Cross-sectional and longitudinal relationships between abdominal fat depots and cardiometabolic risk in a sample of Mexican adolescents

Authors: ORTÍZ-HERNÁNDEZ, LUIS - Autonomous University Of Mexico City; SOLTERO, ERICA - Children'S Nutrition Research Center (CNRC); CAMEJO, MIGUEL - Children'S Nutrition Research Center (CNRC); VALDES, JESUS - Non ARS Employee

Submitted to: Medical Bulletin of the Children's Hospital of Mexico
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/1/2025
Publication Date: 2/20/2026
Citation: Ortíz-Hernández, L., Soltero, E.G., Camejo, M., Valdes, J. 2026. Cross-sectional and longitudinal relationships between abdominal fat depots and cardiometabolic risk in a sample of Mexican adolescents. Medical Bulletin of the Children's Hospital of Mexico. 83(1):21-31. https://doi.org/10.24875/BMHIM.25000061.
DOI: https://doi.org/10.24875/BMHIM.25000061

Interpretive Summary: While obesity in youth is widely recognized as a risk factor for cardiometabolic disease, less is known about the independent roles of different fat depots like subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT), particularly in adolescent populations in low- and middle-income countries. Most prior studies investigating abdominal fat distribution and cardiometabolic outcomes in youth have been cross-sectional and have relied on indirect measures of body composition such as body mass index or waist circumference, which are less accurate. This study advances the field by using magnetic resonance imaging (MRI) to directly measure abdominal fat depots and examining both cross-sectional and longitudinal relationships with cardiometabolic risk factors among Mexican adolescents. Participants included 169 Mexican adolescents at baseline, with 134 completing a one-year follow-up assessment. Anthropometric measurements, blood pressure, and fasting blood samples were collected to assess multiple cardiometabolic risk indicators, including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, glucose, and insulin. The use of MRI allowed for precise measurement of both SAT and VAT at multiple anatomical locations. Multilevel linear regression models revealed that higher levels of SAT were positively associated with several cardiometabolic risk indicators among boys, including glucose, insulin, total cholesterol, triglycerides, and both systolic and diastolic blood pressure. SAT was also negatively associated with HDL-C, suggesting an unfavorable lipid profile. Among girls, SAT was positively associated with diastolic blood pressure. VAT also demonstrated significant cross-sectional associations with metabolic risk markers, particularly among boys, where VAT was positively associated with glucose, insulin, and blood pressure. Longitudinal analyses revealed that visceral adiposity may play a particularly important role in the development of cardiometabolic risk during adolescence. Specifically, VAT measured at the L1–L2 vertebral level predicted increases in several cardiometabolic risk indicators at follow-up among boys, including insulin, total cholesterol, LDL cholesterol, and diastolic blood pressure. These findings suggest that increases in visceral fat during adolescence may contribute to early metabolic dysregulation and may represent a key target for early prevention strategies. These findings underscore the potential value of targeting visceral adiposity in prevention and intervention strategies aimed at reducing cardiometabolic disease risk and preventing disease across the lifespan.

Technical Abstract: The relationship between abdominal fat depots and cardiometabolic risk among youth is inconclusive due to the cross-sectional nature of existing studies and limitations in assessment methods. In this study, we examined cross-sectional and longitudinal associations of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) with cardiometabolic risk indicators among Mexican adolescents. Participants (n=169 at baseline and 134 at follow-up) were assessed for diastolic or systolic blood pressure (DBP or SBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, glucose, and insulin. VAT and SAT were measured using magnetic resonance imaging. Measures were repeated at 1-year follow-up. Using multilevel linear regression models, the associations among fat depots and cardiometabolic risk indicators were examined. At baseline, SAT measures were cross-sectional and positively associated with glucose, insulin, TC, triglycerides, SBP, and BDP in boys, and DBP in girls, but negatively with HDL-C. VAT measures were cross-sectional and positively associated with glucose, insulin, and SBP and DBP in boys. VAT at L1-L2 was longitudinal and positively associated with insulin, TC, LDL-C, and DBP in boys. Higher levels of SAT and increases in VAT during adolescence may be particularly detrimental to cardiometabolic health, contributing to an increased risk of future diseases. Future intervention and treatment strategies should target VAT to reduce disease risk in this population.