Trunk-to-limb fat ratio and its relationship with cardiometabolic risk factors in Korean children and adolescents

Sep 30, 2026

Childhood obesity is linked to cardiometabolic risk, but traditional measures may not capture fat distribution relevant to metabolic health. This study examined how the trunk-to-limb fat ratio measured by dual-energy X-ray absorptiometry (DXA) relates to cardiometabolic risk factors in Korean children and adolescents. Data from 1,661 participants aged 10–18 were analyzed, assessing waist circumference, blood pressure, lipid profiles, and fasting glucose, with odds ratios evaluating metabolic syndrome risk. The ratio showed strong, sex- and age-specific associations.

LanguageEnglish

CategoryHealthcare

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Pages10

Reading Time25 min

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Original article [https://doi.org/10.6065/apem.2550020.010](https://doi.org/10.6065/apem.2550020.010)[ ](https://doi.org/10.6065/apem.2550020.010)[Ann Pediatr Endocrinol Metab 2025](Ann Pediatr Endocrinol Metab 2025);[30:320-329](30:320-329) Trunk-to-limb fat ratio and its relationship with cardiometabolic risk factors in Korean children and adolescents Jong Han Kim1, Jun Hong Park2, Hae Sang Lee2, Young Suk Shim2 1Ikey Pediatric Clinic, Seoul, Korea 2Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea Received: 16 January, 2025 Revice: 5 February, 2025 Accepted: 20 February, 2025 Address for correspondence: Young Suk Shim Department of Pediatrics, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon 16499, Korea Email: [royjays@gmail.com](royjays@gmail.com) [https://orcid.org/0000-0002-0850-](https://orcid.org/0000-0002-0850-)[ ](https://orcid.org/0000-0002-0850-)5279 Purpose: Childhood obesity is a growing global health concern associated with various cardiometabolic risk factors. The aim of this study was to examine the relationships between the trunk-to-limb fat ratio on dual-energy x-ray absorptiometry (DXA) and cardiometabolic risk factors in Korean children and adolescents. Methods: Data for 891 boys and 770 girls aged 10-18 years from the 2009–2011 Korean National Health and Nutrition Examination Survey were analyzed. The trunk-to-limb fat ratio was calculated using DXA measurements. Cardiometabolic risk factors including waist circumference, blood pressure, lipid profiles, and fasting glucose were assessed. The Lambda-Mu-Sigma method was used to evaluate the distribution of the trunk-to-limb fat ratio by sex and age. Correlations between the trunk-to-limb fat ratio and metabolic syndrome risk factors were analyzed using adjusted mean values and odds ratios (ORs). Results:Trunk-to-limbfatratiowassignificantlycorrelatedwithvariouscardiometabolic risk factors, including waist circumference, body mass index, and lipid profiles. The group with the highest trunk-to-limb fat ratio (≥95th percentile) demonstrated significantly increased odds of metabolic syndrome, particularly in girls (adjusted OR, 8.66). Sex-specific patterns in trunk-to-limb fat ratio with age were observed, with boys showing an increasing trend and girls maintaining a relatively stable ratio. Conclusion: Trunk-to-limb fat ratio on DXA is significantly associated with cardiometabolic risk factors and metabolic syndrome in Korean children and adolescents. This measure provides valuable information beyond traditional anthropometric measurements and maybe particularly useful in assessing metabolic health in young populations. Keywords: Body fat distribution, Obesity, Metabolic syndrome, Sex characteristics, Cardiometabolic risk factors, Dual-energy x-ray absorptiometry Highlights · This study shows that a higher dual-energy x-ray absorptiometry-derived trunkto-limb fat ratio is strongly associated with cardiometabolic risk factors and metabolic syndrome in Korean youth aged 10–18 years. Adolescents in the highest trunk-to-limb fat ratio group had markedly increased odds of metabolic syndrome, especially girls. The trunk-to-limb fat ratio has incremental value for metabolic risk beyond body mass index and waist circumference. Introduction Obesity in children and adolescents has become a serious health problem worldwide, and its prevalence has increased rapidly in recent decades [1]. This trend is This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://](http://)[ ](http://)[creativecommons.org/licenses/by-nc/4.0](creativecommons.org/licenses/by-nc/4.0)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ©2025 Annals of Pediatric Endocrinology & Metabolism ISSN: 2287-1012(Print) ISSN:

FAQs

What was the main purpose of this study?

To examine relationships between the trunk-to-limb fat ratio measured by DXA and cardiometabolic risk factors in Korean children and adolescents.

How was the trunk-to-limb fat ratio measured?

Using dual-energy X-ray absorptiometry (DXA), and calculating the trunk-to-limb fat ratio from DXA measurements.

Which participants were included and what outcomes were assessed?

Data from 891 boys and 770 girls aged 10–18 years were analyzed, assessing waist circumference, blood pressure, lipid profiles, fasting glucose, and metabolic syndrome risk.

Sep 30, 2026

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