Development of waist circumference percentiles for Japanese children and an examination of their screening utility for childhood metabolic syndrome: a population-based cross-sectional study

Abstract

BackgroundIn Japan, waist circumference (WC) percentiles to screen for childhood metabolic syndrome (MetS) are unavailable. The objectives of this study were to develop WC and WC-to-height ratio (WC/Ht) percentile curves by age and sex for Japanese children, and to test their utility in screening for MetS in children with obesity who are otherwise healthy.MethodsThe WC and WC/Ht percentiles were developed using the LMS method of summarizing growth standards, which monitors changing skewness (L), medians (M), and coefficients of variation (S) in childhood distributions. A representative dataset was used, which consisted of 3,634 boys and 3,536 girls aged 4.5–12.75 years in Shizuoka prefecture, Japan, between 2010 and 2012. Children who were obese (355 boys and 230 girls) aged 6–12 years from Osaka prefecture, Japan, were screened for childhood MetS using the new percentiles and the International Diabetes Federation’s (IDF’s) definition of MetS.ResultsThe number of participants with certain metabolic abnormalities (high systolic and diastolic blood pressure, and a high level of triglycerides) was significantly higher in boys aged 10–12 years, with a WC ≥ 90th percentile, than among those with a WC < 90th percentile. None of the participants with a WC < 90th percentile exhibited two or more metabolic abnormalities, regardless of their age or sex. Among the participants aged 10–12 years, 11.4 % of boys and 4.4 % of girls with a WC ≥ 90th percentile were diagnosed with MetS.ConclusionsThe new percentiles may have a certain level of potential to screen Japanese children for childhood MetS in accordance with the IDF definition.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2447-1) contains supplementary material, which is available to authorized users.

CCL2 level is elevated with metabolic syndrome and CXCL10 level is correlated with visceral fat area in obese children

“…The levels of FPG, insulin, HOMA-R, ALT, HDL-C, TG and adiponectin significantly differed between the MS and non-MS groups. According to International Diabetes Foundation (IDF) criteria and the waist circumference percentile for Japanese children which Matsushita et al showed [23], nine subjects were diagnosed with MS and nineteen with non-MS. Other sixteen subject whose ages were between six years old to younger than ten years old could not be diagnosed because there was no definition of MS between six years to younger than ten years old in the IDF criteria.…”

“…Normal weight date based on age-and sex-specific standard body weights for height were obtained from the Ministry of Education, Culture, Sports, Science and Technology. Theoretically, POW that is unique to Japan is not influenced by height, therefore it is a highly useful index for longitudinal studies and has been widely used in school health checkups to evaluate children's weight periodically [22,23]. Among 44 obese subject, 22 (14 boys and 8 girls) met the Japan criteria for mild to moderate obesity (POW up to 50%), 22 obese subjects (11 boys and 11 girls) for morbidly obesity (POW ≥50%).…”

Intra-abdominal fat accumulation is an important predictor of metabolic syndrome in young adults

“…[ 14 ] Several previous studies in Japan demonstrated a strong correlation between the level of umbilical WC and the risk of MetS [ 15 , 16 ] ; however, this method is not used internationally. [ 17 – 20 ] The Japan Obesity Society proposed a standard WC ≥ 85 cm for males and ≥ 90 cm for females as the main diagnostic criteria of MetS, corresponding to an IAF accumulation of ≥ 100 cm 2 based on a study in adults aged approximately 55 years. [ 21 ] In Japan, metabolic health check-up diagnosis is heavily based on the WC.…”

Predictive Biological Markers in Post-therapeutic Evolution in Obese Patients

“…Initial screening included physical examination (weight, height, BMI and waist circumference (WC)), fasting blood profile (total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, tryglicerides (TG)). Visceral adiposity was assessed by measuring WC, expressed in absolute value and percentile by age and sex [4]. TG and cholesterol values were interpreted according to percentile for sex and age.…”