Yi Ying Ong1, Jonathan Y Huang2, Navin Michael2, Suresh Anand Sadananthan2, Wen Lun Yuan1, Ling-Wei Chen2, Neerja Karnani2, S Sendhil Velan2,3, Marielle V Fortier2,4, Kok Hian Tan5,6, Peter D Gluckman2,7, Fabian Yap5,8, Yap-Seng Chong2,9, Keith M Godfrey10, Mary F-F Chong2,11, Shiao-Yng Chan2,9, Yung Seng Lee1,2,12, Mya-Thway Tint2,9,13, Johan G Eriksson2,9,14,13. 1. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 2. Singapore Institute for Clinical Sciences, Agency for Sciences, Technology, and Research, Singapore, Singapore. 3. Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore. 4. Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore. 5. Duke-NUS Medical School, Singapore, Singapore. 6. Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore. 7. Liggins Institute, University of Auckland, Auckland, New Zealand. 8. Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore. 9. Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 10. MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. 11. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. 12. Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore. 13. Folkhälsan Research Center, Helsinki, Finland. 14. Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Abstract
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.
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.
Authors: Rafael T Mikolajczyk; Jun Zhang; Ana Pilar Betran; João Paulo Souza; Rintaro Mori; A Metin Gülmezoglu; Mario Merialdi Journal: Lancet Date: 2011-05-28 Impact factor: 79.321
Authors: Ahila Ayyavoo; José G B Derraik; Paul L Hofman; Janene Biggs; Wayne S Cutfield Journal: Clin Endocrinol (Oxf) Date: 2014-03-13 Impact factor: 3.478
Authors: David E Brumbaugh; Tessa L Crume; Kristen Nadeau; Ann Scherzinger; Dana Dabelea Journal: J Clin Endocrinol Metab Date: 2012-04-16 Impact factor: 5.958
Authors: Ellen W Demerath; Christine M Schubert; L Michele Maynard; Shumei S Sun; W Cameron Chumlea; Arthur Pickoff; Stefan A Czerwinski; Bradford Towne; Roger M Siervogel Journal: Pediatrics Date: 2006-03 Impact factor: 7.124
Authors: L-W Chen; M-T Tint; M V Fortier; I M Aris; L P-C Shek; K H Tan; V S Rajadurai; P D Gluckman; Y-S Chong; K M Godfrey; M S Kramer; C J Henry; F Yap; Y S Lee Journal: Pediatr Obes Date: 2017-10-12 Impact factor: 4.000
Authors: Aaron Misakian; Michelle McLoughlin; Louisa C Pyle; Thomas F Kolon; Andrea Kelly; Maria G Vogiatzi Journal: Front Endocrinol (Lausanne) Date: 2021-08-30 Impact factor: 5.555