Aim: to explore the relationship between insulin sensitivity, body fat distribution, ectopic (liver and skeletal muscle) fat deposition, adipokines (leptin and adiponectin) and inflammation markers (hsCRP, IL-6, IL-10 and TNF-) in prepubertal children.

Subjects and methods: Thirty overweight and obese children (M/F:16/14; BMI z-score range: 1.1–3.2) were recruited. Body fat distribution and fat accumulation in liver and skeletal muscle were measured using Magnetic Resonance imaging (MRI). Insulin sensitivity was assessed by IVGTT.

Results: Insulin sensitivity was associated with subcutaneous abdominal adipose tissue (r= -0.52; P<0.01) and liver fat content (r= -0.44; P<0.02), but not with visceral abdominal adipose tissue (VAT) (r= -0.193; P=NS) and fat accumulation in skeletal muscle (r= -0.210; P=NS). Adipokines, but not inflammation markers, were significantly correlated to insulin sensitivity. VAT correlated with CRP (r = 0.55; P<0.01) as well as adiponectin (r = -0.53; P<0.01). Multiple regression analysis showed that only subcutaneous adipose tissue and fat liver content were independently correlated to insulin sensitivity (p<0.01; 20% and 16% of explained variance, respectively).

Conclusions: In overweight and moderately obese prepubertal children, insulin sensitivity was negatively correlated with subcutaneous abdominal adipose tissue (SAT) and liver fat content. Furthermore, contrary to adults, VAT and inflammation markers were not correlated with insulin sensitivity in children.