{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T09:47:34Z","timestamp":1791020854668,"version":"4.1.0"},"reference-count":24,"publisher":"American Diabetes Association","issue":"2","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2008,2,1]]},"abstract":"<jats:p>OBJECTIVE\u2014 To explore whether an imbalance between the visceral and subcutaneous fat depots and a corresponding dysregulation of the adipokine milieu is associated with excessive accumulation of fat in the liver and muscle and ultimately with insulin resistance and the metabolic syndrome.<\/jats:p>\n                  <jats:p>RESEARCH DESIGN AND METHODS\u2014 We stratified our multi-ethnic cohort of 118 obese adolescents into tertiles based on the proportion of abdominal fat in the visceral depot. Abdominal and liver fat were measured by magnetic resonance imaging and muscle lipid (intramyocellular lipid) by proton magnetic resonance spectroscopy.<\/jats:p>\n                  <jats:p>RESULTS\u2014 There were no differences in age, BMI Z score, or fat-free mass across tertiles. However, as the proportion of visceral fat increased across tertiles, BMI and percentage of fat and subcutaneous fat decreased, while hepatic fat increased. In addition, there was an increase in 2-h glucose, insulin, c-peptide, triglyceride levels, and insulin resistance. Notably, both leptin and total adiponectin were significantly lower in tertile 3 than 1, while C-reactive protein and interleukin-6 were not different across tertiles. There was a significant increase in the odds ratio for the metabolic syndrome, with subjects in tertile 3 5.2 times more likely to have the metabolic syndrome than those in tertile 1.<\/jats:p>\n                  <jats:p>CONCLUSIONS\u2014 Obese adolescents with a high proportion of visceral fat and relatively low abdominal subcutaneous fat have a phenotype reminiscent of partial lipodystrophy. These adolescents are not necessarily the most severely obese, yet they suffer from severe metabolic complications and are at a high risk of having the metabolic syndrome.<\/jats:p>","DOI":"10.2337\/db07-0932","type":"journal-article","created":{"date-parts":[[2007,10,31]],"date-time":"2007-10-31T20:54:28Z","timestamp":1193864068000},"page":"367-371","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":292,"title":["High Visceral and Low Abdominal Subcutaneous Fat Stores in the Obese Adolescent"],"prefix":"10.2337","volume":"57","author":[{"given":"Sara E.","family":"Taksali","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Caprio","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Dziura","sequence":"additional","affiliation":[{"name":"Yale Clinical Research Center, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Dufour","sequence":"additional","affiliation":[{"name":"Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.G.","family":"Cali\u0301","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Robin","family":"Goodman","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xenophon","family":"Papademetris","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania S.","family":"Burgert","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget M.","family":"Pierpont","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Savoye","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisha A.","family":"Seyal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hadassah-Hebrew University Medical School, Jerusalem, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031207572705700_R1","doi-asserted-by":"crossref","unstructured":"Despres JP: Is visceral obesity the cause of the metabolic syndrome?Ann Med\u200838:52\u201363,2006","DOI":"10.1080\/07853890500383895"},{"key":"2022031207572705700_R2","doi-asserted-by":"crossref","unstructured":"Kelley DE, Thaete FL, Troost F, Huwe T, Goodpaster BH: Subdivisions of subcutaneous abdominal adipose tissue and insulin resistance. 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