Open Access Research article

Intra-abdominal fat is related to metabolic syndrome and non-alcoholic fat liver disease in obese youth

Loreana Sanches Silveira1*, Paula Alves Monteiro2, Bárbara de Moura Mello Antunes2, Patrícia Monteiro Seraphim1, Rômulo Araújo Fernandes3, Diego G Destro Christofaro3 and Ismael F Freitas Júnior3

Author Affiliations

1 Department of Physiotherapy, UNESP, 421 Garcia Paes St. Jardim Paulista, 19023-060 Presidente Prudente, SP, Brazil

2 Department of Physical Education, UNESP, Rio Claro, SP, Brazil

3 Department of Physical Education, UNESP, Presidente Prudente, SP, Brazil

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BMC Pediatrics 2013, 13:115  doi:10.1186/1471-2431-13-115

Published: 7 August 2013



Previous studies have shown an association between adiposity, especially intra-abdominal adipose tissue, and hemodynamic/metabolic comorbidities in adults, however it is not clear in pediatric population. The aim of the study was to analyze the relationship between non-alcoholic fatty liver disease (NAFLD) and components of metabolic syndrome (MS) with values of intra-abdominal (IAAT) and subcutaneous (SCAT) adipose tissue in obese children and adolescents.


Cross-sectional study. Subjects: 182 obese sedentary children and adolescents (aged 6 to 16 y), identified by the body mass index (BMI). Measurements: Body composition and trunk fat by dual-energy X-ray absorptiometry- DXA; lipid profile, blood pressure and pubertal stage were also assessed. NAFLD was classified as absent (0), mild (1), moderate (2) and severe (3), and intra-abdominal and subcutaneous abdominal fat thickness were identified by ultrasound. The MS was identified according to the cut offs proposed by World Health Organization adapted for children and adolescents. The chi-square test was used to compare categorical variables, and the binary logistic regression indicated the magnitude of the associations adjusted by potential cofounders (sex, age, maturation, NAFLD and HOMA-IR).


Higher quartile of SCAT was associated with elevated blood pressure (p = 0.015), but not associated with NAFLD (p = 0.665). Higher IAAT was positively associated with increased dyslipidemia (p = 0.001), MS (p = 0.013) and NAFLD (p = 0.005). Intermediate (p = 0.007) and highest (p = 0.001) quartile of IAAT were also associated with dyslipidemia, independently of age, sex, maturation, NAFLD and HOMA-IR (homeostatic model assessment-insulin resistance).


Obese children and adolescents, with higher IAAT are more prone to develop MS and NAFLD than those with higher values of SCAT, independent of possible confounding variables.

Obesity; Children; Adolescents; Metabolic syndrome; Non-alcoholic fatty liver disease; Trunk fat