Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Threshold values of visceral fat measures and their anthropometric alternatives for metabolic derangement in Japanese obese boys

Abstract

OBJECTIVE: To determine whether the direct measure of visceral adipose tissue (VAT) by computed tomography (CT) is a superior diagnostic criterion to the anthropometric surrogates and more classical criteria of obesity.

DESIGN: Cross-sectional, clinical study. Obese boys were classified according to the occurrence of abnormal values in either serum triglyceride, alanine aminotransferase or insulin level. A threshold value of each criterion for such metabolic derangement was calculated, using the analysis of receiver operating characteristic (ROC) curve.

SUBJECTS: Seventy-five consecutive outpatient Japanese obese boys, ranging in age from 6 to 14 y, were studied.

MEASUREMENTS: Anthropometric indices measured were height, body weight, waist girth, hip girth, triceps and subscapular skinfold thicknesses. Classical criteria for obesity used were percentage overweight (POW), body mass index (BMI) and percentage body fat. Waist girth, sagittal diameter by CT and waist–hip ratio (WHR) were evaluated as anthropometric surrogates for VAT. The areas of total abdominal fat (TAF), VAT and subcutaneous adipose tissue (SAT) were measured by CT at the level of the umbilicus. Clinical blood biochemistry was analyzed in fasting blood samples of obese boys.

RESULTS: Thirty-three boys were classified into a no-complication group, and 42 into a complication group. TAF, VAT and SAT areas were closely associated with age, body size and degree of overweight and adiposity, while VAT/SAT was not. VAT area, sagittal diameter, TAF area and waist girth were closely correlated with alanine aminotransferase, insulin, TG and HDL-C. VAT/SAT, BMI, SAT area, WHR, percentage body fat and POW were less closely associated with these biochemical indices. The descending order of the values of area under the curve for the ROC curves were as follows: VAT>sagittal diameter>TAF>VAT/SAT>waist girth>BMI>WHR>percentage body fat>POW. Both VAT area and VAT/SAT gave >80% of sensitivity and specificity. Among the anthropometric indices studied, the sagittal diameter was the best surrogate of visceral fat measure. The sensitivity and specificity for the rest of the anthropometric indices were in an unsatisfactory range. The threshold values for VAT area, VAT/SAT and sagittal diameter were 58.0 cm2, 0.276 and 19.2 cm, respectively.

CONCLUSION: The threshold values for VAT area, VAT/SAT and sagittal diameter for detecting biochemical complication in Japanese obese boys were lower than the respective values reported in adults. These values can be used for classifying the obese boys into two types: those with medical problem and those without.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Ronnemaa T, Koskenvuo M, Marniemi J, Koivunen T, Sajantila A, Rissanen A, Kaitsaari M, Bouchard C, Kaprio J . Glucose metabolism in identical twins discordant for obesity. The critical role of visceral fat. J Clin Endocrinol Metab 1997 82: 383–387.

    CAS  PubMed  Google Scholar 

  2. Sjostrom CD, Lissner L, Sjostrom L . Relationships between changes in body composition and changes in cardiovascular risk factors: the SOS Intervention Study Obes Res 1997 5: 519–530.

    Article  CAS  Google Scholar 

  3. Despres JP . The insulin resistance–dyslipidemic syndrome of visceral obesity: effect on patients' risk Obes Res 1998 6(Suppl 1): 8S–17S.

    Article  Google Scholar 

  4. Berenson GS, Srinivasan SR, Bao W, Newman WP III, Tracy RE, Wattigney WA . Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults New Engl J Med 1998 338: 1650–1656.

    Article  CAS  Google Scholar 

  5. Asayama K, Hayashibe H, Dobashi K, Uchida N, Kawada Y, Nakazawa S . Relationships between biochemical abnormalities and anthropometric indices of overweight, adiposity and body fat distribution in Japanese elementary school children Int J Obes Relat Metab Disord 1995 19: 253–259.

    CAS  PubMed  Google Scholar 

  6. Asayama K, Hayashi K, Hayashibe H, Uchida N, Nakane T, Kodera K, Nakazawa S . Relationships between an index of body fat distribution based on waist and hip circumferences and stature and biochemical complications in obese children Int J Obes Relat Metab Disord 1998 22: 1209–1216.

    Article  CAS  Google Scholar 

  7. Brambilla P, Manzoni P, Sironi S, Del Maschio A, di Natale B, Chiumello G . Peripheral and abdominal adiposity in childhood obesity Int J Obes Relat Metab Disord 1994 18: 795–800.

    CAS  PubMed  Google Scholar 

  8. Goran MI, Kashkoun, Shuman WP . Intra-abdominal adipose tissue in young children Int J Obes Relat Metab Disord 1995 19: 279–283.

    CAS  PubMed  Google Scholar 

  9. Goran MI, Nagy TR, Treuth MS, Trowbridge C, Dezenberg C, McGloin A, Gower BA . Visceral fat in white and African American prepubertal children Am J Clin Nutr 1997 65: 1703–1708.

    Article  CAS  Google Scholar 

  10. Owens S, Gutin B, Ferguson M, Allison J, Karp W, Le NA . Visceral adipose tissue and cardiovascular risk factors in obese children J Pediatr 1998 133: 41–45.

    Article  CAS  Google Scholar 

  11. Caprio S, Hyman LD, Limb C, McCarthy S, Lange R, Sherwin RS, Shulman G, Tamborlane WV . Central adiposity and its metabolic correlates in obese adolescent girls Am J Physiol 1995 269: E118–126.

    Article  CAS  Google Scholar 

  12. Caprio S, Hyman LD, McCarthy S, Lange R, Bronson M, Tamborlane WV . Fat distribution and cardiovascular risk factors in obese adolescent girls: importance of the intraabdominal fat depot Am J Clin Nutr 1996 64: 12–17.

    Article  CAS  Google Scholar 

  13. Gower BA, Nagy TR, Goran MI . Visceral fat, insulin sensitivity, and lipids in prepubertal children Diabetes 1999 48: 1515–1521.

    Article  CAS  Google Scholar 

  14. Matsuura F, Yamashita S, Nakamura T, Nishida M, Nozaki S, Funahashi T, Matsuzawa Y . Effect of visceral fat accumulation on uric acid metabolism in male obese subjects Metabolism 1998 47: 929–933.

    Article  CAS  Google Scholar 

  15. Lemieux S, Prud'homme D, Bouchard C, Tremblay A, Despres JP . A single threshold value of waist girth identifies normal-weight and overweight subjects with excess visceral adipose tissue Am J Clin Nutr 1996 64: 685–693.

    Article  CAS  Google Scholar 

  16. Ross R, Rissanen J, Hudson R . Sensitivity associated with the identification of visceral adipose tissue levels using waist circumference in men and women: effects of weight loss Int J Obes Relat Metab Disord 1996 20: 533–538.

    CAS  PubMed  Google Scholar 

  17. Zamboni M, Turcato E, Armellini F, Kahn HS, Zivelonghi A, Santana H, Bergamo-Andreis IA, Bosello O . Sagittal abdominal diameter as a practical predictor of visceral fat Int J Obes Relat Metab Disord 1998 22: 655–660.

    Article  CAS  Google Scholar 

  18. Barnes VA, Treiber FA, Davis H, Kelly TR, Strong WB . Central adiposity and hemodynamic functioning at rest and during stress in adolescents Int J Obes Relat Metab Disord 1998 22: 1079–1083.

    Article  CAS  Google Scholar 

  19. Megnien JL, Denarie N, Cocaul M, Simon A, Levenson J . Predictive value of waist-to-hip ratio on cardiovascular risk events Int J Obes Relat Metab Disord 1999 23: 90–97.

    Article  CAS  Google Scholar 

  20. Egusa G, Murakami F, Ito C, Matsumoto Y, Kado S, Okamura M, Mori H, Yamane K, Hara H, Yamakido M . Westernized food habits and concentrations of serum lipids in the Japanese Atherosclerosis 1993 100: 249–255.

    Article  CAS  Google Scholar 

  21. Brozek J, Grande J, Anderson T, Keys A . Densitometric analysis of body composition: revision of some quantitative assumptions Ann NY Acad Sci 1963 110: 113–140.

    Article  CAS  Google Scholar 

  22. Nagamine S, Suzuki S . Anthropometry and body composition of Japanese young men and women Hum Biol 1964 36: 8–15.

    CAS  PubMed  Google Scholar 

  23. Tokunaga K, Matsuzawa Y, Ishikawa K, Tarui S . A novel technique for the determination of body fat by computed tomography Int J Obes Relat Metab Disord 1983 7: 437–445.

    CAS  Google Scholar 

  24. Friedewald WT, Levy RI, Fredrickson DS . Estimation of the concentration of low density lipoprotein cholesterol without use of the preparative ultracentrifuge Clin Chem 1972 18: 499.

    CAS  Google Scholar 

  25. Hayashibe H, Asayama K, Nakane T, Uchida N, Kawada Y, Nakazawa S . Increased plasma cholesteryl ester transfer activity in obese children Atherosclerosis 1997 129: 53–58.

    Article  CAS  Google Scholar 

  26. Lemieux S, Prud'homme D, Tremblay A, Bouchard C, Despres JP . Anthropometric correlates to changes in visceral adipose tissue over 7 y in women Int J Obes Relat Metab Disord 1996 20: 618–624.

    CAS  PubMed  Google Scholar 

  27. Weidner MD, Gavigan KE, Tyndall GL, Hickey MS, McCammon MR, Houmard JA . Which anthropometric indices of regional adiposity are related to the insulin resistance of aging? Int J Obes Relat Metab Disord 1995 19: 325–330.

    CAS  PubMed  Google Scholar 

  28. Ross R, Fortier L, Hudson R . Separate associations between visceral and subcutaneous adipose tissue distribution, insulin and glucose levels in obese women Diabetes Care 1996 19: 1404–1411.

    Article  CAS  Google Scholar 

  29. Owens S, Litaker M, Allison J, Riggs S, Ferguson M, Gutin B . Prediction of visceral adipose tissue from simple anthropometric measurements in youths with obesity Obes Res 1999 7: 16–22.

    Article  CAS  Google Scholar 

  30. Goran MI, Gower BA, Treuth M, Nagy TR . Prediction of intra-abdominal and subcutaneous abdominal adipose tissue in healthy pre-pubertal children Int J Obes Relat Metab Disord 1998 22: 549–558.

    Article  CAS  Google Scholar 

  31. Williams MJ, Hunter GR, Kekes-Szabo T, Trueth MS, Snyder S, Berland L, Blaudeau T . Intra-abdominal adipose tissue cut-points related to elevated cardiovascular risk in women Int J Obes Relat Metab Disord 1996 20: 613–617.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work is supported in part by Health Science Research Grants (Research on Children and Families) from Ministry of Health, Labor and Welfare, Japan, and Grant from Tanita Health and Body Weight Fund.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to K Asayama.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Asayama, K., Dobashi, K., Hayashibe, H. et al. Threshold values of visceral fat measures and their anthropometric alternatives for metabolic derangement in Japanese obese boys. Int J Obes 26, 208–213 (2002). https://doi.org/10.1038/sj.ijo.0801865

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0801865

Keywords

This article is cited by

Search

Quick links