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OBJECTIVE: This study aimed to investigate how visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) volumes were associated with metabolic risk factors in 7-year-old children. METHODS: A total of 81 children (52% girls) from a Swedish birth cohort were studied. At 6 years of age, anthropometric data, fasting insulin, glucose, cholesterol, and blood pressure were collected on 53 children with normal weight and 28 children with overweight or obesity, and insulin resistance was estimated. At 7 years of age, magnetic resonance imaging quantified VAT and SAT. Sex and regression analyses were conducted. RESULTS: SAT was more strongly associated with metabolic risk factors than VAT. The associations between VAT and metabolic risk factors were stronger in girls (P < 0.05). When VAT was adjusted for birth weight and maternal BMI and education, it accounted for 51% of insulin variance (β = 11.72; P = 0.001) but only in girls. The key finding of this study was that adjusted SAT accounted for 63% of the fasting insulin variance in girls (β = 2.76; P < 0.001). Waist circumference was the best anthropometric marker for insulin resistance. CONCLUSIONS: Insulin resistance was associated with abdominal adipose tissue and its associated metabolic risk factors in children as young as 7 years old., De 2 sista författarna delar sistaförfattarskapet.

I ett historiskt perspektiv har transpersoner varit en icke accepterad grupp och heteronormativa antaganden har varit det synsätt som präglat det svenska samhället. I Sverige finns idag lagar som styr vården för att alla ska få vård på lika villkor. Unga transpersoner är fortfarande i dagens samhälle en utsatt grupp, inte minst inom vården där man ser att bemötande och kunskap om dessa individer är viktiga aspekter för att öka chansen till en jämlik vård. Syftet med studien är att ur ett patientperspektiv beskriva unga transpersoners upplevelse av bemötande vid vårdkontakt. Vi har valt att göra en litteraturstudie för att sammanfatta dagens kunskap kring ämnet. Det finns få vetenskapliga artiklar publicerade inom ämnet. De kvalitativa och kvantitativa artiklarna som vi valt utifrån vårt intresseområde har analyserats och tolkats. Resultatet av analysen beskrivs i tre teman: bemötande, upplevelse av utsatthet i vårdmiljö och att mötas av okunskap. Resultatet visar att vården inte är anpassad för unga transpersoner. Det finns brister i bemötandet vilket skapar frustration och transpersoner upplever att de får undervisa vårdpersonalen i transrelaterad vård. Vidare belyses att transpersoner förväntas passa in i ett heteronormativt system, att de ofta känner sig i underläge samt är beroende av vårdaren och tvingas svara på obekväma frågor för att få vård. Vår tolkning av resultatet är att det finns en kunskapsbrist bland vårdpersonal och att de normer som finns inom vården idag behöver medvetandegöras. All vårdpersonal har ett ansvar att motverka diskriminering och stigmatisering inom sjukvården.

The presence of adipose tissue in the abdominal area in particular is associated with unfavourable metabolic changes. Furthermore, there are clear sex differences in the distribution of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in adults, with males having more VAT and less SAT than females. The present study assessed whether these differences between the sexes were already present in preschool children. It also evaluated which measures of body composition were most appropriate for assessing abdominal obesity in this age group. One-hundred and five children (57 boys, 48 girls) participated in the study. Body composition was measured using dual-energy X-ray absorptionetry (DXA). Weight, height and waist circumference (WC) were also recorded. Magnetic resonance imaging (MRI) of the entire abdomen using sixteen 10 mm thick T1-weighted slices was performed in a subgroup of 48 children (30 boys, 18 girls); SAT and VAT volumes were measured using semi-automated segmentation. Boys had significantly more VAT than girls (0.17 versus 0.10 L, p<0.001). Results showed that VAT correlated significantly with all measurements of anthropometry (p<0.01) after adjusting for SAT and for total fat mass measured with DXA. The mean limits of agreement between DXA and MRI regarding truncal FM were calculated to -11.4 (range -17.8 to -3.6), using a Bland-Altman plot. In conclusion, sex differences in adipose tissue distribution are apparent at an early age. MRI is the best method with which to study abdominal fat distribution in young children.