Waist circumference for the screening of the metabolic syndrome in children

Moreno, LA; Pineda, I; Rodrı́guez, Gerardo; Fleta, J; Sarrı́a, Antonio; Bueno, Manuel

doi:10.1080/08035250216112

Cited by 206 publications

(133 citation statements)

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“…The most strongly associated individual factor of the six was fasting insulin, followed by TG and HDL, with systolic more strongly associated than diastolic BP, and LDL cholesterol and blood glucose only weakly or insignificantly associateda hierarchy of individual associations similar to that noted previously. 38 WC showed a slightly stronger association than BMI with the lipid and insulin risk factors, supporting the growing use of WC in preference to BMI 39,40 and consistent with the fact that WC is a measure of central obesity which is specifically related to the presence of CV risk factors. 41,42 Weight/hip ratio and weight/height ratios, as previously used in adults 43,44 albeit controversially in children, 15,21,45,46 were shown to be less strongly associated with the CV risk factors.…”

Section: Discussionsupporting

confidence: 63%

“…In particular the representative 50th percentile for WC (which reflects waist size in the population) was higher in the USA national data collected from 1988 to 1994 29 than in these ethnic Chinese children in Hong Kong (Figure 3). Data relating WC to CV risk factors in different child populations are scant 15,34,38,39,47,48 and valid comparisons are limited by differences in methodology (non-random population sampling, different sites of WC measurement, selection and number of CV risk factors) and/ or failure to include more than one of the inter-related variables (WC percentiles, WC risk threshold percentiles and cutoff values) in the same study. The only methodologically comparable study to derive WC risk thresholds percentiles and gender-and age-related cutoff values is the Bogalusa study of 2597 Black and White American children, 34 in which three-or-more of the same six CV risk factors as in the present study were used.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2006

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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.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

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

et al. 2006

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“…Importantly, the low HDL-C (, 45 mg/dl) cut-off value defined by the Brazilian Guidelines in Atherosclerosis Prevention for children and adolescents (15) , and used here, is arbitrary because of a lack of literature consensus. For the same reason, cut-off values adopted by others are also not standardised; for example, Moreno et al (12) considered low HDL-C value less than the 25th percentile, Jessup and Harrel (23) adopted HDL-C # 35 mg/dl, and Cook et al (18) and Duncan et al (19) considered HDL-C # 40 mg/dl. Analysing our data according to the parameter of HDL-C , 45 mg/dl, low HDL-C was found in 43?2 % of the whole sample, varying from 39?9 % in the normalweight group to 62?9 % in the obese group.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of metabolic syndrome and associated risk factors in Brazilian schoolchildren

Seki

Matsuo

Carrilho

2009

Public Health Nutr.

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Objective: To determine the prevalence of metabolic syndrome (MetS) in schoolchildren from 6 to 16 years old, while considering their socio-economic status and other potential risk factors. Design: A cross-sectional study was conducted between April and November of 2005 in a semi-rural city with a total population of 13 000 inhabitants. Setting: The study was conducted in Maracai city, located in the Brazilian state of Sao Paulo. Subjects: Schoolchildren (n 2170) of both genders, corresponding to approximately 82 % of all Maracai schoolchildren, were evaluated for components of MetS, as defined by the National Cholesterol Education Program; reference values for children and adolescents were adjusted for age and sex. Results: Overall, MetS prevalence was 3?6 % (95 % CI 2?9, 4?5) and did not differ statistically between genders, skin colour, between children and adolescents. However, when we analysed groups of subjects by weight, MetS prevalence progressively increased from 0?3 % (95 % CI 0?1, 0?8) in normal-weight subjects to 10?7 % (95 % CI 7?4, 14?8) and 34?5 % (95 % CI 25?9, 43?9) in overweight and obese subjects, respectively (both P , 0?001 compared to normal-weight controls). When socio-economic classes were considered, 4?7 % high-income students (95 % CI 3?5, 6?2) had MetS, which was significantly greater than low-income students (2?7 %; 95 % CI 1?9, 3?9; P 5 0?023). Conclusions: MetS prevalence was high in overweight and obese schoolchildren and these risk factors were present during childhood and adolescence. Changes in lifestyle and alimentary safety should be encouraged to avoid future cardiovascular morbidity and type 2 diabetes mellitus.

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“…28,29 Definitive internationally acceptable cut points for waist circumference that are linked to metabolic risk have yet to be established in children, 31 however, waist circumference is being increasingly used for clinical assessment in younger populations. 32,33 Therefore, we have used waist circumference as a continuous variable in our analyses. Each variable was measured twice or thrice depending on the tolerance and the mean of two measures or median of three measures were utilized.…”

Section: Anthropometric Measurementsmentioning

confidence: 99%

The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial

2008

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Background: High-intensity progressive resistance training (PRT) improves adiposity and metabolic risk in adults, but has not been investigated in children within a randomized controlled trial (RCT). Objective: We hypothesized that high-intensity PRT (8 weeks, twice a week) would decrease central adiposity in children, as assessed via waist circumference. Methods Design/Setting/Participants: Concealed randomization stratified by age and gender was used to allocate rural New Zealand school students to the wait-list control or PRT group. Intervention: Participants were prescribed two sets (eight repetitions per set) of 11 exercises targeting all the major muscle groups at high intensity. Primary Outcome: Waist circumference; secondary outcomes included whole body fat, muscular fitness (one repetition maximum), cardiorespiratory fitness (peak oxygen consumption during a treadmill test), lipids, insulin sensitivity and fasting glucose. Results: Of the 78 children (32 girls and 46 boys; mean age 12.2(1.3) years), 51% were either overweight (33%) or obese (18%). High-intensity PRT significantly improved waist circumference (mean change PRT À0.8 (2.2) cm vs þ 0.5 (1.7) cm control; F ¼ 7.59, P ¼ 0.008), fat mass (mean change PRT þ 0.2 (1.4) kg vs þ 1.0 (1.2) kg control; F ¼ 6.00, P ¼ 0.017), percent body fat (mean change PRT -0.3 (1.8)% vs þ 1.2 (2.1)% control; F ¼ 9.04, P ¼ 0.004), body mass index (mean change PRT À0.01 (0.8) kg m À2 vs þ 0.4 (0.7) kg m À2 control; F ¼ 6.02, P ¼ 0.017), upper body strength (mean change PRT þ 11.6(6.1) kg vs þ 2.9(3.7) kg control; F ¼ 48.6, Po0.001) and lower body strength (mean change PRT þ 42.9(26.6) kg vs þ 28.5(26.6) kg control; F ¼ 4.72, P ¼ 0.034) compared to the control group. Waist circumference decreased the most in those with the greatest baseline relative strength (r ¼ À0.257, P ¼ 0.036), and greatest relative (r ¼ À0.400, P ¼ 0.001) and absolute (r ¼ 0.340, P ¼ 0.006) strength gains during the intervention. Conclusion: Isolated high-intensity PRT significantly improves central and whole body adiposity in association with muscle strength in normal-weight and overweight children. The clinical relevance and sustainability of these changes in adiposity should be addressed in future long-term studies.

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Waist circumference for the screening of the metabolic syndrome in children

Abstract: Waist circumference seems to be the best predictor of children with the metabolic syndrome in paediatric clinical settings.

Cited by 206 publications

References 0 publications

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

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

Prevalence of metabolic syndrome and associated risk factors in Brazilian schoolchildren

The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial

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