Changes in fat distribution in children following severe burn injury.

BACKGROUND Children with severe cutaneous burn injury show persistent metabolic abnormalities, including inflammation and insulin resistance. Such abnormalities could potentially increase their future risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This could be related to changes in body composition and fat distribution. METHODS We studied body composition, fat distribution, and inflammatory cytokines changes in children with severe burn injury up to 6 months from discharge. Sixty-two boys and 35 girls (burn ≥30% of total body surface area) were included. RESULTS We found a decrease in total body fat and subcutaneous peripheral fat at 6 months (6% and 2%, respectively; P<0.05 each). An inverse correlation between the decrease in peripheral fat content at 6 months and the extent of burn injury (r=-041, P=0.02) was also observed. In addition, there was a 12% increase in serum tumor necrosis factor-α (TNF-α) (P=0.01 vs. discharge) and 9% decrease in serum interleukin-10 (IL-10) (P<0.0001 vs. discharge) over 6 months after burn. CONCLUSION Severe burn injury in children is associated with changes in body fat content and distribution up to 6 months from hospital discharge. These changes, accompanied by persisting systemic inflammation, could possibly mediate the observed persistence of insulin resistance, predisposing burn patients to the development of T2DM and CVD.

[1]  Yuanyuan Wu,et al.  Adipose tissue heterogeneity: implication of depot differences in adipose tissue for obesity complications. , 2013, Molecular aspects of medicine.

[2]  Yu Zhang,et al.  Targeting adipocyte apoptosis: a novel strategy for obesity therapy. , 2012, Biochemical and biophysical research communications.

[3]  D. Herndon,et al.  Long-Term Persistance of the Pathophysiologic Response to Severe Burn Injury , 2011, PloS one.

[4]  F. Karpe,et al.  Gluteofemoral body fat as a determinant of metabolic health , 2010, International Journal of Obesity.

[5]  D. Chinkes,et al.  Pathophysiologic Response to Severe Burn Injury , 2008, Annals of surgery.

[6]  D. Herndon,et al.  Insulin Resistance Postburn: Underlying Mechanisms and Current Therapeutic Strategies , 2008, Journal of burn care & research : official publication of the American Burn Association.

[7]  D. Herndon,et al.  Gender Differences in Pediatric Burn Patients: Does It Make a Difference? , 2008, Annals of surgery.

[8]  J. Murabito,et al.  Visceral and Subcutaneous Adipose Tissue Volumes Are Cross-Sectionally Related to Markers of Inflammation and Oxidative Stress: The Framingham Heart Study , 2007, Circulation.

[9]  R. Barrow,et al.  The Influence of Age and Gender on Resting Energy Expenditure in Severely Burned Children , 2006, Annals of surgery.

[10]  C. Finnerty,et al.  Burn size determines the inflammatory and hypermetabolic response , 2006, Critical care.

[11]  C. Ryan,et al.  The Metabolic Basis of the Increase in Energy Expenditure in Severely Burned Patients , 1999 .

[12]  S. Grundy,et al.  Relationships of generalized and regional adiposity to insulin sensitivity in men. , 1995, The Journal of clinical investigation.

[13]  J. Hokanson,et al.  The visceral adiposity syndrome in Japanese-American men. , 1994, Obesity research.

[14]  C. Ryan,et al.  The metabolic basis of the increase of the increase in energy expenditure in severely burned patients. , 1999, JPEN. Journal of parenteral and enteral nutrition.

[15]  H. Lebovitz,et al.  Body composition, visceral fat, leptin, and insulin resistance in Asian Indian men. , 1999, The Journal of clinical endocrinology and metabolism.