Objective. Risk phenotypes for cardiovascular disease (CVD) differ markedly between countries, like the reported high difference in CVD mortality in Austria and Estonia. Hitherto, the goal of this study was to find out risk profiles in body fat distribution yet present in childhood, paving the way for later clinical end points. Methods. he subcutaneous adipose tissue (SAT) distribution patterns in 553 Austrian (A) and Estonian (E) clinically healthy normal weight boys aged 11.1 (±0.8) years were analysed. We applied the patented optical device Lipometer which determines the individual subcutaneous adipose tissue topography (SAT-Top). Results. Total body fat did not differ significantly between E and A boys. A discriminant analysis using all Lipometer data, BMI, and the total body fat (TBF) yielded 84.6% of the boys correctly classified in Estonians and Austrians by 9 body sites. A factor analysis identified the SAT distribution of E as critically similar to male adult patients with coronary heart disease (CHD). Conclusions. We show in normal weight Estonian boys a highly significant decreased fat accumulation on the lower body site compared to age matched Austrian males. This SAT-Top phenotype may play an important role for the increased cardiovascular risk seen in the Estonian population. 1. Introduction The risk for populational diseases differs markedly between geographic regions and countries, as, for example, the reported greater rate of cardiovascular mortality in Estonia compared to Austria. The latest age standardised ischemic heart disease (IHD) mortality data per 100 000 population are for Austria 80,68, while for Estonia 254,25 [1]. So far, the studies investigating cardiovascular disease (CVD) risk factors focused on adult obesity and associated metabolic disorders. However, for the assessment of populational health, it is of outmost interest to gain a better insight in the pediatric roots of CVD. Although it is well established that obesity and the subcutaneous adipose tissue (SAT) phenotype are essentially involved in CVD risk, little information exists about risk phenotypes in prepubertal obese children. Notably, the prevalence of childhood obesity increased 4-fold during the last 20 years [2], and this represents a strong risk factor for obesity of adulthood [3]. The SAT phenotype in children is of growing interest for later on CVD risk. An improved understanding of individual subcutaneous body fat distribution and body composition in children may essentially support the development of effective preventive strategies [4–7] for the
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