Submitted to: Pediatric Diabetes
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/3/2022
Publication Date: 1/10/2022
Citation: Pimental, J.L., Vander Wyst, K.B., Soltero, E.G., Pena, A., Hu, H.H., Bailey, S., Pokorney, A., Ayers, S., Valenicia, A.M., Olson, M.L., Shaibi, G.Q. 2022. Organ fat in Latino youth at risk for type 2 diabetes. Pediatric Diabetes. https://doi.org/10.1111/pedi.13311.
DOI: https://doi.org/10.1111/pedi.13311

Interpretive Summary: High levels of body and organ fat has shown to increase the risk for type 2 diabetes in adults and children. However, it is not clear which fat depots in the body contribute the most to the development of diabetes in high-risk Hispanic youth. The purpose this study was to examine relationships among measures of body fat including total body fat, visceral or abdominal fat, and organ fat, specifically liver and pancreatic fat, and diabetes risk in Hispanic adolescents (14-16 years) with obesity. Using a DXA scan and magnetic resonance imaging, we found that total body fat was associated with visceral and liver fat. We also found that high levels of visceral fat were associated with high levels of fat in the liver and pancreas. Liver and pancreatic fat were significant predictors of fasting glucose indicating that youth with high levels of organ fat were at a higher risk for type 2 diabetes. Additionally, liver fat significantly predicted 2-hour glucose levels further indicating that high levels of liver fat is a driver of diabetes risk. These findings suggest that while there are many factors such as environment and genetics that contribute to type 2 diabetes, organ fat also plays a small and important role in the development of diabetes. Given that Hispanic youth are at a high risk for type 2 diabetes, our findings point to a need for intervention strategies that can effectively reduce organ fat in order to reduce the overall risk for type 2 diabetes. While this work demonstrated that organ fat is related to diabetes risk, further research is needed to fully understand the role that organ fat plays in the development of diabetes.

Technical Abstract: Obesity in youth increases the risk for type 2 diabetes (T2D) and elevated abdominal adipose tissue and organ fat may be particularly deleterious. The purpose of this study was to examine associations among measures of adiposity including total, visceral, and organ fat (hepatic and pancreatic) and whether these measures were independently associated with glycemia in Latino youth at risk for diabetes. Latino adolescents (47 boys and 32 girls, 13.7+/-1.4 years) with obesity (BMIz 2.3+/-0.3) were assessed for total fat by DXA and visceral and organ fat by 3 Tesla magnetic resonance imaging. Glycemic indicators included HbA1c, fasting glucose (FG), and 2-hour glucose (2-HrG) following an oral glucose tolerance test. Pearson correlations and stepwise linear regression analyses controlling for age and sex were used to examine independent associations between adiposity and glycemia. Total fat was associated with visceral (r=0.66, p=0.001) and hepatic fat (r=0.34, p<0.01) while visceral fat was associated with hepatic (r=0.42, p<0.001) and pancreatic fat (r=0.36, p<0.001). In stepwise linear regression analysis, hepatic and pancreatic fat were significant predictors of FG, explaining 4.7% and 5.2% of the variance, respectively (total R2 =0.14, p=0.02). Hepatic fat was the only significant predictor of 2-HrG explaining 9.9% of the variance in the model (total R2 =0.12, p=0.03). No measure of adiposity was retained as a significant predictor of HbA1c. Hepatic and pancreatic fat were the only adiposity measures independently associated with glycemia but the small amount of variance explained underscores the need for additional T2D biomarkers in high risk youth.