Comparison of anthropometric measurements in children to predict metabolic syndrome in adolescence: analysis of prospective cohort data

• Published in: International Journal of Obesity Vol. 39; no. 7; pp. 1070 - 1078
• Main Authors: Wicklow, B A, Becker, A, Chateau, D, Palmer, K, Kozyrskij, A, Sellers, E A C
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.07.2015; Nature Publishing Group
• Subjects: 631/443/319/1642/2037; 631/443/319/1642/393; 692/163; 692/499; 692/699/75; 692/700; 692/700/1720; Adipose tissue; Adolescence; Age; Anthropometry; Blood Pressure; Body Height; Body Mass Index; Body measurements; Body size; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Care and treatment; Child; Child development; Children; Children & youth; Childrens health; Cholesterol; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Chronology; Confidence intervals; Diabetes; Diagnosis; Epidemiology; Female; Health aspects; Health Promotion and Disease Prevention; Health risk assessment; Health sciences; High density; High density lipoprotein; Hip; Homeostasis; Humans; Insulin; Internal Medicine; Low density lipoprotein; Low density lipoproteins; Male; Measurement techniques; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - epidemiology; Metabolic Syndrome - etiology; Metabolic Syndrome - prevention & control; Obesity; Obesity - blood; Obesity - complications; Obesity - epidemiology; Obesity - prevention & control; Overweight; pediatric-original-article; Pediatrics; Population studies; Predictive Value of Tests; Prospective Studies; Public Health; Residential density; Risk analysis; Risk Factors; Sex Distribution; Standard deviation; Standard scores; Teenagers; Triglycerides; Triglycerides - blood; Waist Circumference; Waist-Hip Ratio; Canada; Manitoba Canada
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/ijo.2015.55

Objectives: The optimal screening measures for obesity in children remain controversial. Our study aimed to determine the anthropometric measurement at age 10 years that most strongly predicts the incidence of cardio-metabolic risk factors at age 13 years. Subjects/Methods: This was a prospective cohort study of a population-based cohort of 438 children followed between age 7 and 13 years of age. The main exposure variables were adiposity at age 10 years determined from body mass index (BMI) Z -score, waist circumference (WC) Z -score, waist-to-hip ratio and waist-to-height ratio. Outcome measures included systolic (SBP) and diastolic blood pressure (DBP), fasting high-density (HDL-c) and low-density lipoprotein cholesterol (LDL-c), triglycerides, insulin and glucose (homeostasis model of assessment, HOMA), and the presence of metabolic syndrome (MetS). Results: WC Z -score at age 10 years was a stronger predictor of SBP ( β 0.21, R 2 0.38, P <0.001 vs β 0.30, R 2 0.20, P <0.001) and HOMA ( β 0.51, R 2 0.25, P <0.001 vs 0.40, R 2 0.19, P <0.001) at age 13 years compared with BMI Z -score. WC relative to height and hip was stronger predictors of cardio- metabolic risk than BMI Z -score or WC Z -score. The relative risk (RR) of incident MetS was greater for an elevated BMI Z- score than for an elevated WC (girls: RR 2.52, 95% confidence interval (CI): 1.46–4.34 vs RR 1.56, 95% CI 1.18–2.07) and (boys: RR 2.86, 95% CI 1.79–4.62 vs RR 2.09, 95% CI 1.59–2.77). Conclusions: WC was a better predictor of SBP and HOMA compared with BMI or WC expressed relative to height or hip circumference. BMI was associated with higher odds of MetS compared with WC. Thus, BMI and WC may each be clinically relevant markers of different cardio-metabolic risk factors, and important in informing obesity-related prevention and treatment strategies.