Waist circumference as a predictor of cardiovascular and metabolic risk factors in obese girls

Abstract

Objectives: (a) to explore the relationship between waist circumference and certain cardiovascular risk factors in a group of girls; and (b) to assess the clinical relevance of waist circumference in identifying girls with higher cardiovascular risk across puberty. Subjects and methods: One-hundred and fifty-five overweight or obese girls aged 5 -16 y were recruited. Overweight and obesity were defined on the basis of BMI, according to Cole. Results: Waist circumference was significantly correlated with plasma insulin (r ¼ 0.43; P < 0.001), systolic blood pressure (r ¼ 0.22; P ¼ 0.007) and IR HOMA (r ¼ 0.40; P < 0.001). A multivariate linear correlation analysis showed that, when adjusted for age and Tanner stage, waist circumference was significantly associated with plasma insulin (r 2 ¼ 0.23; P < 0.01), IR HOMA (r 2 ¼ 0.17; P < 0.02), systolic and diastolic blood pressure (r 2 ¼ 0.20; P ¼ 0.006 and r 2 ¼ 0.32; P < 0.001, respectively). A logistic regression analysis, using IR HOMA as the dependent variable, showed that waist circumference was a significant independent risk factor of insulin resistance (IR HOMA 5 2.6) in this group of girls (OR 1.10; 95% CI 1.03 -1.18; P ¼ 0.003), independently of their age and Tanner stage. Conclusions: Waist circumference of these girls was independently associated with certain cardiovascular risk factors, in particular insulin resistance and diastolic blood pressure, independently of age and Tanner stage. Thus suggesting that waist circumference may be reasonably included in clinical practice as a simple tool that may help to identify sub-groups of obese girls at higher metabolic risk across puberty.

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

“…[1][2][3][4] Clustering of these CV risk factors in children and adolescents tends to track into adult life. [5][6][7][8][9] CV disease appears to be related specifically to intraabdominal fat (visceral adipose tissue) 10,11 of which waist circumference (WC) provides a good and clinically useful measure, [12][13][14][15][16][17] supporting the growing view that WC is a better measure of CV risk than body mass index (BMI) in both children and adults. [18][19][20][21] Ethnic differences of WC have been described in adults 22,23 but have not been studied in children, although reference data for WC are available from a number of different countries.…”

Central and total adiposity are lower in overweight and obese children with high cardiorespiratory fitness

“…Indeed, subscapular and truncal skinfold thickness and waist circumference are associated with elevated fasting insulin, LDL cholesterol, total cholesterol and triglycerides levels (Freedman et al, 1999;Savva et al, 2000). These body composition indices are also related to increased systolic and diastolic pressure (Savva et al, 2000;Maffeis et al, 2003) and decreased HDL cholesterol concentration in children (Freedman et al, 1999).…”

“…Central adiposity is associated with multiple risk factors for cardiovascular disease in both children (Freedman et al, 1999;Savva et al, 2000;Maffeis et al, 2003) and adults (Bigaard et al, 2003). In men and women, there is strong evidence that physical activity and cardiorespiratory fitness (CRF) may protect from the adverse effects of obesity on health.…”

Adiposidad visceral y su asociación con lípidos séricos e insulinemis en adolescentes obesas

“…Esto puede ir acompañado de una alta producción hepática de glucosa y una disminución en la extracción de insulina por el hígado 14,15 . Se ha encontrado una asociación positiva entre grasa visceral y medidas antropométricas de adiposidad en adolescentes; sin embargo no se ha observado una asociación entre mediciones externas de adiposidad, incluyendo circunferencia de la cintura, con hipercolesterolemia 16,17 . En nuestro estudio no se observó una asociación entre la magnitud de la obesidad evaluada por IMC o perímetro de cintura y las concentraciones séricas de colesterol.…”