Changes in fat distribution in children following severe burn injury

Abstract

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.

Trial registration: ClinicalTrials.gov NCT00675714.

Figures

FIG. 1.

Burn injury associates with significant changes in body fat distribution and low-grade systemic inflammation. (A) Significant decrease of subcutaneous peripheral fat content 6 months after burn as compared to discharge from the hospital (*P<0.05). (B) Changes in cytokines concentration [proinflammatory tumor necrosis factor-α (TNF-α) and anti-inflammatory interleukin-10 (IL-10)] suggestive of systemic inflammatory activation (*P=0.01 and <0.0001 for TNF-α and IL-10, respectively).

FIG. 2.

Correlation between extent of burn injury and peripheral fat content at 6 months following burn injury. The decrease in peripheral fat content at 6 months was found to be inversely correlated with the extent of burn injury (r=−041; P=0.015).