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A master's thesis from Aalborg University
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The associations between subcomponents of physical activity and regional fat deposits in obese children and adolescents

Translated title

Sammenhængen mellem karakteristika ved fysisk aktivitet og regionale fedtdepoter hos børn og unge med fedme

Authors

;

Term

4. semester

Publication year

2021

Abstract

Baggrund: Fedme blandt børn og unge er udbredt, og sundhedsrisikoen afhænger af, hvor fedtet er placeret; visceralt fedt (VAT) og leverfedt er typisk mere skadelige end subkutant fedt (SAT). Formålet med dette tværsnitsstudie var at undersøge sammenhængen mellem specifikke karakteristika ved fysisk aktivitet og MRI-bestemte regionale fedtdepoter (VAT, SAT og leverfedt) hos 20 børn og unge med fedme (10–15 år), samt at vurdere udfald og inter-rater reliabilitet af fire metodiske tilgange til kvantificering af leverfedt. Deltagerne bar accelerometer i syv dage for at måle let aktivitet (LPA), moderat til høj aktivitet (MVPA), stillesiddende tid og total fysisk aktivitet; kondital (CRF) blev målt med en watt-max cykeltest. Sammenhænge blev analyseret med multipel regression for LPA og MVPA og simpel lineær regression for stillesiddende tid, total aktivitet og kondital. Leverfedt blev kvantificeret med 2, 4 og 9 regions of interest (ROIs) samt hele-lever ROI, og to ratere vurderede inter-rater reliabilitet med Bland-Altman og intraclass correlation coefficient (ICC). Resultaterne viste en signifikant omvendt sammenhæng mellem LPA og SAT, mens MVPA kun var omvendt relateret til SAT uden signifikant koefficient; der var ingen signifikant sammenhæng til VAT eller leverfedt for LPA/MVPA. Kondital var omvendt associeret med både VAT og SAT, mens stillesiddende tid og total fysisk aktivitet ikke var relateret til de regionale fedtdepoter. Alle leverfedt-metoder havde fremragende inter-rater reliabilitet (ICC>0,999), med små fordele for 4 ROIs, 9 ROIs og hele-lever ROI sammenlignet med 2 ROIs, og ingen signifikante metodeforskelle. Overordnet peger resultaterne på, at mere tid i let aktivitet er forbundet med mindre SAT, og højere kondital med mindre VAT og SAT; større studier er nødvendige for at bekræfte disse sammenhænge. Studiet antyder, at 4 ROIs, 9 ROIs eller hele-lever ROI er velegnede til kvantificering af leverfedt med MRI.

Background: Childhood and adolescent obesity is widespread, and health risks depend on fat location; visceral adipose tissue (VAT) and liver fat are generally more harmful than subcutaneous adipose tissue (SAT). This cross-sectional study examined associations between specific characteristics of physical activity and MRI-derived regional fat deposits (VAT, SAT, and liver fat) in 20 obese children and adolescents aged 10–15 years, and assessed the outcomes and inter-rater agreement of four methodological approaches for liver fat quantification. Participants wore accelerometers for seven days to measure light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time, and total physical activity; cardiorespiratory fitness (CRF) was assessed with a watt-max bicycle test. Associations were analyzed using multiple regression for LPA and MVPA and simple linear regression for sedentary time, total activity, and CRF. Liver fat was quantified using 2, 4, and 9 regions of interest (ROIs) and a whole-liver ROI, with two raters evaluating inter-rater reliability via Bland-Altman plots and intraclass correlation coefficients (ICC). Results showed a significant inverse association between LPA and SAT, while MVPA was inversely related to SAT but with a non-significant coefficient; LPA and MVPA were not significantly associated with VAT or liver fat. CRF was inversely associated with both VAT and SAT, whereas sedentary time and total physical activity were not related to regional fat deposits. All liver fat methods demonstrated excellent inter-rater reliability (ICC>0.999), with small advantages for 4 ROIs, 9 ROIs, and whole-liver ROI compared to 2 ROIs, and no significant differences across methods. Overall, more time in light activity was associated with lower SAT, and higher fitness with lower VAT and SAT; larger studies are needed to confirm these associations. The study suggests using 4 ROIs, 9 ROIs, or whole-liver ROI for liver fat quantification with MRI.

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