Effect of Android to Gynoid Fat Ratio on Insulin Resistance in Obese Youth

Background: Upper body fat distribution is associated with the early development of insulin resistance in obese children and adolescents. Objective: To determine if an android to gynoid fat ratio is associated with the severity of insulin resistance in obese children and adolescents, whereas peripheral subcutaneous fat may have a protective effect against insulin resistance. Setting: The pediatric department of University Hospital, Clermont-Ferrand, France. Design: A retrospective analysis using data from medical consultations between January 2005 and January 2007. Participants: Data from 66 obese children and adolescents coming to the hospital for medical consultation were used in this study. Main Outcome Measures: Subjects were stratified into tertiles of android to gynoid fat ratio determined by dual-energy x-ray absorptiometry. Insulin resistance was assessed by the homeostasis model of insulin resistance (HOMA-IR) index. Results: There were no differences in weight, body mass index, and body fat percentage between tertiles. Values of HOMA-IR were significantly increased in the 2 higher tertiles (mean [SD], tertile 2, 2.73 [1.41]; tertile 3, 2.89 [1.28]) compared with the lower tertile (tertile 1, 1.67 [1.24]) of android to gynoid fat ratio (P < .001). The HOMA-IR value was significantly associated with android to gynoid fat ratio (r = 0.35; P < .01). Conclusions: Android fat distribution is associated with an increased insulin resistance in obese children and adolescents. An android to gynoid fat ratio based on dual-energy x-ray absorptiometry measurements is a useful and simple technique to assess distribution of body fat associated with an increased risk of insulin resistance.