BackgroundThe prevalence of childhood obesity and associated conditions, such as
hypertension, has become a major problem of public health. Although waist
circumference (WC) is a marker of cardiovascular risk in adults, it is
unclear whether this index is associated with cardiovascular risk factors in
children.ObjectiveOur aim was to evaluate the association between increased WC and elevated
blood pressure (BP) in children with normal body mass index (BMI)
ranges.MethodsCross-sectional evaluation of students between 6 and 11 years with normal
BMI. WC was categorized by quartile for each age group. Normal BP was
defined as values < 90th percentile, and levels above this range were
considered elevated. Values of p < 0.05 were considered statistically
significant.ResultsOf the 5,037 children initially assessed, 404 (8%) were excluded for being
underweight and 1,216 (24.1%) were excluded for being overweight or obese. A
final sample of 3,417 children was evaluated. The prevalence of elevated BP
was 10.7%. In children with WC in the lowest quartile, the prevalence of
elevated BP was 8.1%. This prevalence increased in upper quartiles: 10.6% in
the second, 12.4% in third and 12.1% in the upper quartile. So, in this
group, being in the highest WC quartile was associated with a 57% higher
likelihood to present elevated BP when compared to those in the lowest
quartile (Q4 vs Q1; OR 1.57 - 95%CI 1.14 - 2.17).ConclusionIn children aged 6 to 11 years, increased waist circumference is associated
with elevated BP even when BMI is normal.
Obesity is the most common chronic disease in adolescents. In adults, waist circumference (WC) is associated with the presence of cardiovascular risk factors and is also a better predictor of cardiovascular (CV) risk than body mass index (BMI). The association between WC and CV risk factors in adolescents has been poorly explored so far, mainly in those within the normal BMI range. Objective: To evaluate the association between WC and elevated blood pressure (BP) in adolescents with a normal BMI. Methods: Cross-sectional analysis of 73,399 scholars between 12 and 17 years old from the ERICA study, a school-based, national representative study with Brazilian adolescents. Only those within the normal range of BMI were included. The WC was categorized into quartiles for sex and age (Q1 to Q4). For the analysis, BP values ≥ 90th percentile were considered to indicate elevated BP, what includes hypertension and pre-hypertension. The Poisson Regression model was used and the prevalence ratio was estimated. Results: A total of 53,308 adolescents with normal BMI were included. Prevalence of elevated BP in the overall group was 18.0%. In female adolescents with WC in the lowest quartile for their age, the prevalence of elevated BP was 7.3% (12-14 years) and 6.9% (15-17 years), increasing in the upper quartile to 15.2% and 19.5% respectively, with a prevalence ratio (PR) indicating chance at least two times higher for elevated BP in Q4 (p < 0.001). Similarly, this was observed in boys, with a prevalence of elevated BP of 10.0% and 18.9% in Q1, increasing to 21.4% and 49.6% in Q4 (p < 0.001). Conclusion: In adolescents, there is a strong association of increased WC with BP elevation, even when the BMI is adequate.
Background: Cardiovascular diseases are the leading cause of death in Brazil and worldwide. The growing incidence of obesity in children and adolescents and its association with lipid abnormalities may worsen this scenario, mainly in developing countries where obesity has reached epidemic levels. Dyslipidemias have several patterns, and the combination of some lipid abnormalities may have higher atherogenic potential. Objectives: To evaluate the prevalence of single or multiple combined lipid abnormalities in adolescents and its association with nutritional status assessed by body mass index. Methods: Data were obtained from the Study of Cardiovascular Risks in Adolescents (ERICA), a school-based, national representative study with Brazilian adolescents between 12 and 17 years of age. Adolescents whose lipid profiles were available were included, and lipid abnormalities were defined as LDL-C ≥ 100 mg/dL, HDL-C < 45 mg/dL, and tryglicerides (TG) ≥ 100 mg/dL. We assessed the prevalence of single or combined lipid abnormalities and correlated this nutritional status with body mass index of low weight, normal, overweight, and obesity. Results: A total of 38,069 adolescents were included, with more than 24,000 of them presenting at least one lipid abnormality (64.7%), and 3.7% showing alterations in all of them. The most prevalent combination was high TG with low HDL-C levels. The higher the BMI, the more lipid abnormalities were found. Conclusions: In this large and representative sample of Brazilian adolescents, the majority had at least one lipid abnormality. Higher BMI was associated with a higher prevalence of combined lipid abnormalities. Highlights:-There is a high prevalence of Brazilian adolescents with dyslipidemias.-BMI was associated with a higher prevalence of combined lipid abnormalities.-BMI can be considered as an indicator of the diagnosis of dyslipidemia in adolescents.
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