Waist circumference and body mass index in Chinese children: cutoff values for predicting cardiovascular risk factors

Abstract

Background: Body mass index (BMI) and waist circumference (WC) correlate with cardiovascular (CV) risk factors in childhood which track into adulthood. WC provides a measure of central obesity, which has been specifically associated with CV risk factors. Reference standards for WC, and for WC and BMI risk threshold values are not established in Chinese children. Objectives: To construct reference percentile charts of WC, establish relationships between WC, BMI and other risk factors, and propose WC and BMI threshold values predictive of CV risk factors in Hong Kong ethnic Chinese children. Methods: Weight, height, waist and hip circumference were measured in 2593 (52% boys, 47% girls) randomly sampled Hong Kong school children aged 6-12 years. In 958 of these and 97 additional overweight children (n ¼ 1055), the relationships between WC, BMI, waist/hip and waist/height ratio and six age-adjusted CV risk factors (485% percentile levels of blood pressure (BP), fasting triglycerides, low-density lipoprotein (LDL) cholesterol, glucose and insulin levels, and o15% percentile levels of high-density lipoprotein (HDL) cholesterol) were studied. Receiver-operating characteristic analysis was employed to derive optimal age-adjusted sex-specific WC and BMI thresholds for predicting these measures of risk. Results: WC percentiles were constructed. WC correlated slightly more than BMI with CV risk factors and most strongly with insulin and systolic BP, but poorly or not with LDL and glucose. Optimal WC and BMI risk thresholds for predicting four of these six CV risk factors were ca. the 85th percentiles (sensitivities B0.8, specificities B0.87) with age-specific cutoff values in girls/ boys from B57/58 to B71/76 cm and 17/18 to 22/23 kg/m 2 . Conclusion: These are the first set of WC reference data for Chinese children. WC risk cutoff values are proposed which, despite a smaller waist in Chinese children, are similar to those reported for American children. WC percentiles may reflect population risk.

Prehypertension in Children and Adolescents: Association with Body Weight and Neck Circumference

“…Good predictors for elevated blood pressure are necessary for preventing the early onset of hypertension and its future impact on cardiovascular system. Although several anthropometric parameters have been considered to be related to cardiovascular disease (CVD) risk factors (22)(23)(24)(25), the best marker assessing the relationship between body fat and hypertension is still controversial. BMI is a well-established and widely accepted measure to define obesity in children and adolescents in spite of some limitations (e.g.…”

Health behaviors, waist circumference and waist-to-height ratio in children

“…In some studies, WC has been found to be an even stronger indicator of cardiometabolic disease risk factors than BMI in children (Lee et al, 2006;Sung et al, 2007;Reinehr and Wunsch, 2010). However, a recent systematic review concluded that WC and BMI were equally useful in identifying cardiometabolic disturbances in children (Reilly et al, 2010).…”

Prevalência e preditores antropométricos de pressão arterial elevada em escolares de João Pessoa - PB

“…As described in the literature, the AC is a measurement of central obesity and it is specifically associated with risk factors of cardiovascular diseases, both in adults and children 27,28 , which makes it a relevant measurement to evaluate the risk of chronic diseases, such as hypertension. The present study showed a low prevalence of abdominal obesity.…”