Association of Abdominal Skeletal Muscle Quantity and Quality with Cardiometabolic Risk Factors in Obese Children

Purpose or Learning Objective: Abdominal low skeletal muscle tissue (SMT) and intermuscular abdominal adipose tissue (IMAAT) are associated with cardiovascular diseases and diabetes risk in adults. Whether these relationships exist in children is unknown.

We evaluated the relationships of abdominal SMT and IMAAT measured by magnetic resonance imaging (MRI) with insulin resistance and metabolic syndrome in children with overweight or obesity (OW/OB) who are at elevated risk of developing diabetes and cardiovascular diseases.

Methods or Background: We conducted two cross-sectional studies on 114 children aged 10.6 ± 1.1 years (EFIGRO project, 2015), and 56 children aged 11.3 ± 1.5 years (MICROKID project, 2020) with OW/OB who underwent abdominal MRI examination (1.5 T), physical examination, and fasting blood sampling. We analyzed insulin, glucose, triglycerides (TG), and high-density lipoprotein cholesterol [CCS1] (HDL). We calculated Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), TG-to-HDL ratio, and the International Diabetes Federation metabolic syndrome z-score (MetSynd) [MM2].

MRI images were acquired with breath holding during expiration. Sagittal, coronal, and transverse abdominal localizers (from diaphragm to symphysis pubis) were used to determine the accurate location of each image with respect to the vertebral disks. The total abdominal area (TAA), SMT area (cm²), and IMAAT (%) were calculated at three axial slices (L2–L3, L3, and L4–L5), and the average was used for analyses. Then we calculated the SMT-to-TAA ratio.

Results or Findings: Higher abdominal skeletal muscle tissue seems to protect against diabetes and cardiovascular disease risk factors in children with OW/OB. In contrast, impaired abdominal muscle quality (myosteatosis) is already related to increased cardiometabolic risk in childhood.

Conclusion: Abdominal SMT and IMAAT may serve as cardiometabolic-imaging biomarkers and therapeutic targets to prevent diabetes and cardiovascular [MM1] diseases in children with OW/OB.

Publication History

Article published online:
26 May 2023