BMI and waist circumference at 7/8 yr and metabolic profile in adolescence

Garnett, S. P.; Baur, L. A.; Srinivasan, S.; Lee, J.; Cowell, C. T.
December 2005
Asia Pacific Journal of Clinical Nutrition;2005 Supplement, Vol. 14, pS47
Academic Journal
Background -- Estimates of the prevalence of overweight and obesity in young people are typically based on body mass index (BMI). However, BMI may not indicate the level of central adiposity. Waist circumference (WC) has therefore been recommended to identify young people at risk of morbidity associated with central adiposity. Objective -- To determine whether sex and age specific WC cut points at 7/8 yr are more effective at predicting elevated metabolic risk (metabolic syndrome) in adolescence compared to recognised BMI cut points. Design -- Anthropometric measurements were taken on 342 children in 1996/97. Seven years later blood pressure (BP) was measured in 270 children and fasting blood samples obtained from 174 of the children for measurement of lipids, glucose and insulin. Metabolic syndrome was defined as the presence of three or more of the following: overweight, high systolic BP, high triglycerides, low HDL cholesterol, high insulin and impaired fasting glucose. Outcomes -- The prevalence of the metabolic syndrome was 17.7%. Being overweight defined by WC (OR 3.6[95% CI: 1.7,8.0], P=0.002) at 7/8 yr was more strongly associated with the metabolic syndrome in adolescence compared to BMI (3.0[1.3,7.0], P=0.007). Being overweight, as defined by both BMI and WC at 7/8 yr, was also associated with high SBP in adolescence (2.1[1.1,4.2], P=0.048 and 2.0[1.1,3.7], P=0.031, respectively) but not with triglycerides, glucose or insulin concentrations. Conclusions -- Results from this study demonstrate the value of both WC and BMI at 7/8 yr in predicting an elevated metabolic risk in adolescence. Identifying predictors of risk factor clusters is important; clusters may track more than the individual risk factors.


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