention and prevention of long-term health consequences.

Purpose of the Study:

• To establish and validate age- and sex-specific visceral fat area (VFA) cutoff values for identifying cardiometabolic risk (CMR) in pediatric populations.
• To evaluate the predictive performance of these VFA cutoffs for key CMR indicators.
• To assess the longitudinal risk of CMR associated with elevated VFA levels.

Main Methods:

• A cross-sectional study derived age- and sex-specific VFA cutoffs from 8133 participants.
• A longitudinal cohort of 10,805 individuals validated the derived VFA cutoffs.
• Logistic regression and ROC curve analysis were used to assess predictive performance and relative risk (RR) of CMR.

Main Results:

• The 75th percentile of VFA was optimal for screening hypertension, hyperglycemia, dyslipidemia, and CMR clustering in boys and girls (except hyperglycemia in girls, where the 80th percentile was optimal).
• Longitudinal validation confirmed significantly higher CMR risk in individuals exceeding VFA cutoffs (RR 1.33-3.89 for boys, 1.63-3.16 for girls).
• Normal-weight boys with high VFA showed increased CMR risk, highlighting VFA's importance beyond BMI.

Conclusions:

• Established age- and sex-specific VFA cutoffs are effective tools for screening CMR in Chinese children and adolescents.
• These VFA cutoffs facilitate early identification and intervention for cardiometabolic abnormalities.
• The findings underscore the utility of VFA measurement in pediatric risk assessment, irrespective of overall weight status.