Adding anthropometric measures of regional adiposity to BMI improves prediction of cardiometabolic, inflammatory and adipokines profiles in youths: a cross-sectional study

Abstract

BackgroundPaediatric research analysing the relationship between the easy-to-use anthropometric measures for adiposity and cardiometabolic risk factors remains highly controversial in youth. Several studies suggest that only body mass index (BMI), a measure of relative weight, constitutes an accurate predictor, whereas others highlight the potential role of waist-to-hip ratio (WHR), waist circumference (Waist C), and waist-to-height ratio (WHtR). In this study, we examined the effectiveness of adding anthropometric measures of body fat distribution (Waist C Z Score, WHR Z Score and/or WHtR) to BMI Z Score to predict cardiometabolic risk factors in overweight and obese youth. We also examined the consistency of these associations with the “total fat mass + trunk/legs fat mass” and/or the “total fat mass + trunk fat mass” combinations, as assessed by dual energy X-ray absorptiometry (DXA), the gold standard measurement of body composition.MethodsAnthropometric and DXA measurements of total and regional adiposity, as well as a comprehensive assessment of cardiometabolic, inflammatory and adipokines profiles were performed in 203 overweight and obese 7–17 year-old youths from the Paediatrics Clinic, Centre Hospitalier de Luxembourg.ResultsAdding only one anthropometric surrogate of regional fat to BMI Z Score improved the prediction of insulin resistance (WHR Z Score, R2: 45.9 %. Waist C Z Score, R2: 45.5 %), HDL-cholesterol (WHR Z Score, R2: 9.6 %. Waist C Z Score, R2: 10.8 %. WHtR, R2: 6.5 %), triglycerides (WHR Z Score, R2: 11.7 %. Waist C Z Score, R2: 12.2 %), adiponectin (WHR Z Score, R2: 14.3 %. Waist C Z Score, R2: 17.7 %), CRP (WHR Z Score, R2: 18.2 %. WHtR, R2: 23.3 %), systolic (WHtR, R2: 22.4 %), diastolic blood pressure (WHtR, R2: 20 %) and fibrinogen (WHtR, R2: 21.8 %). Moreover, WHR Z Score, Waist C Z Score and/or WHtR showed an independent significant contribution according to these models. These results were in line with the DXA findings.ConclusionsAdding anthropometric measures of regional adiposity to BMI Z Score improves the prediction of cardiometabolic, inflammatory and adipokines profiles in youth.

Assessing truncal obesity in predicting cardiometabolic risk in children: clinical measures versus dual‐energy X‐ray absorptiometry

“…Few studies have assessed the relationship of DXA‐derived measures of abdominal obesity to cardiometabolic risk factors in children . Similar to the current study, Ali et al found that measures of central adiposity by DXA were associated with insulin resistance and triglyceride levels in adolescents .…”

Body composition of obese adolescents: association between adiposity indicators and cardiometabolic risk factors

“…The adiposity variables investigated in the present study also proved to be able to predict the variability of IS, highlighting % Fat DXA for boys and BMI for girls. Given the difficulty of assessing the % Fat DXA in clinical practice, as well as that described by Samouda et al (53) , we suggest that a study with a larger sample size is accomplished by combining the BMI evaluation with an anthropometric measurement of regional adiposity, such as WC or WSR. In such a study, inflammation, as assessed by C-reactive protein, improved its prediction when the WSR Z-score was added to the BMI Z-score (53) .…”

Fundamental movement skills and weight status in children: A systematic review

“…In addition, skinfold thickness was measured in one study [22], WC in three studies [22][23][24] and only in one study [23] DXA was used to measure abdominal fat percentage and total body fat percentage. As body fatness and specifically abdominal fatness are associated with less favorable cardiovascular risk factor status in children and adolescents [34], it is important to assess weight status using more accurate methods than only BMI in order to obtain more precise evidence for a relationship between FMS performance and weight status in children. BMI is based on weight and does not differentiate between fat mass (adipose tissue) and lean mass (mostly muscle tissue) and, therefore, it is an imperfect measure of either fatness or thinness.…”