Adiposity Distribution and Cardiometabolic Risk in Children and Adolescents: Clinical Implications and Contributing Factors

Résumé

Childhood adiposity is a major driver of cardiometabolic risk; however, the relative contribution of fat distribution and ectopic fat remain an area of active research. The review presents evidence on childhood adiposity, focusing on adiposity distribution, its pathophysiological links to cardiometabolic risk, and its implications for clinical assessment. An extensive literature search across scientific databases, including Google Scholar, PubMed, and Web of Science, was conducted, focusing on childhood adiposity, cardiometabolic risk, and methods of assessing adiposity. The available literature shows that both central and ectopic fat in childhood were associated with early metabolic disorders such as dyslipidaemia, insulin resistance, and hypertension, as well as subclinical cardiovascular alterations, including arterial stiffness, endothelial dysfunction, and carotid intima-media thickening. These modifications serve as predictors of future cardiovascular disease risks. Body mass index (BMI) was reported as a commonly used tool for assessment, but it was not adequate on its own. Indicators of central adiposity (waist circumference and waist-to-height ratio), along with novel indices and metabolic profiling, were reported to be preferable to BMI. Obesity in childhood has several clinical implications for cardiometabolic risk factors, where early changes in metabolism and blood vessels can continue into adulthood. The inclusion of body fat distribution indices in clinical practice will aid in early diagnosis and preventive interventions.

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