肥満小児のインスリン抵抗性獲得における内臓脂肪の影響

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It is well known that abdominal visceral fat is closely related to insulin resistance inadult subjects. But few reports have evaluated the relationship between abdominal fat andinsulin resistance in obese children using MRI or CT scanning. The purpose of this studywas to investigate the sex difference in abdominal fat distribution（AFD）and insulinresistance in obese children. The subjects were 66 obese children（38 boys, and 28 girls）with a mean age of 10.9 years（7-17 years）and a mean relative weight（RW）of152.9%. Abdominal subcutaneous fat（ASF）and visceral fat（AVF）were measuredusing L4-L5 CT scanning. The 3-h（Pre, 30, 60, 120, and 180min）oral glucose tolerancetest（OGTT）was performed, and we regarded the insulin area-under-the-curve（AUC）as an index of insulin resistance. There was no significant difference in ASF between boysand girls（253.3 vs 268.0cm2），but AVF was significantly larger in boys than in girls（57.8 vs 43.7cm2: p < 0.05）．The insulin AUC was significantly greater in girls than inboys（10652.1 vs 6922.3uU min/ml: p < 0.001）．The simple correlation of both ASF andAVF with insulin AUC in both sexes was significant. After controlling for the totaladiposity（RW）by partial correlation, the relationship between AFD and insulin AUCdisappeared in girls, but remained in boys. These data suggest that total body fat, ratherthan abdominal fat, may be the primary determinant of insulin resistance in girls. On theother hand, in boys the abdominal fat depot, especially AVF, is associated with insulinresistance independent of total body fat level.
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肥満小児のインスリン抵抗性獲得における内臓脂肪の影響

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