101
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Shimotake Y, Mbelambela EP, Muchanga SM, Villanueva AF, Yan SS, Minami M, Shimomoto R, Lumaya AJ, Suganuma N. Comparative evaluation of anthropometric measurements and prevalence of hypertension: community based cross-sectional study in rural male and female Cambodians. Heliyon 2020; 6:e04432. [PMID: 32715126 PMCID: PMC7371755 DOI: 10.1016/j.heliyon.2020.e04432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/23/2020] [Accepted: 07/08/2020] [Indexed: 02/06/2023] Open
Abstract
Introduction Hypertension is a major and preventable risk factor that can lead to cardiovascular disease. The extent that obesity impacts hypertension differs when using body mass index (BMI), waist circumference (WC) or waist to height ratio (WHtR). This study aimed to determine the prevalence of hypertension and to compare several anthropometric measurements in the prediction of hypertension between males and females from Chet Borey district of Kratie province, in Cambodia. Methods A cross-sectional study was conducted among 276 healthy adults aged 18 years or older, including 94 males and 182 females who visited the local health post of Kaoh chraeng in Kratie province from November 21 to 27, 2015. Systolic and diastolic blood pressures were measured. Anthropometric measures: Body mass index (BMI), as well as waist circumference (WC) and waist to height ratio (WHtR) were assessed to analyze adiposity indices. Multivariate analysis was performed to evaluate the association between anthropometric measures and hypertension among males and females after adjustment for confounders. Results Hypertension was more prevalent in males (38.3%) compared to females (26.4%). When considering adiposity indices, WC was higher in females than males (35.7% vs 10.6% females vs males), the same for WHtR (55.0% vs 30.9% females vs males). In the multivariate analysis, for males, in addition to high BMI [aOR 4.37 (1.01–18.81)], high WC [aOR 7.55 (1.42–39.99)] was associated with the risk of developing hypertension. Whereas for females, only WC [aOR 3.24 (1.54–6.83)] was associated with the concerned risk. Conclusion Prediction of hypertension using anthropometric measurements differs by sex and by the index used. In our population, BMI and WC appeared more appropriate for men while only WC was applicable to women. These results afford alternatives to hypertensive screening that may be useful tools for the majority of rural Cambodians since accessibility to health facilities is limited.
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Affiliation(s)
- Yuki Shimotake
- Department of Environmental Medicine, Kochi University Kochi Medical School, Nankoku, Japan
| | - Etongola P Mbelambela
- Department of Environmental Medicine, Kochi University Kochi Medical School, Nankoku, Japan
| | - Sifa Mj Muchanga
- Department of Gynecology and Obstetrics, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Antonio F Villanueva
- EUCLID UN University (Public International Health), The Gambia and Washington, D.C, USA
| | - Sok Seng Yan
- Royal School of Administration ATTN, Khan Chamkarmorn, Phnom penh, Cambodia
| | - Marina Minami
- Department of Environmental Medicine, Kochi University Kochi Medical School, Nankoku, Japan
| | - Rie Shimomoto
- Department of Nursing, Kochi University, Nankoku, Japan
| | - Ambis Joelle Lumaya
- Department of Gynecology and Obstetrics, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi University Kochi Medical School, Nankoku, Japan
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102
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Tozo TA, Pereira BO, Menezes Junior FJD, Montenegro CM, Moreira CMM, Leite N. Hypertensive Measures In Schoolchildren: Risk Of Central Obesity And Protective Effect Of Moderate-To-Vigorous Physical Activity. Arq Bras Cardiol 2020; 115:42-49. [PMID: 32785497 PMCID: PMC8384320 DOI: 10.36660/abc.20180391] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/18/2019] [Accepted: 07/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background The proportion of arterial hypertension (AH) has increased in children and adolescents and is associated with several comorbidities. Objective To verify the association of arterial hypertension with central and general obesity as well as according to the level of physical activity in schoolchildren. Methods 336 children and adolescents aged 11 to 17 participated in the study. Height, body weight, waist circumference (WC) and blood pressure (BP) were measured. The body mass index z-score (BMI-z) was calculated. The level of physical activity was assessed by the short form of the International Physical Activity Questionnaire (IPAQ) according to the practice of moderate-to-vigorous physical activities (AF-mv). Students with systolic (SBP) and/or diastolic blood pressure (DBP) higher than the 95thpercentile according to sex, age and height or ≥120/80 were considered hypertensive. Statistical tests of t-Student, Chi-square, Mann-Whitney and binary logistic regression model were used, considering the significance level of p<0.05. Results It was found that 40.5% of the students had AH, 35.11% were overweight (12.5% obese), 13.39% had high WC and 40.2% were considered insufficiently active in AF-mv. The chances of AH were related to high WC (OR = 6.11; 95% CI: 2.59¬-14.42) and overweight (OR = 2.91; 95% CI: 1.76-4.79). In addition, adolescents who practiced AF-mv had a lower risk of high DBP (OR = 0.33; 95% CI: 0.15-0.72). Conclusion Central obesity was the best predictor of AH in children and adolescents, as well as general obesity and males. The practice of AF-mv demonstrated a protective effect on high DBP in schoolchildren. (Arq Bras Cardiol. 2020; 115(1):42-49).
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Affiliation(s)
| | | | | | | | | | - Neiva Leite
- Universidade Federal do Paraná, Curitiba, PR, Brasil
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103
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Rico-Martín S, Calderón-García JF, Sánchez-Rey P, Franco-Antonio C, Martínez Alvarez M, Sánchez Muñoz-Torrero JF. Effectiveness of body roundness index in predicting metabolic syndrome: A systematic review and meta-analysis. Obes Rev 2020; 21:e13023. [PMID: 32267621 DOI: 10.1111/obr.13023] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/07/2020] [Accepted: 03/08/2020] [Indexed: 01/02/2023]
Abstract
Body roundness index (BRI) is a new anthropometric index developed to predict both body fat and the percentage of visceral adipose tissue. Our aim was to investigate whether BRI is superior to traditional anthropometric indices in predicting metabolic syndrome (MetS). This systematic review and meta-analysis was conducted using Pubmed, Scopus and Web of Sciences databases. The estimated pooled areas under curve (AUCs) for BRI predicting MetS was higher than body mass index (BMI), waist-to-hip ratio (WHR), body shape index (ABSI) and body adiposity index (BAI), similar to waist circumference (WC) and lower than waist-to-height ratio (WHtR). However, the difference between BRI and BMI, WC and WHtR predicting MetS was statistically non-significant. Similar results were found with the summary receiver operating characteristic curve (AUC-SROC). In addition, the non-Chinese population had pooled AUCs greater than the Chinese population for all indices. Pooled ORs showed that BRI is associated with an increased MetS risk. In conclusion, BRI had good discriminatory power for MetS in adults of both sexes from diverse populations (AUC > 0.7; AUC-SROC>0.7). However, WC and WHtR offer the best performance when screening for MetS, and non-significant differences were found with BRI. In contrast, BRI was superior to BMI, WHR, ABSI and BAI in predicting MetS.
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Affiliation(s)
- Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Julían F Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Purificación Sánchez-Rey
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Cristina Franco-Antonio
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
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104
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Lo K, Huang YQ, Shen G, Huang JY, Liu L, Yu YL, Chen CL, Feng YQ. Effects of waist to height ratio, waist circumference, body mass index on the risk of chronic diseases, all-cause, cardiovascular and cancer mortality. Postgrad Med J 2020; 97:306-311. [PMID: 32371408 DOI: 10.1136/postgradmedj-2020-137542] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/02/2020] [Accepted: 04/17/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Given the fat redistribution in later stages of life, how the associations between abdominal obesity and the risk of morbidity and mortality have changed with age have not been elucidated, especially for waist to height ratio (WHtR). OBJECTIVE To compare the strength of association between obesity indices and chronic diseases at baseline, and the subsequent mortality risk among US adults. METHODS We included 21 109 participants from National Health and Nutrition Examination Survey 1999-2014. We performed logistic regression and receiver operating curve analysis to examine the discriminatory power of obesity indicators on cardiometabolic diseases and cancer at baseline. Sex-stratified and age-stratified Cox models were constructed to explore the prospective association between obesity indices and all-cause, cardiovascular and cancer mortality. RESULTS Elevated WHtR, elevated waist circumference (WC) and body mass index (BMI)-classified obesity are associated with higher odds of hypertension (OR: 1.37-2.13), dyslipidemia (OR: 1.06 to 1.75, all p<0.05) and diabetes (OR: 1.40-3.16, all p<0.05). WHtR had significantly better discriminatory power to predict cardiometabolic health than BMI, especially for diabetes (area under the curve: 0.709 vs 0.654). After multivariable adjustment, all obesity indicators are associated with lower risk of all-cause mortality among females aged ≥65 years (HR: 0.64 to 0.85), but the association was only significant for BMI when obesity indicators were mutually adjusted (HR: 0.79). CONCLUSIONS WHtR and WC appeared to be the better indicators for cardiometabolic health than BMI. However, BMI had a stronger and inverse association with a greater risk of all-cause mortality among older females.
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Affiliation(s)
- Kenneth Lo
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China .,Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Yu-Qing Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Geng Shen
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Jia-Yi Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Lin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Yu-Ling Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Chao-Lei Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Ying Qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
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105
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Cristine Silva K, Santana Paiva N, Rocha de Faria F, Franceschini SDCC, Eloiza Piore S. Predictive Ability of Seven Anthropometric Indices for Cardiovascular Risk Markers and Metabolic Syndrome in Adolescents. J Adolesc Health 2020; 66:491-498. [PMID: 31980321 DOI: 10.1016/j.jadohealth.2019.10.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of the study was to evaluate the reliability of 7 anthropometric indices in predicting cardiovascular risk markers (CRMs) and metabolic syndrome (MetS) in Brazilian adolescents. METHODS A cross-sectional study conducted with 1,069 participants of the Cardiovascular Risk in Adolescents Study aged 12-17 years. Receiver operating characteristics curves were plotted, and area under curve (AUC) was calculated for body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHR), conicity index (CoI), body shape index (BSI), adjusted BSI for adolescents (adjusted BSI), and body roundness index (BRI). RESULTS In girls, reliability of BMI, WC, WHR, and BRI was sufficient (≥.6 AUC <.7) only to predict high blood pressure. Among boys, reliability of BMI, WC, WHR, BRI, and adjusted BSI ranged from good to sufficient (≥6 AUC <.8) to predict insulin resistance and high blood pressure, but poor to sufficient (≥.5 AUC <.7) for high total cholesterol, triglycerides, and low-density lipoprotein. For both sexes, CoI and BSI presented AUC ≤.5 for all CRM. A majority of the anthropometric indices showed AUC ≥.9 for MetS. CONCLUSION Reliability of CoI, BSI, adjusted BSI, and BRI is not superior to BMI, WC, and WHR in predicting CRM and MetS. All the anthropometric indices had excellent predictive capacity for MetS, but limited accuracy for CRM. Among the evaluated indices, we recommend the use of cutoff point WHR ≥.55 to screening MetS in girls and boys because of its easy to measure and interpretation.
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Affiliation(s)
- Kellen Cristine Silva
- Curso de Nutrição, Universidade Federal do Tocantins, Palmas, Brazil; Universidade Federal de Viçosa, Viçosa, Brazil.
| | - Natália Santana Paiva
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Franciane Rocha de Faria
- Curso de Medicina, Instituto de Ciências Exatas e Naturais, Universidade Federal de Mato Grosso, Rondonópolis, Brazil
| | | | - Silvia Eloiza Piore
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Brazil
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106
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Aranceta-Bartrina J, Gianzo-Citores M, Pérez-Rodrigo C. Prevalencia de sobrepeso, obesidad y obesidad abdominal en población española entre 3 y 24 años. Estudio ENPE. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.07.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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107
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Vaquero Alvarez M, Aparicio-Martinez P, Fonseca Pozo FJ, Valle Alonso J, Blancas Sánchez IM, Romero-Saldaña M. A Sustainable Approach to the Metabolic Syndrome in Children and Its Economic Burden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1891. [PMID: 32183278 PMCID: PMC7142435 DOI: 10.3390/ijerph17061891] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 01/19/2023]
Abstract
The prevalence of obesity continues to grow, resulting in metabolic syndrome and increasing economic burden for health systems. The objectives were to measure the ability of the NIM-MetS test, previously used in the adults, for the early and sustainable detection of the Metabolic Syndrome (MetS) in children and adolescents. Moreover, to determine the economic burden of the children with MetS. Furthermore, finally, to use and implement the NIM-MetS test, via a self-created online software, as a new method to determine the risk of MetS in children. The method used was an observational study using different instruments (NIM-MetS test, International Diabetes Federation (IDF), or Cook) and measures (body mass index). Additionally, the economic burden was estimated via a research strategy in different databases, e.g., PubMed, to identify previous papers. The results (N = 265 children, age from 10-12) showed that 23.1% had obesity and 7.2% hypertension. The prevalence of MetS using the NIM-Mets was 5.7, and the cost of these children was approximate 618,253,99 euros. Finally, a model was obtained and later implemented in a web platform via simulation. The NIM-MetS obtained is a non-invasive method for the diagnosis of risk of MetS in children.
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Affiliation(s)
- Manuel Vaquero Alvarez
- Grupo Investigación GC09 Nutrigenomics, Metabolic Syndrome, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, 14071 Córdoba, Spain; (M.V.A.); (I.M.B.S.)
| | - Pilar Aparicio-Martinez
- Grupo Investigación GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, 14071 Córdoba, Spain;
- Departamento de Enfermería, Fisioterapia y Farmacología, Universidad de Córdoba, Campus de Menéndez Pidal, 14071 Córdoba, Spain;
| | - Francisco Javier Fonseca Pozo
- Grupo Investigación GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, 14071 Córdoba, Spain;
| | - Joaquín Valle Alonso
- Department of Emergency Medicine, Royal Bournemouth Hospital, Bournemouth BH7 7DW, UK;
| | - Isabel María Blancas Sánchez
- Grupo Investigación GC09 Nutrigenomics, Metabolic Syndrome, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, 14071 Córdoba, Spain; (M.V.A.); (I.M.B.S.)
| | - Manuel Romero-Saldaña
- Departamento de Enfermería, Fisioterapia y Farmacología, Universidad de Córdoba, Campus de Menéndez Pidal, 14071 Córdoba, Spain;
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108
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Predictive Ability of Waist Circumference and Waist-to-Height Ratio for Cardiometabolic Risk Screening among Spanish Children. Nutrients 2020; 12:nu12020415. [PMID: 32033484 PMCID: PMC7071136 DOI: 10.3390/nu12020415] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/16/2020] [Accepted: 02/02/2020] [Indexed: 11/17/2022] Open
Abstract
An excess of fat mass has been associated with adverse cardiometabolic risk factors. Different anthropometric measures have been proposed as alternative non-invasive measures for obesity-related cardiometabolic risk. To evaluate the magnitude of association between waist circumference (WC) and waist-to-height ratio (WtHR) with cardiometabolic risk factors and metabolic syndrome and to determine the WtHR cutoff associated with a more favorable cardiometabolic risk profile in Spanish children, data were taken from a cross-sectional survey conducted in 2010 among 848 schoolchildren aged 8–11 years from 20 public schools in the province of Cuenca (Spain). Anthropometric variables, glucose, insulin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), systolic (SBP) and diastolic blood pressure (DBP) and metabolic syndrome (MetS) were also analyzed. WtHR and WC had a good accuracy for TG, insulin, and MetS. The diagnostic odds ratio ranged from 2.95 to 9.07 for WtHR and from 5.30 to 27.40 for WC. The main result of the present study suggests that both WtHR and WC could be used as a screening tool to identify children with cardiometabolic abnormalities.
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109
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Ghouili H, Ouerghi N, Ben Khalifa W, Boughalmi A, Dridi A, Gmada N, Bouassida A. First reference curves of waist circumference and waist-to-height ratio for Tunisian children. Arch Pediatr 2020; 27:87-94. [DOI: 10.1016/j.arcped.2019.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 11/11/2019] [Indexed: 11/28/2022]
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Aranceta-Bartrina J, Gianzo-Citores M, Pérez-Rodrigo C. Prevalence of overweight, obesity and abdominal obesity in the Spanish population aged 3 to 24 years. The ENPE study. ACTA ACUST UNITED AC 2020; 73:290-299. [PMID: 31987815 DOI: 10.1016/j.rec.2019.07.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/12/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION AND OBJECTIVES The aim of this study was to assess the prevalence of excess weight and abdominal obesity (AO), based on individual anthropometric measurements, according to various criteria in the Spanish population aged 3 to 24 years and to analyze their distribution by age and sex. METHODS We analyzed data from the ENPE study. This analysis included the population aged 3 to 24 years (n=1601). Anthropometric measurements were taken in participants' homes by trained observers following standardized international protocols. We defined overweight and obesity according to the International Obesity Task Force, World Health Organization, and Orbegozo 2011 criteria, and AO according to a waist-to-height index ≥ 0.5, Taylor criteria, and the 90th percentile of Orbegozo 2011. RESULTS The prevalence of excess weight (overweight+obesity) exceeded 30% with all the criteria used. The prevalence of excess overweight (International Obesity Task Force) was estimated at 34.1% (95%CI, 31.8-36.4) and obesity at 10.3% (95%CI, 8.9-11.9). The estimated prevalence of AO (waist-to-height index ≥ 0.5) was 31.2% (95%CI, 29.0-33.5), and 20.9% (95%CI, 18.1-22.1) satisfied all 3 criteria. A total of 16% (95%CI, 13.8-17.8) were overweight and had concomitant AO. CONCLUSIONS The prevalence of overweight, obesity and AO in the Spanish population aged 3 to 24 years old is high and is higher in men than in women. When distinct criteria were used, the prevalence of AO was approximately 30%. Among persons classified as obese by the 3 criteria, 71.6% were also classified as having AO according to distinct cutoffs.
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Affiliation(s)
- Javier Aranceta-Bartrina
- Departamento de Ciencias de la Alimentación y Fisiología, Universidad de Navarra, Pamplona, Navarra, Spain; Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain; Departamento de Fisiología, Facultad de Medicina, Universidad del País Vasco (UPV/EHU), Leioa, Vizcaya, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición CB12/03/30038 (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Marta Gianzo-Citores
- Biobanco Vasco, Fundación Vasca de Innovación e Investigación Sanitarias (BIOEF), Baracaldo, Vizcaya, Spain
| | - Carmen Pérez-Rodrigo
- Departamento de Fisiología, Facultad de Medicina, Universidad del País Vasco (UPV/EHU), Leioa, Vizcaya, Spain
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111
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Matsuo AR, Lopes WA, Locatelli JC, Simões CF, de Oliveira GH, Nardo N. Tri-ponderal mass index as a tool for insulin resistance prediction in overweight adolescents: A cross-sectional study. Nutrition 2020; 74:110744. [PMID: 32217458 DOI: 10.1016/j.nut.2020.110744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/30/2019] [Accepted: 01/01/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The aims of this study were to assess the capacity of tri-ponderal mass index (TMI) to screen and predict insulin resistance (IR) in overweight Brazilian adolescents, comparing it with body mass index (BMI) predictive capacity; and to verify the IR predictive capacity of other assessment tools such as waist circumference (WC), and waist-to-height ratio (WHR). METHODS A cross-sectional study was carried out with 217 overweight adolescents, from both sexes, between 12 and 18 y of age. The participants were classified as having IR according to a previous established cutoff point of ≤3.16. IR was determined by the homeostasis model assessment of insulin resistance. The other assessment tools were measured with standard protocols. RESULTS There was no difference between TMI and BMI to explain the presence of IR. In girls, BMI presented a slightly better predictive capacity to explain IR than TMI. Moreover, WC was reported to be the most effective IR screening methods for girls. Receiver operating characteristic curves showed that TMI and BMI presented similar values of sensibility and specificity for boys. Nevertheless, BMI had a better sensibility and TMI had a better specificity for girls. Interestingly, WC demonstrated a strong sensibility for both sexes. CONCLUSIONS TMI did not present a superior predictive accuracy for IR screening in overweight Brazilian adolescents when compared with BMI. TMI and BMI presented similar values of sensitivity and specificity for boys and WC a slightly superior IR predictive capacity for girls.
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Affiliation(s)
- Adriano Ruy Matsuo
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Multidisciplinary Centre of Obesity Studies-NEMO, State University of Maringa, Maringa, Brazil
| | - Wendell Arthur Lopes
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Research Group on Systemic Arterial Hypertension, Arterial Stiffness and Vascular Aging-GPHARV, State University of Maringa-UEM, Maringa, Brazil
| | - João Carlos Locatelli
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Research Group on Systemic Arterial Hypertension, Arterial Stiffness and Vascular Aging-GPHARV, State University of Maringa-UEM, Maringa, Brazil.
| | - Caroline Ferraz Simões
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Research Group on Systemic Arterial Hypertension, Arterial Stiffness and Vascular Aging-GPHARV, State University of Maringa-UEM, Maringa, Brazil
| | - Gustavo Henrique de Oliveira
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Research Group on Systemic Arterial Hypertension, Arterial Stiffness and Vascular Aging-GPHARV, State University of Maringa-UEM, Maringa, Brazil
| | - Nelson Nardo
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Multidisciplinary Centre of Obesity Studies-NEMO, State University of Maringa, Maringa, Brazil
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112
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Assessing association of waist-height ratio (WHtR) and body mass index (BMI) with non-communicable disease risk factors. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-020-01196-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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113
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The utility of anthopometric indicators to identify cardiovascular risk factors in Vietnamese children. Br J Nutr 2020; 123:1043-1055. [PMID: 31964435 DOI: 10.1017/s0007114520000203] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BMI, waist circumference (WC) and waist-to-height ratio (WHtR) can be used for discriminating children and adolescents at risk of CVD. However, consensus on how to use these anthropometric indicators is lacking for children and adolescents in Asia. Discrete criteria are promoted internationally, but continuous variables could be used. Data from a survey of 10 949 Vietnamese school-aged children (6-18 years) were used to evaluate the performance of anthropometric indicators to identify elevated blood pressure (BP), dyslipidaemia or at least three cardiovascular risk factors (CVRF). Weight, height, WC and BP were measured using standardised protocols; 1009 participants who had blood lipids were analysed. AUC was used to assess the performance, and the Youden index to identify optimal cut-offs. The prevalence of elevated BP, dyslipidaemia and CVRF was 26·5, 49·3 and 12·2 %, respectively. BMI, WC and WHtR had low capacity to identify elevated BP and dyslipidaemia (AUC range 0·61-0·66) but moderate capacity to identify CVRF (0·72-0·74). Optimal BMIZ cut-offs to identify elevated BP, dyslipidaemia and CVRF were 0·40, 1·01 and 1·1 sd; for WC z-score, they were 0·06, 0·49 and 0·62 sd; for WHtR, optimal cut-offs were close to 0·5. A BMIZ cut-off of 1·0 sd and a WHtR cut-off of 0·5 would, therefore, be useful criteria to identify Vietnamese children who are likely to have CVRF. However, further validation of these criteria in other studies of Asian children and adolescents is needed.
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The predictive value of anthropometric indices for cardiometabolic risk factors in Chinese children and adolescents: A national multicenter school-based study. PLoS One 2020; 15:e0227954. [PMID: 31961891 PMCID: PMC6974264 DOI: 10.1371/journal.pone.0227954] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 01/05/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives This study aimed to assess the accuracy of body mass index (BMI) percentile, waist circumference (WC) percentile, waist-height ratio, and waist-hip ratio for identifying cardiometabolic risk factors in Chinese children and adolescents stratified by sex and BMI categories. Methods We measured anthropometric indices, fasting plasma glucose, lipid profile and blood pressure for 15698 participants aged 6–17 in a national survey between September and December 2013. The predictive accuracy of anthropometric indices for cardiometabolic risk factors was examined using receiver operating characteristic (ROC) analyses. The DeLong test and Z test were used for the comparisons of areas under ROC curves (AUCs). Results The prevalence of impaired fasting glucose, dyslipidemia, hypertension and cluster of risk factors were 2.9%, 27.3%, 10.5% and 5.7% respectively. The four anthropometric indices showed poor to fair discriminatory ability for cardiometabolic risk factors with the AUCs ranging from 0.53–0.72. Each index performed significantly better AUCs for dyslipidemia (0.59–0.63 vs. 0.56–0.59), hypertension (0.62–0.70 vs. 0.55–0.65) and clustered risk factors (0.70–0.73 vs. 0.60–0.64) in boys than that in girls. BMI percentile performed the best accuracy for hypertension in both sexes; WC percentile had the highest AUC for dyslipidemia and BMI percentile and waist-height ratio performed similarly the best AUCs for clustered risk factors in boys while BMI percentile, WC percentile and waist-height ratio performed similar and better AUCs for dyslipidemia and clustered risk factors in girls; whereas waist-hip ratio was consistently the poorest predictor for them regardless of sex. Though the anthropometric indices were more predictive of dyslipidemia, hypertension and clustered risk factors in overweight/obese group compared to their normal BMI peers, the AUCs in overweight/obese group remained in the poor range below 0.70. Conclusions Anthropometric indices are not effective screening tools for pediatric cardiometabolic risk factors, even in overweight/obese children.
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Tee JYH, Gan WY, Lim PY. Comparisons of body mass index, waist circumference, waist-to-height ratio and a body shape index (ABSI) in predicting high blood pressure among Malaysian adolescents: a cross-sectional study. BMJ Open 2020; 10:e032874. [PMID: 31932391 PMCID: PMC7044891 DOI: 10.1136/bmjopen-2019-032874] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To compare the performance of different anthropometric indices including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and a body shape index to predict high blood pressure (BP) in adolescents using the 90th and 95th percentiles as two different thresholds. DESIGN Cross-sectional study. SETTING Probability proportionate to size was used to randomly select two schools in Selangor state, Malaysia. PARTICIPANTS A total of 513 adolescents (58.9% women and 41.1% men) aged 12-16 years were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES Weight, height, WC and BP of the adolescents were measured. The predictive power of anthropometric indices was analysed by sex using the receiver operating characteristic curve. RESULTS BMI and WHtR were the indices with higher areas under the curve (AUCs), yet the optimal cut-offs to predict high BP using the 95th percentile were higher than the threshold for overweight/obesity. Most indices showed poor sensitivity under the suggested cut-offs. In contrast, the optimal BMI and WHtR cut-offs to predict high BP using the 90th percentile were lower (men: BMI-for-age=0.79, WHtR=0.46; women: BMI-for-age=0.92, WHtR=0.45). BMI showed the highest AUC in both sexes but had poor sensitivity among women. WHtR presented good sensitivity and specificity in both sexes. CONCLUSIONS These findings suggested that WHtR might be a useful indicator for screening high blood pressure risk in the routine primary-level health services for adolescents. Future studies are warranted to involve a larger sample size to confirm these findings.
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Affiliation(s)
- Joyce Ying Hui Tee
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Wan Ying Gan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Associations of childhood adiposity and changes in adiposity status from childhood to adulthood with pregnancy hypertension. Pregnancy Hypertens 2020; 19:218-225. [DOI: 10.1016/j.preghy.2019.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/17/2019] [Accepted: 11/18/2019] [Indexed: 12/16/2022]
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Shang X, Li Y, Xu H, Zhang Q, Hu X, Liu A, Du S, Li T, Guo H, Li Y, Xu G, Liu W, Ma J, Ma G. Independent and Interactive Associations of Fitness and Fatness With Changes in Cardiometabolic Risk in Children: A Longitudinal Analysis. Front Endocrinol (Lausanne) 2020; 11:342. [PMID: 32595599 PMCID: PMC7304437 DOI: 10.3389/fendo.2020.00342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/30/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Findings for associations between cardiorespiratory fitness (CRF) and cardiometabolic risk (CMR) factors are inconsistent, and the interactive association between CRF and fatness with CMR factors is unclear in children. Our study aimed to examine whether CRF and fatness are independently and interactively associated with CMR factors. Methods: We included 5,869 children aged 6-13 years in the analysis. Physical examinations, blood tests, and CRF were measured at baseline and 1 year later. Cardiometabolic risk score (CMRS) was computed by summing Z scores of waist circumference (WC), averaged systolic and diastolic blood pressure, glucose, high-density lipoprotein cholesterol (HDL-C, multiplied by -1), and triglycerides. Results: There was a high correlation between fatness and CRF in both boys and girls. High baseline CRF was independently associated with favorable changes in CMRS, BMI, WC, percent body fat (PBF), total cholesterol, LDL-C, and HDL-C (all P < 0.025). Improved CRF was independently associated with favorable changes in CMRS, BMI, WC, PBF, total cholesterol, LDL-C, HDL-C, triglycerides, and fasting glucose (all P < 0.0321). Baseline BMI was positively associated with changes in CMRS, WC, blood pressure, triglycerides, insulin, and HOMA-IR (all P < 0.0462). Low PBF at baseline was associated with favorable changes in CMRS, BMI, WC, blood pressure, HDL-C, triglycerides, insulin, and HOMA-IR (all P < 0.0423). The percentage of the total effect of baseline CRF on changes in CMRS, triglycerides, HDL-C, PBF, and WC mediated by baseline BMI was 66.0, 61.6, 40.3, 20.7, and 9.2%, respectively. Baseline CRF was a significant mediator for the association between baseline BMI and changes in CMRS (mediated by 4.3%), triglycerides (5.1%), and HDL-C (12.0%). An inverse association was found between baseline CRF and CMRS in children with high baseline BMI/PBF only. Improved CRF was associated with decreased BMI and WC in children with low baseline CRF. Conclusions: Fatness and CRF are each independently associated with changes in CMR factors. Fatness is a major mediator for the association between CRF and CMR factors, whereas the association between fatness and CMR factors is also mediated by CRF. The beneficial effect of high CRF on CMR factors was more evident in obese or unfit children.
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Affiliation(s)
- Xianwen Shang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Yanping Li
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Haiquan Xu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Qian Zhang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Xiaoqi Hu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Ailing Liu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Songming Du
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Tingyu Li
- Department of Pediatrics, Chongqing Children's Hospital, Chongqing, China
| | - Hongwei Guo
- School of Public Health, Fudan University, Shanghai, China
| | - Ying Li
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, China
| | - Guifa Xu
- Department of Public Health, Shandong University, Jinan, China
| | - Weijia Liu
- School Health Department, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- *Correspondence: Guansheng Ma
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A simple cut-off for waist-to-height ratio (0·5) can act as an indicator for cardiometabolic risk: recent data from adults in the Health Survey for England. Br J Nutr 2019; 123:681-690. [DOI: 10.1017/s0007114519003301] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractThe National Institute for Health and Care Excellence (NICE) has acknowledged the value of waist-to-height ratio (WHtR) as an indicator for ‘early health risk’. We used recent UK data to explore whether classification based on WHtR identifies more adults at cardiometabolic risk than the ‘matrix’ based on BMI and waist circumference, currently used for screening. Data from the Health Survey for England (4112 adults aged 18+ years) were used to identify cardiometabolic risk, indicated by raised glycated Hb, dyslipidaemia and hypertension. HbA1c, total/HDL-cholesterol and systolic blood pressure (BP) were more strongly associated with WHtR than the ‘matrix’. In logistic regression models for HbA1c ≥ 48 mmol/mol, total/HDL-cholesterol > 4 and hypertension (BP > 140/90 mmHg or on medication), WHtR had a higher predictive value than the ‘matrix’. AUC was significantly greater for WHtR than the ‘matrix’ for raised HbA1c and hypertension. Of adults with raised HbA1c, 15 % would be judged as ‘no increased risk’ using the ‘matrix’ in contrast to 3 % using WHtR < 0·5. For hypertension, comparative values were 23 and 9 %, and for total/HDL-cholesterol > 4, 26 and 13 %. Nearly one-third of the ‘no increased risk’ group in the ‘matrix’ had WHtR ≥ 0·5 and hence could be underdiagnosed for cardiometabolic risk. WHtR has the potential to be a better indicator of cardiometabolic risks associated with central obesity than the current NICE ‘matrix’. The cut-off WHtR 0·5 in early screening translates to a simple message, ‘your waist should be less than half your height’, that allows individuals to be aware of their health risks.
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Wang Y, Liu W, Sun L, Zhang Y, Wang B, Yuan Y, Li T, Yao R, Han H, Qian Q, Fu L. A novel indicator, childhood lipid accumulation product, is associated with hypertension in Chinese children and adolescents. Hypertens Res 2019; 43:305-312. [PMID: 31819153 DOI: 10.1038/s41440-019-0366-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/24/2019] [Accepted: 11/06/2019] [Indexed: 11/10/2022]
Abstract
Childhood hypertension has become an important public health issue. This study explored a novel indicator, namely, childhood lipid accumulation product (CLAP), which is associated with hypertension among children and adolescents. A total of 683 children and adolescents aged 8-15 years were measured for body weight, height, waist circumference (WC), abdominal skinfold thickness (AST), triacylglycerol (TG), blood pressure, dietary behaviors, and physical activity time. The novel childhood lipid accumulation product (CLAP) was the product of WC, AST, and TG (CLAP = WC (cm) × AST (mm) × TG (mmol/L)). The logarithmic CLAP (LnCLAP), height, weight, WC, WHtR, BMI, AST, and TG were standardized for sex and age using the z-score method (standardized variables: SLnCLAP, Sheight, Sweight, SWC, SWHtR, SBMI, SAST, and STG). The results showed that the overall prevalence of hypertension was 11.6% (13.1% in boys and 9.7% in girls). SLnCLAP ≥ 1, Sweight ≥ 1, SWC ≥ 1, SWHtR ≥ 1, SBMI ≥ 1, SAST ≥ 1, and STG ≥ 1 increased the statistical risk of childhood hypertension (odds ratio values (95% CI) were 3.70 (2.22-6.16), 2.58 (1.50-4.43), 3.08 (1.84-5.15), 2.33 (1.38-3.93), 2.96 (1.72-5.29), 2.38 (1.41-4.70), and 2.40 (1.38-4.19), respectively). The area under the ROC curve (AUC) for CLAP was higher than that for weight, WC, WHtR, BMI, AST, and TG in the prediction of hypertension. In conclusion, this study showed that CLAP is a novel indicator associated with hypertension in children and adolescents and can more effectively predict childhood hypertension than weight, WC, WHtR, BMI, AST, and TG can.
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Affiliation(s)
- Yuan Wang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Wenmin Liu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Lili Sun
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Yifei Zhang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Bangxuan Wang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Yongting Yuan
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Ting Li
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Rongying Yao
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Hui Han
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Qingwen Qian
- Bengbu Centers for Disease Control and Prevention, Bengbu, 233000, Anhui, PR China
| | - Lianguo Fu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China.
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Ozsu E, Yazıcıoğlu B. Obese boys with low concentrations of high-density lipoprotein cholesterol are at greater risk of hepatosteatosis. Hormones (Athens) 2019; 18:477-484. [PMID: 31754954 DOI: 10.1007/s42000-019-00152-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 10/24/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE Non-alcoholic fatty liver disease (NAFLD) and associated morbidities have become a major public health problem, with a global three-fold increase in incidence among obese children over the last three decades. Although the gold standard for diagnosis of NAFLD is liver biopsy, it is not widely used in children. Imaging techniques, including magnetic resonance imaging (MRI) and ultrasound (US), can provide information on liver fat deposition, however, with variable sensitivity. A number of other predictors are therefore being investigated for pediatric screening and diagnostic purposes. The aim of this study was to assess easily measured parameters to prompt further investigation into NAFLD in obese children. METHODS Obese children/adolescents with a body mass index (BMI) percentile > 95 were enrolled in the study (n = 353). After a 12-hour fast, venous glucose, insulin, cholesterol, triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and uric acid were measured and a full blood count was performed in all subjects. TG/LDL ratio, AST/platelet ratio index (APRI score), and homeostatic model of assessment for insulin resistance (HOMA-IR) were calculated. All patients underwent an abdominal US examination to assess hepatosteatosis. RESULTS Of 353 patients, median age 12.5 (range, 6-17.9) years, 210 patients (59%) had US-proven hepatosteatosis. Female gender reduced the risk of steatosis 2.08-fold (p = 0.005), a one-unit increase in HDL reduced the risk of steatosis 1.02-fold (p = 0.042), and a one-unit increase in BMI led to a 1.11-fold (p = 0.002) increase in the risk of steatosis. CONCLUSION Gender, BMI, and HDL were found to be predictors of steatosis. Male patients with low HDL and high BMI are at greater risk of steatosis and should be carefully examined for the presence of NAFLD.
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Affiliation(s)
- Elif Ozsu
- Department of Pediatric Endocrinology, Ankara University School of Medicine, Ataturk Sıtesi 15th Block No. 21 Flat 7 Door Number 14 Oran, Ankara, Turkey.
| | - Bahadır Yazıcıoğlu
- Department of Family Medicine, Samsun Obstetrics and Children Hospital, Samsun, Turkey
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Fan H, Zhu Q, Medrano‐Gracia P, Zhang X. Comparison of child adiposity indices in prediction of hypertension in early adulthood. J Clin Hypertens (Greenwich) 2019; 21:1858-1862. [PMID: 31742895 PMCID: PMC8030433 DOI: 10.1111/jch.13734] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/11/2019] [Accepted: 10/23/2019] [Indexed: 11/28/2022]
Abstract
We aimed to compare child body mass index (BMI) in prediction of hypertension in early adulthood with 4 other adiposity indices (waist circumference [WC], waist circumference-to-height ratio [WHtR], waist-to-hip ratio [WHR], and triceps skinfold [TSF]). The cohort from the China Health and Nutrition Survey 1993-2011 consisted of 1444 adults aged 18-36 years who were examined in childhood and early adulthood. Child adiposity indices and adult blood pressure (BP) were transformed into age-, sex-, and survey year-specific Z-scores. Adult hypertension was defined as BP ≥130/80 mm Hg as per the 2017 American College of Cardiology/American Heart Association guidelines. Adult hypertension prevalence was 32.9% during a mean follow-up of 10.1 years. Childhood BMI showed stronger correlation with adult BP than WHR and TSF (PS for difference <.05). Child BMI showed the better prediction of adult hypertension compared with WHtR, WHR, and TSF using area under the receiver operating characteristic curves (PS for difference <.05). Per SD change in the predictor, child BMI (relative risk [95% confidence interval], 1.11 [1.04-1.18]) and WC (1.12 [1.05-1.20]) were significantly associated with adult hypertension using covariate-adjusted Poisson models with robust standard errors. Child BMI performed equally or better compared with 4 other adiposity indices in predicting adult hypertension.
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Affiliation(s)
- Hui Fan
- Department of Preventive MedicineNorth Sichuan Medical CollegeNanchongChina
| | - Qi Zhu
- Department of Preventive MedicineNorth Sichuan Medical CollegeNanchongChina
| | - Pau Medrano‐Gracia
- Department of Anatomy and Medical ImagingSchool of Medical ScienceFaculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
| | - Xingyu Zhang
- Applied Biostatistics LaboratoryUniversity of Michigan School of NursingAnn ArborMIUSA
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Henrique RS, Stodden DF, Fransen J, Feitoza AHP, Ré AHN, Martins CML, Prazeres TMP, Cattuzzo MT. Is motor competence associated with the risk of central obesity in preschoolers? Am J Hum Biol 2019; 32:e23364. [DOI: 10.1002/ajhb.23364] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 10/21/2019] [Accepted: 11/13/2019] [Indexed: 02/06/2023] Open
Affiliation(s)
- Rafael S. Henrique
- Department of Physical EducationFederal University of Pernambuco Recife Brazil
| | - David F. Stodden
- Department of Physical Education & Athletic TrainingUniversity of South Carolina Columbia South Carolina
| | - Job Fransen
- Human Performance Research Centre (HPRC)University of Technology Sydney Sydney Australia
| | | | | | | | | | - Maria T. Cattuzzo
- Department of Physical EducationFederal University of Pernambuco Recife Brazil
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Association between qat chewing and dyslipidaemia among young males. J Taibah Univ Med Sci 2019; 14:538-546. [PMID: 31908642 PMCID: PMC6940620 DOI: 10.1016/j.jtumed.2019.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/19/2019] [Accepted: 09/27/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives This study investigated the association between qat chewing and prevalence and patterns of dyslipidaemia among young Yemeni males. Methods In this cross-sectional study, we used a multistage random cluster sampling method. Data were obtained using a questionnaire. Additionally, anthropometric measurements and fasting blood samples were collected. We used Program-Adult Treatment Panel III. The blood samples were analysed for lipid profile measurements including levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Results A total of 440 Yemeni male with mean age of 21.4 ± 3.6 years were enrolled. The students were divided into the following two groups—qat chewers (n = 283) and non-qat chewers (n = 77). The overall occurrence of dyslipidaemia was significantly higher in qat chewers than that in non-qat chewers (89.8% versus 80.5%) (P < 0.05). Hypercholesterolaemia, hypertriglyceridaemia, high LDL-C level, and mixed hyperlipidaemia were lower in qat chewers than in non-qat chewers (16.6%, 58.3%, 16.3%, and 10.6%, respectively, versus 20.8%, 64.9%, 18.2%, and 20.8%, respectively). Isolated hypertriglyceridaemia was slightly higher in qat chewers than in non-qat chewers (47.7% versus 44.2%). However, the incidence of low HDL-C level, isolated low HDL-C level, and isolated hypercholesterolaemia were generally higher in qat chewers than in non-qat chewers (83%, 25.1%, and 6%, respectively, versus 75.3%, 15.6%, and 0%, respectively). Conclusion This study showed high prevalence of dyslipidaemia among Yemeni male qat chewers. Low HDL-C level was the main lipid variable, followed by hypertriglyceridaemia. Genetic factors, war conditions, physical inactivity, and low-fat traditional Yemeni diet were considered the determinants of the study findings.
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Brambilla A, Bianchi ML, Cancello R, Galimberti C, Gasperini S, Pretese R, Rigoldi M, Tursi S, Parini R. Resting energy expenditure in argininosuccinic aciduria and in other urea cycle disorders. J Inherit Metab Dis 2019; 42:1105-1117. [PMID: 31056765 DOI: 10.1002/jimd.12108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 04/28/2019] [Accepted: 04/30/2019] [Indexed: 12/30/2022]
Abstract
No data are available on the specific energy needs of patients affected with Urea Cycle disorders (UCD) and especially argininosuccinic aciduria (ASA). In our experience, ASA patients tend to develop central adiposity and hypertriglyceridemia when treated with apparently adequate energy intake, while the other UCD do not. The aim of this study was to evaluate anthropometric parameters, body composition, risk of metabolic syndrome (MS) and resting energy expenditure (REE), both by indirect calorimetry (IC) and predictive equations, in UCD patients. Hypertension (5/13), pathological waist circumference-to-height ratio (WtHr) (6/13), hypertriglyceridemia (12/13), reduced HDL cholesterol (12/13), and MS (5/13) were found in ASA group. In the ASA cohort, the mean and median IC-REE were 88% of what was predicted by Food and Agriculture Organization of the United Nations and Harris-Benedict equations. The "other UCD" cohort did not show hypertension, dyslipidaemia nor MS; IC-REE was similar to the REE predicted by equations. A significant difference was seen for the presence of hypertension, dyslipidaemia, pathological WtHr, MS and IC-REE/predictive equations-REE in the two cohorts. ASA patients have a risk of overfeeding if their energy requirement is not assessed individually with IC. Excessive energy intake might increase the cardiovascular risk of ASA patients. We suggest to test ASA individuals with IC every year if the patient is sufficiently collaborative. We speculate that most of the features seen in ASA patients might depend on an imbalance of Krebs cycle. Further studies are needed to verify this hypothesis.
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Affiliation(s)
- Alessandra Brambilla
- Department of Pediatrics, Fondazione MBBM, ATS Monza, University Hospital San Gerardo, Monza, Italy
| | - Maria L Bianchi
- Bone Metabolism Unit, Istituto Auxologico Italiano, Milano, Italy
| | | | - Cinzia Galimberti
- Department of Pediatrics, Fondazione MBBM, ATS Monza, University Hospital San Gerardo, Monza, Italy
| | - Serena Gasperini
- Department of Pediatrics, Fondazione MBBM, ATS Monza, University Hospital San Gerardo, Monza, Italy
| | - Roberta Pretese
- Department of Pediatrics, Fondazione MBBM, ATS Monza, University Hospital San Gerardo, Monza, Italy
| | - Miriam Rigoldi
- Department of Medical Genetics, Rare Disease Center, ASST San Gerardo, Monza, Italy
| | - Serena Tursi
- Department of Pediatrics, Fondazione MBBM, ATS Monza, University Hospital San Gerardo, Monza, Italy
| | - Rossella Parini
- Department of Pediatrics, Fondazione MBBM, ATS Monza, University Hospital San Gerardo, Monza, Italy
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Woolcott OO, Bergman RN. Relative Fat Mass as an estimator of whole-body fat percentage among children and adolescents: A cross-sectional study using NHANES. Sci Rep 2019; 9:15279. [PMID: 31649287 PMCID: PMC6813362 DOI: 10.1038/s41598-019-51701-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 10/07/2019] [Indexed: 02/07/2023] Open
Abstract
We evaluated the ability of the Relative Fat Mass (RFM) to estimate whole-body fat percentage among children and adolescents who participated in the National Health and Nutrition Examination Survey from 1999 through 2006 (n = 10,390). The RFM equation for adults (64 − (20 × height/waist circumference) + (12 × sex)) may be used for adolescents 15 to 19 years of age. For children and adolescents 8 to 14 years of age, we suggest a modified RFM equation, named as the RFMp (RFM pediatric): 74 − (22 × height/waist circumference) + (5 × sex). In both equations, sex equals 0 for boys and 1 for girls. RFMp was more accurate than BMI to estimate whole-body fat percentage (measured by dual energy X-ray absorptiometry, DXA) among girls (percentage of estimates that were <20% of measured body fat percentage, 88.2% vs. 85.7%; P = 0.027) and boys 8 to 14 years of age (83.4% vs. 71.0%; P < 0.001). RFM was more accurate than BMI among boys 15 to 19 years of age (82.3% vs. 73.9%; P < 0.001) but slightly less accurate among girls (89.0% vs. 92.6%; P = 0.002). Compared with BMI-for-age percentiles, RFMp had lower misclassification error of overweight or obesity (defined as a DXA-measured body fat percentage at the 85th percentile or higher) among boys 8 to 14 years of age (6.5% vs. 7.9%; P = 0.018) but not girls (RFMp: 8.2%; BMI-for-age: 7.9%; P = 0.681). Misclassification error of overweight or obesity was similar for RFM and BMI-for-age percentiles among girls (RFM: 8.0%; BMI-for-age: 6.6%; P = 0.076) and boys 15 to 19 years of age (RFM: 6.9%; BMI-for-age: 7.8%; P = 0.11). RFMp for children and adolescents 8 to 14 years of age and RFM for adolescents 15 to 19 years of age were useful to estimate whole-body fat percentage and diagnose body fat-defined overweight or obesity.
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Affiliation(s)
- Orison O Woolcott
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
| | - Richard N Bergman
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
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Kahn HS, Divers J, Fino NF, Dabelea D, Bell R, Liu LL, Zhong VW, Saydah S. Alternative waist-to-height ratios associated with risk biomarkers in youth with diabetes: comparative models in the SEARCH for Diabetes in Youth Study. Int J Obes (Lond) 2019; 43:1940-1950. [PMID: 30926953 PMCID: PMC9425551 DOI: 10.1038/s41366-019-0354-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/19/2018] [Accepted: 02/07/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES The waist-to-height ratio (WHtR) estimates cardiometabolic risk in youth without need for growth charts by sex and age. Questions remain about whether waist circumference measured per protocol of the National Health and Nutrition Examination Survey (WNHAHtR) or World Health Organization (WWHOHtR) can better predict blood pressures and lipid parameters in youth. PARTICIPANTS/METHODS WHtR was measured under both anthropometric protocols among participants in the SEARCH Study, who were recently diagnosed with diabetes (ages 5-19 years; N = 2 773). Biomarkers were documented concurrently with baseline anthropometry and again ~7 years later (ages 10-30 years; N = 1 712). For prediction of continuous biomarker outcomes, baseline WNHAHtR or WWHOHtR entered semiparametric regression models employing restricted cubic splines. To predict binary biomarkers (high-risk group defined as the most adverse quartile) linear WNHAHtR or WWHOHtR terms entered logistic models. Model covariates included demographic characteristics, pertinent medication use, and (for prospective predictions) the follow-up time since baseline. We used measures of model fit, including the adjusted-R2 and the area under the receiver operator curves (AUC) to compare WNHAHtR and WWHOHtR. RESULTS For the concurrent biomarkers, the proportion of variation in each outcome explained by full regression models ranged from 23 to 46%; for the prospective biomarkers, the proportions varied from 11 to 30%. Nonlinear relationships were recognized with the lipid outcomes, both at baseline and at follow-up. In full logistic models, the AUCs ranged from 0.75 (diastolic pressure) to 0.85 (systolic pressure) at baseline, and from 0.69 (triglycerides) to 0.78 (systolic pressure) at the prospective follow-up. To predict baseline elevations of the triglycerides/HDL cholesterol ratio, the AUC was 0.816 for WWHOHtR compared with 0.810 for WNHAHtR (p = 0.003), but otherwise comparisons between alternative WHtR protocols were not significantly different. CONCLUSIONS Among youth with recently diagnosed diabetes, measurements of WHtR by either waist circumference protocol similarly helped estimate current and prospective cardiometabolic risk biomarkers.
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Affiliation(s)
- Henry S Kahn
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jasmin Divers
- Department of Biostatistics, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nora F Fino
- Biostatistics and Design Program, Oregon Health and Science University, Portland, OR, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ronny Bell
- Department of Public Health, East Carolina University, Greenville, NC, USA
| | - Lenna L Liu
- Department of General Pediatrics, Seattle Children's Hospital, Seattle, WA, USA
| | - Victor W Zhong
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sharon Saydah
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Lo K, Liu Q, Allison M, Feng YQ, Chan K, Phillips L, Manson J, Liu S. Prospective Associations of Waist-to-Height Ratio With Cardiovascular Events in Postmenopausal Women: Results From the Women's Health Initiative. Diabetes Care 2019; 42:e148-e149. [PMID: 31308018 PMCID: PMC6702600 DOI: 10.2337/dc19-0612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/18/2019] [Indexed: 02/03/2023]
Affiliation(s)
- Kenneth Lo
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Center for Global Cardiometabolic Health and Departments of Epidemiology, Medicine, and Surgery, Brown University, Providence, RI
| | - Qing Liu
- Center for Global Cardiometabolic Health and Departments of Epidemiology, Medicine, and Surgery, Brown University, Providence, RI
| | - Matthew Allison
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA
| | - Ying-Qing Feng
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Katie Chan
- Departments of Biomedical Sciences and Electronic Engineering, City University of Hong Kong, Hong Kong
| | - Lawrence Phillips
- Division of Endocrinology, School of Medicine, Emory University, Atlanta, GA
| | - JoAnn Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Simin Liu
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Center for Global Cardiometabolic Health and Departments of Epidemiology, Medicine, and Surgery, Brown University, Providence, RI
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Yakovenko V, Henn L, Bettendorf M, Zelinska N, Soloviova G, Hoffmann GF, Grulich-Henn J. Risk Factors for Childhood Overweight and Obesity in Ukraine and Germany. J Clin Res Pediatr Endocrinol 2019; 11:247-252. [PMID: 30630809 PMCID: PMC6745453 DOI: 10.4274/jcrpe.galenos.2019.2018.0157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE The prevalence of overweight and obesity in childhood and adolescence are rapidly increasing and influenced by genetic, familial, environmental, socioeconomic and cultural factors. The aim of the study was to compare risk factors for childhood obesity in Ukraine (UA) and Germany (DE) using comparable investigative tools. METHODS Two groups of children, aged 8 to 18 years, from DE (93 children) and UA (95 children) were divided into overweight and obese groups. Anthropometric data and detailed medical history were collected. RESULTS Risk factors in pregnancy (prematurity, weight gain >20 kg, early contractions) were equally frequent in both groups. Positive correlations of body mass index (BMI)-standard deviation score (SDS) between children and mothers were noted. The proportion of family members with diabetes mellitus was lower in the UA group. Obesity was more frequent at one year of age in DE children. The DE group also became overweight at an earlier age and remained overweight over a longer period of time compared to UA. The mean BMI-SDS of obese children was lower in the UA group. In both groups waist circumference to height ratio was >0.5, indicating presence of a cardiometabolic risk factor. About half of the patients in both groups had blood pressure values exceeding the 95th percentile. CONCLUSION Similar risk factors for obesity were observed among two groups of children in UA and DE. Differences were observed regarding the prevalence of specific risk factors for childhood obesity. Population-specific distribution of risk factors needs to be considered in order to optimize prevention and treatment strategies.
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Affiliation(s)
- Vira Yakovenko
- Ruprecht-Karls-University Heidelberg, University Children’s Hospital, Department of General Pediatrics, Heidelberg, Germany
| | - Laura Henn
- Otto-von-Guericke University Magdeburg, Institute of Psychology, Magdeburg, Germany
| | - Markus Bettendorf
- Ruprecht-Karls-University Heidelberg, University Children’s Hospital, Department of General Pediatrics, Heidelberg, Germany
| | - Natalia Zelinska
- Ukrainian Center of Endocrine Surgery and Transplantation of Endocrine Organs and Tissues, Kiev, Ukraine
| | - Galyna Soloviova
- Ukrainian Children Specialized Hospital “OHMATDIT”, Kiev, Ukraine
| | - Georg F. Hoffmann
- Ruprecht-Karls-University Heidelberg, University Children’s Hospital, Department of General Pediatrics, Heidelberg, Germany
| | - Juergen Grulich-Henn
- Ruprecht-Karls-University Heidelberg, University Children’s Hospital, Department of General Pediatrics, Heidelberg, Germany,* Address for Correspondence: Ruprecht-Karls-University Heidelberg, University Children’s Hospital, Department of General Pediatrics, Heidelberg, Germany Phone: +496221564002 E-mail:
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129
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Liu J, Tse LA, Liu Z, Rangarajan S, Hu B, Yin L, Leong DP, Li W. Predictive Values of Anthropometric Measurements for Cardiometabolic Risk Factors and Cardiovascular Diseases Among 44 048 Chinese. J Am Heart Assoc 2019; 8:e010870. [PMID: 31394972 PMCID: PMC6759887 DOI: 10.1161/jaha.118.010870] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 05/15/2019] [Indexed: 12/25/2022]
Abstract
Background The predictive value of adiposity indices and the newly developed index for cardiometabolic risk factors and cardiovascular diseases (CVDs) remains unclear in the Chinese population. This study aimed to compare the predictive value of A Body Shape Index with other 5 conventional obesity-related anthropometric indices (body mass index, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio) in Chinese population. Methods and Results A total of 44 048 participants in the study were derived from the baseline data of the PURE-China (Prospective Urban and Rural Epidemiology) study in China. All participants' anthropometric parameters, CVDs, and risk factors (dyslipidemia, abnormal blood pressure, and hyperglycemia) were collected by standard procedures. Multivariable logistic regression models and receiver operator characteristic curve analysis were used to evaluate the predictive values of obesity-related anthropometric indices to the cardiometabolic risk factors and CVDs. A positive association was observed between each anthropometric index and cardiometabolic risk factors and CVDs in all models (P<0.001). Compared with other anthropometric indices (body mass index, waist circumference, hip circumference, waist-to-hip ratio, and A Body Shape Index), waist-to-height ratio had significantly higher areas under the curve (AUCs) for predicting dyslipidemia (AUCs: 0.646, sensitivity: 65%, specificity: 44%), hyperglycemia (AUCs: 0.595, sensitivity: 60%, specificity: 45%), and CVDs (AUCs: 0.619, sensitivity: 59%, specificity: 41%). Waist circumference showed the best prediction for abnormal blood pressure (AUCs: 0.671, sensitivity: 66%, specificity: 40%) compared with other anthropometric indices. However, the new body shape index did not show a better prediction to either cardiometabolic risk factors or CVDs than that of any other traditional obesity-related indices. Conclusions Waist-to-height ratio appeared to be the best indicator for dyslipidemia, hyperglycemia, and CVDs, while waist circumference had a better prediction for abnormal blood pressure.
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Affiliation(s)
- Jia Liu
- State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesPeking Union Medical College & Chinese Academy of Medical SciencesBeijingChina
| | - Lap Ah Tse
- The Jockey Club School of Public Health and Primary CarePrince of Wales HospitalThe Chinese University of Hong KongChina
| | - Zhiguang Liu
- The Jockey Club School of Public Health and Primary CarePrince of Wales HospitalThe Chinese University of Hong KongChina
| | - Sumathy Rangarajan
- Population Health Research InstituteHamilton Health Sciences and McMaster UniversityHamiltonCanada
| | - Bo Hu
- State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesPeking Union Medical College & Chinese Academy of Medical SciencesBeijingChina
| | - Lu Yin
- State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesPeking Union Medical College & Chinese Academy of Medical SciencesBeijingChina
| | - Darryl P. Leong
- Population Health Research InstituteHamilton Health Sciences and McMaster UniversityHamiltonCanada
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Naja F, Itani L, Hwalla N, Sibai AM, Kharroubi SA. Identification of dietary patterns associated with elevated blood pressure among Lebanese men: A comparison of principal component analysis with reduced rank regression and partial least square methods. PLoS One 2019; 14:e0220942. [PMID: 31419246 PMCID: PMC6697315 DOI: 10.1371/journal.pone.0220942] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To examine the associations of dietary patterns with odds of elevated Blood Pressure (BP) among Lebanese adult males using principal component analysis (PCA), and compare the results to two other data reduction methods, including reduced rank regression (RRR) and partial least-squares (PLS) regression. METHODS Data from the National Nutrition and Non-Communicable Disease Risk Factor Survey conducted in Lebanon between years 2008 and 2009 were used. Dietary intake data were collected by a 61-item food frequency questionnaire (FFQ). In addition, anthropometric and blood pressure measurements were obtained following standard techniques. For the purpose of this study, data of males older than 20 years with no history of chronic diseases were selected (n = 673). Elevated BP was indicated if the systolic blood pressure was > = 130mm Hg and/or the diastolic blood pressure > = 85 mm Hg. Dietary patterns were constructed using PCA, PLS and RRR and compared based on the performance to identify plausible patterns associated with elevated BP. For PLS and RR, the response variables were BMI, waist circumference and percent body fat. Multiple logistic regression was used to evaluate the associations between the dietary pattern scores of each method and risk of elevated BP. RESULTS Three dietary patterns were identified using PCA: Western, Traditional Lebanese, and Fish and alcohol. Both the Western and the Traditional Lebanese patterns were associated with higher odds of elevated BP in the study population (OR = 1.23, CI 1.03, 1.46; OR = 1.29, CI 1.09, 1.52 respectively). The comparison among the three methods for dietary patterns derivation showed that PLS and RRR derived patterns explained greater variance in the outcome (PCA: 1.2%; PLS: 14.1%; RRR: 15.36%) and were significantly associated with elevated BP, while the PCA dietary patterns were descriptive of the study population's real dietary habits (PCA: 23.6%; PLS: 19.8%; RRR: 11.3%). CONCLUSIONS The Western and Traditional Lebanese dietary patterns were associated with higher odds of elevated BP among Lebanese males. The findings of this study showed that, compared to PCA, the use of RRR method resulted in more significant associations with the outcome while the PCA-derived patterns were more related to the real habits in the study population.
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Affiliation(s)
- Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Laila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University Beirut, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Abla M Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Samer A Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
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131
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Abstract
This cross-sectional study examined the associations of recreational screen time (viewing TV programs on any screen-based device and computer use, performed while sitting) with body mass index (BMI) categories and waist-to-height ratio (WHtR) tertiles in 10,228 children (mean age 11.1 years, SD 0.8). We categorized the children into Light, Medium and Heavy TV viewers and computer users, and into Low, Medium and High exercise groups. Compared with Light TV viewers, Medium (OR: 1.30, 95% CI: 1.11–1.52, when adjusted for age, sex, language, sleep duration and exercise) and Heavy (OR: 1.57, 95% CI: 1.34–1.83) TV viewers had a higher risk of being overweight. Similarly, Heavy computer users had a higher risk of being overweight (OR: 1.42, 95% CI: 1.21–1.67). We observed interactions between exercise and TV viewing (p = 0.012) or computer use (p = 0.010). However, Heavy TV viewers had a higher risk of being overweight in all exercise groups. The associations of TV viewing and computer use were similar with BMI and WHtR. To conclude, heavy sedentary screen time is associated with overweight and central adiposity in children. Moreover, heavy TV viewers have a higher risk for overweight and central adiposity, regardless of weekly exercise duration.
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132
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Ejtahed HS, Kelishadi R, Qorbani M, Motlagh ME, Hasani-Ranjbar S, Angoorani P, Beshtar S, Ziaodini H, Taheri M, Heshmat R. Utility of waist circumference-to-height ratio as a screening tool for generalized and central obesity among Iranian children and adolescents: The CASPIAN-V study. Pediatr Diabetes 2019; 20:530-537. [PMID: 30968521 DOI: 10.1111/pedi.12855] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Waist-to-height ratio (WHtR) is regarded as a simple anthropometric index for evaluating central adiposity because of its independence of age, gender, and ethnicity. OBJECTIVE The purpose of this study was to determine the optimal WHtR cutoff value in screening obesity and to compare it with other obesity indicators including body mass index (BMI) and waist circumference (WC) in Iranian children and adolescents. METHODS This large survey was conducted on 14 274 Iranian children and adolescents as a national school-based surveillance study (CASPIAN) in 2015. The receiver operating characteristic curve analysis was performed to estimate the optimal cut-off points of WHtR for the prediction of general and central obesity. The area under curve (AUC) was used to compare the ability of WHtR cut-off points, BMI and WC percentiles to discriminate students with and without obesity according to age and sex. RESULTS The optimal WHtR cutoff value for predicting general obesity was 0.49 and 0.48 for boys and girls, respectively and for central obesity according to WC ≥ 90th percentile was 0.50 for both genders. AUC values of WHtR for predicting general and central obesity were 87% and 96%, which indicates its strong predictive ability. For central obesity, the AUCs of WHtR were superior to those of WC percentiles. The kappa agreement coefficient was 0.55 between WC ≥ 90th percentile and WHtR ≥ 0.5. CONCLUSIONS The WHtR ≥ 0.5 as a simple and useful screening tool is better than WC, for predicting general and central obesity in different age and sex groups of Iranian children and adolescents.
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Affiliation(s)
- Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shirin Hasani-Ranjbar
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pooneh Angoorani
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Beshtar
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Hasan Ziaodini
- Health Psychology Research Center, Education Ministry, Tehran, Iran
| | - Majzoubeh Taheri
- Office of Adolescents and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Kuciene R, Dulskiene V. Associations between body mass index, waist circumference, waist-to-height ratio, and high blood pressure among adolescents: a cross-sectional study. Sci Rep 2019; 9:9493. [PMID: 31263167 PMCID: PMC6602926 DOI: 10.1038/s41598-019-45956-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/17/2019] [Indexed: 02/06/2023] Open
Abstract
The purpose of the present study was to examine the associations between body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and high blood pressure (HBP), and to determine which anthropometric parameters can best predict HBP among Lithuanian adolescents aged 12–15 years. Data from the survey of “Prevalence and Risk Factors of HBP in 12–15-Year-Old Lithuanian Children and Adolescents (Study 1, 2010–2012)” were used; a total of 7,457 respondents (3,494 boys and 3,963 girls) were included in this analysis. Adolescents with BP above the 90th percentile were measured on two different occasions. Logistic regression analysis was used to assess the associations and to calculate odds ratios. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive ability of the three anthropometric parameters to predict HBP. The adjusted odds ratios (aOR) in the highest quartiles of BMI, WC, and WHtR were statistically significant for both sexes separately (reference group – the first quartile): in boys, prehypertension – 4.91, 4.09, and 1.59; hypertension – 7.96, 6.44, and 2.81; and prehypertension/hypertension – 6.85, 5.65, and 2.37, respectively; and in girls, prehypertension – 3.42, 2.70, and 1.66; hypertension – 5.71, 3.54, and 2.90; and prehypertension/hypertension – 4.62, 3.17, and 2.31, respectively). According to the analyses of the ROC curve, BMI z-score provided the largest area under the curve (AUC) value, followed by WC z-score, while WHtR z-score showed the lowest AUC value in predicting elevated BP in both sexes separately. Among Lithuanian adolescents aged 12–15 years, both anthropometric indices – BMI and WC (but particularly BMI) – showed stronger associations with HBP and were better for the prediction of HBP, compared to WHtR.
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Affiliation(s)
- Renata Kuciene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, LT-50161, Kaunas, Lithuania.
| | - Virginija Dulskiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, LT-50161, Kaunas, Lithuania
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Ashley-Martin J, Ensenauer R, Maguire B, Kuhle S. Predicting cardiometabolic markers in children using tri-ponderal mass index: a cross-sectional study. Arch Dis Child 2019; 104:577-582. [PMID: 30655268 DOI: 10.1136/archdischild-2018-316028] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/09/2018] [Accepted: 12/10/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To model the development of the tri-ponderal mass index (TMI, kg/m3) throughout childhood and adolescence and to compare the utility of the TMI with that of the body mass index (BMI, kg/m2) to predict cardiometabolic risk in a population-based sample of Canadian children and youth. METHODS We used data from the Canadian Health Measures Survey to model TMI from 6 to 19 years of age. Percentile curves were developed using the LMS method. Logistic regression was used to predict abnormal levels of cardiometabolic markers; predictive accuracy was assessed using the area under the ROC curve (AUC). RESULTS Mean TMI was relatively stable from ages 6 to 19 years for both sexes, but variability increased with age. There was no notable difference in AUC values for prediction models based on BMI z-score compared with TMI for any of the outcomes. For both BMI z-score and TMI, prediction accuracy was good for homeostasis model assessment insulin resistance and having ≥3 abnormal tests (AUC>0.80), fair for C-reactive protein and poor for the remainder of the outcomes. CONCLUSIONS The use of a single sex-specific TMI cut-off for overweight or obesity is hampered by the increasing variability of the measure with age. Weight-for-height indices likely have only limited ability to predict cardiometabolic marker levels, and changing the scaling power of height is unlikely to improve predictive accuracy.
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Affiliation(s)
- Jillian Ashley-Martin
- Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Regina Ensenauer
- Experimental Pediatrics and Metabolism, University Children's Hospital, Heinrich Heine University, Düsseldorf, Germany
| | | | - Stefan Kuhle
- Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
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Vanky E, Engen Hanem LG, Abbott DH. Children born to women with polycystic ovary syndrome-short- and long-term impacts on health and development. Fertil Steril 2019; 111:1065-1075. [PMID: 31056313 DOI: 10.1016/j.fertnstert.2019.03.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 12/30/2022]
Abstract
Maternal PCOS status may negatively influence offspring infant and childhood growth, cardiometabolic health, reproductive health, and neurodevelopment. Current findings across studies are divergent, often because of small numbers of subjects, as well as heterogeneous selection criteria, ethnicities, and definitions of control groups. Coexisting maternal obesity, pregnancy complications, and comorbidity make it difficult to identify the contribution of maternal PCOS. Large, prospective, international, multiethnic studies with standardized investigation protocols and questionnaires on PCOS offspring health and development are needed.
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Affiliation(s)
- Eszter Vanky
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Gynecology and Obstetrics, St. Olav's Hospital, Trondheim, Norway.
| | - Liv Guro Engen Hanem
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - David H Abbott
- Department of Obstetrics and Gynecology and Wisconsin National Primate Research Center, University of Wisconsin, Madison, Wisconsin
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Ma C, Lu Q, Wang R, Yin F. Using height-corrected definition of metabolic syndrome in children and adolescents. J Pediatr Endocrinol Metab 2019; 32:429-438. [PMID: 31050656 DOI: 10.1515/jpem-2018-0414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/23/2019] [Indexed: 02/06/2023]
Abstract
Metabolic syndrome (MS) is common among children and adolescents. Age- and gender-specific references or age-, gender- and height-specific references were used in pediatric MS definitions. More recently, an increasing number of studies documented that the ratio of waist circumference (WC) to height (WHtR) and blood pressure to height (BPHR) were easy anthropometric indexes for detection of obesity and hypertension in children and adolescents. For these reasons, height-corrected MS definition was proposed. WHtR and BPHR were used as alternatives to WC and BP in the definition of MS. In the present review, we discuss the possibility of the height-corrected MS definition for identifying MS in children.
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Affiliation(s)
- Chunming Ma
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Qiang Lu
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Rui Wang
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Fuzai Yin
- Department of Endocrinology, The First Hospital of Qinhuangdao, No. 258 Wenhua Road, Qinhuangdao 066000, Hebei Province, China, Phone: +86-335-3634208, Fax: +86-335-3032042
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137
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Sentalin PBR, Pinheiro ADO, de Oliveira RR, Zângaro RA, Campos LA, Baltatu OC. Obesity and metabolic syndrome in children in Brazil: The challenge of lifestyle change. Medicine (Baltimore) 2019; 98:e15666. [PMID: 31083270 PMCID: PMC6531096 DOI: 10.1097/md.0000000000015666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The purpose of this observational study was to examine the prevalence of obesity in children of 6 to 8 years of age from primary public schools over a period of 6 years and the associated environmental and metabolic health risk factors.This was a cohort observational study to investigate the prevalence of obesity in children from 14 state primary schools in Vinhedo, Sao Paulo state. Environmental and metabolic health risk factors for obesity were investigated in a cross-sectional survey.This present study revealed 74.0% of children with obesity consumed fried foods and sweets at school, and 84.0% consumed snacks and soft drinks at home. This cohort reported to have engaged in physical activity for less than 3 hours per week at school (93.0%) and at home (85.0%). There was a high prevalence of increased waist circumference and insulin resistance among children with obesity (84.9% and 84.5%, respectively). The body mass index had a significant Spearman correlation with waist circumference, insulin resistance, and triglycerides.Childhood obesity was associated with a high prevalence of both environmental and metabolic risk factors. Also, the authors conclude that the lack of parents' awareness of childhood obesity and its risk factors represents a substantial barrier to lifestyle counseling.
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Affiliation(s)
| | | | - Robson Rocha de Oliveira
- School of Health Sciences at Anhembi Morumbi University—Laureate International Universities, Sao Jose dos Campos
| | | | - Luciana Aparecida Campos
- Center of Innovation, Technology and Education (CITE)
- School of Health Sciences at Anhembi Morumbi University—Laureate International Universities, Sao Jose dos Campos
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE)
- School of Health Sciences at Anhembi Morumbi University—Laureate International Universities, Sao Jose dos Campos
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138
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Quader ZS, Gazmararian JA, McCullough LE. Obesity and understudied minority children: existing challenges and opportunities in epidemiology. BMC Pediatr 2019; 19:103. [PMID: 30971202 PMCID: PMC6458765 DOI: 10.1186/s12887-019-1484-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 04/02/2019] [Indexed: 12/30/2022] Open
Abstract
Background Obesity is a major public health concern in the United States and should be addressed as early as possible, in childhood. Disparities exist in obesity prevalence and its associated comorbidities by racial/ethnic group, however less is known about the smaller racial/ethnic subclasses that are often aggregated and assumed to be homogeneously at risk. As the racial and ethnic composition of the US shifts towards greater diversity, it is important that epidemiologic research addresses these new challenges. Main body In this short communication, we focus on Asian American children given that subgroups are historically understudied and emerging evidence among adults suggest heterogeneous associations for both obesity and cardio-metabolic outcomes. Existing limitations in this research area include: (1) identifying the appropriate measurement of adiposity in Asian American children; (2) determining high-risk cutoffs for intervention; and (3) developing strategies to ensure study robustness. Conclusion Data disaggregation is a necessary approach to understand potentially heterogeneous associations in childhood obesity and cardio-metabolic risk, but epidemiologic investigators must address these challenges. Ultimately, successful strategies could help better identify high risk subgroups, target interventions, and effectively reduce the burden of obesity among American youth.
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Affiliation(s)
- Zerleen S Quader
- Department of Epidemiology, Emory University, CNR 3rd floor, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA.
| | - Julie A Gazmararian
- Department of Epidemiology, Emory University, CNR 3rd floor, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA
| | - Lauren E McCullough
- Department of Epidemiology, Emory University, CNR 3rd floor, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
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139
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Gupta N, Lteif A, Creo A, Iqbal AM, Pittock S, Tebben PJ, Hansen J, Heyrman M, Spee R, Scanlan-Hanson L, Kumar S. Improved utilization of waist-to-height ratio in cardiometabolic risk counselling in children: Application of DMAIC strategy. J Eval Clin Pract 2019; 25:300-305. [PMID: 30378218 DOI: 10.1111/jep.13055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/10/2018] [Accepted: 10/03/2018] [Indexed: 11/30/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Waist circumference (WC) and waist-to-height ratio (WHtR) are superior surrogate markers of central obesity than body mass index. However, WC is not measured routinely in paediatric clinics. The objective of this study was to implement measurement of WC during routine assessment of children in an ambulatory outpatient clinic setting and subsequent dissemination of cardiometabolic risk counselling in children with central obesity (defined as WHtR ≥0.5). METHOD Prospective cohort of patients aged 6 to 20 years. Study period was divided into three phases: baseline (3 months), process improvement (2 months), and implementation (6 months). Define-Measure-Analyse-Improve-Control (DMAIC) strategy was applied. Measurement of WC was implemented as a component of the physical examination in patients. Outcome measures were (1) improvement in frequency of WC measurement and (2) utilization of WHtR in cardiometabolic risk counselling. RESULTS Waist circumference was not measured in any patient during baseline phase (n = 551). During process improvement phase, of the total 347 patients, WC was measured in 35% vs target of 30%. In the implementation phase, WC was measured in 37% patients (365 out of 964). Of these 365 patients, 175 (48%) had elevated WHtR, and 73% of them (n = 128) were counselled about their increased cardiometabolic risk. CONCLUSIONS Application of an evidence-based DMAIC protocol led to significant improvement in assessment for central obesity in an ambulatory clinic practice and appropriate counselling regarding cardiometabolic risk reduction in children and adolescents with central obesity over an 8-month period. Meticulous planning and execution, frequent reinforcement, and integrating feedback from the involved multi-disciplinary team were important factors in successful implementation of this quality improvement project.
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Affiliation(s)
- Nidhi Gupta
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Aida Lteif
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ana Creo
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Anoop Mohamed Iqbal
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Siobhan Pittock
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Peter J Tebben
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Janet Hansen
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mary Heyrman
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Rebecca Spee
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Seema Kumar
- Division of Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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140
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Zhang Q, Yang L, Zhang Y, Zhao M, Liang Y, Xi B. Hypertension Prevalence Based on Three Separate Visits and Its Association With Obesity Among Chinese Children and Adolescents. Front Pediatr 2019; 7:307. [PMID: 31396500 PMCID: PMC6668215 DOI: 10.3389/fped.2019.00307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Clinical practice guidelines recommended that hypertension in children and adolescents should be defined based on elevated blood pressure (BP) on at least three separate occasions. Therefore, in the present study, we aimed to estimate the prevalence of hypertension based on three separate visits among Chinese children and adolescents and to examine its relationship with obesity. Methods: A school-based cross-sectional survey was performed in children and adolescents in Jinan, China between September 2012 and September 2014. A total of 7,832 children and adolescents aged 6-17 years were included. Anthropometric data and BP were measured by trained examiners. Elevated BP was defined as BP ≥ 95th percentile for age and sex based on the Chinese reference data. Participants with elevated BP at the first visit underwent a second visit 2 weeks later, and a third visit was conducted if BP was still high at the second visit. Hypertension was defined as having an elevated BP at all three visits. Obesity was defined in three ways by using body mass index, waist circumference, and waist-to-height ratio. Results: The prevalence of elevated BP decreased substantially across three separate visits, with the prevalence of 17.2, 8.6, and 4.9%, respectively. Obesity was an independent risk factor for elevated BP during each visit. Based on the body mass index, obesity was associated with higher risk of elevated BP, with the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of 8.6 (6.8-11.0), 12.5 (9.1-17.3), and 14.0 (8.9-22.2), respectively, at the first, second and third visit. The ORs of elevated BP were similar in association with obesity defined by waist circumference or waist-to-height ratio. Conclusions: The prevalence of hypertension based on three visits was ~5% in Chinese children and adolescents. There was a dose-response relationship between obesity and elevated BP across three visits.
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Affiliation(s)
- Qian Zhang
- Zibo Center for Disease Control and Prevention, Zibo, China
| | - Lili Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Yanqing Zhang
- Zibo Center for Disease Control and Prevention, Zibo, China
| | - Min Zhao
- Department of Nutrition, School of Public Health, Shandong University, Jinan, China
| | - Yajun Liang
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
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141
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Zhao M, López-Bermejo A, Caserta CA, Medeiros CCM, Kollias A, Bassols J, Romeo EL, Ramos TDA, Stergiou GS, Yang L, Xargay-Torrent S, Amante A, Gusmão TME, Grammatikos E, Zhang Y, Prats-Puig A, de Carvalho DF, Yang L, Carreras-Badosa G, Simões MDO, Hou Y, Mas-Pares B, Shui W, Guo T, Wang M, Chen H, Lou X, Zhang Q, Zhang Y, Bovet P, Magnussen CG, Xi B. Metabolically Healthy Obesity and High Carotid Intima-Media Thickness in Children and Adolescents: International Childhood Vascular Structure Evaluation Consortium. Diabetes Care 2019; 42:119-125. [PMID: 30420475 DOI: 10.2337/dc18-1536] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/21/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE It has been argued that metabolically healthy obesity (MHO) does not increase cardiovascular disease (CVD) risk. This study examines the association of MHO with carotid intima-media thickness (cIMT), a proxy of CVD risk, in children and adolescents. RESEARCH DESIGN AND METHODS Data were available for 3,497 children and adolescents aged 6-17 years from five population-based cross-sectional studies in Brazil, China, Greece, Italy, and Spain. Weight status categories (normal, overweight, and obese) were defined using BMI cutoffs from the International Obesity Task Force. Metabolic status (defined as "healthy" [no risk factors] or "unhealthy" [one or more risk factors]) was based on four CVD risk factors: elevated blood pressure, elevated triglyceride levels, reduced HDL cholesterol, and elevated fasting glucose. High cIMT was defined as cIMT ≥90th percentile for sex, age, and study population. Logistic regression model was used to examine the association of weight and metabolic status with high cIMT, with adjustment for sex, age, race/ethnicity, and study center. RESULTS In comparison with metabolically healthy normal weight, odds ratios (ORs) for high cIMT were 2.29 (95% CI 1.58-3.32) for metabolically healthy overweight and 3.91 (2.46-6.21) for MHO. ORs for high cIMT were 1.44 (1.03-2.02) for unhealthy normal weight, 3.49 (2.51-4.85) for unhealthy overweight, and 6.96 (5.05-9.61) for unhealthy obesity. CONCLUSIONS Among children and adolescents, cIMT was higher for both MHO and metabolically healthy overweight compared with metabolically healthy normal weight. Our findings reinforce the need for weight control in children and adolescents irrespective of their metabolic status.
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Affiliation(s)
- Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China
| | - Abel López-Bermejo
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain.,Department of Pediatrics, Hospital Dr. Josep Trueta, Girona, Spain
| | - Carmelo A Caserta
- Fondazione per la Medicina Solidale, Pellaro, Reggio Calabria, Italy
| | | | - Anastasios Kollias
- Hypertension Center STRIDE-7, School of Medicine, National and Kapodistrian University of Athens, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Judit Bassols
- Department of Pediatrics, Hospital Dr. Josep Trueta, Girona, Spain.,Maternal-Fetal Metabolic Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | | | - Thacira Dantas Almeida Ramos
- Department of Medicine, University Center of Medical Sciences of Campina Grande, Campina Grande, Brazil.,Department of Maternal and Child Health, Professor Fernando Figueira Integral Medicine Institute, Recife, Brazil
| | - George S Stergiou
- Hypertension Center STRIDE-7, School of Medicine, National and Kapodistrian University of Athens, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Lili Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Silvia Xargay-Torrent
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Angela Amante
- Associazione Calabrese di Epatologia, Pellaro, Reggio Calabria, Italy
| | - Tatianne Moura Estrela Gusmão
- Department of Maternal and Child Health, Professor Fernando Figueira Integral Medicine Institute, Recife, Brazil.,Department of Physiotherapy, University Center of Medical Sciences of Campina Grande, Campina Grande, Brazil
| | | | - Yuanyuan Zhang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Anna Prats-Puig
- Department of Physical Therapy, Escola Universitària de la Salut i l'Esport, Salt, Spain
| | | | - Liu Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Gemma Carreras-Badosa
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | | | - Yaping Hou
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Berta Mas-Pares
- Maternal-Fetal Metabolic Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Wang Shui
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Teng Guo
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Mingming Wang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Hua Chen
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Xiaohuan Lou
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Qian Zhang
- Zibo Disease Control and Prevention Center, Zibo, China
| | - Yanqing Zhang
- Zibo Disease Control and Prevention Center, Zibo, China
| | - Pascal Bovet
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
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142
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Performance of Waist-To-Height Ratio, Waist Circumference, and Body Mass Index in Discriminating Cardio-Metabolic Risk Factors in a Sample of School-Aged Mexican Children. Nutrients 2018; 10:nu10121850. [PMID: 30513720 PMCID: PMC6316407 DOI: 10.3390/nu10121850] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/16/2018] [Accepted: 11/20/2018] [Indexed: 12/11/2022] Open
Abstract
The most common tools used to screen for abdominal obesity are waist circumference (WC) and waist-to-height ratio (WHtR); the latter may represent a more suitable tool for the general non-professional population. The objective of this study was to evaluate the association of WHtR, WC, and body mass index with lipidic and non-lipidic cardio-metabolic risk factors and the prediction capability of each adiposity indicator in a sample of school-aged Mexican children. Overall, 125 children aged 6 to 12 years were analyzed. Anthropometric, biochemical, and dietary parameters were assessed. Receiving operating characteristic (ROC) analysis and univariate and multivariate linear and logistic regression analyses were performed. All the three adiposity indicators showed significant areas under the ROC curve (AURC) greater than 0.68 for high low-density lipoprotein cholesterol (LDL-c), triglycerides, and atherogenic index of plasma, and low high-density lipoprotein cholesterol (HDL-c). A significant increased risk of having LDL-c ≥ 3.4 mmol/L was observed among children with WHtR ≥ 0.5 as compared to those with WHtR < 0.5 (odds ratio, OR: 2.82; 95% confidence interval, CI: 0.75–7.68; p = 0.003). Fasting plasma glucose was not associated with any of the adiposity parameters. WHtR performed similarly to WC and z-BMI in predicting lipidic cardio-metabolic risk factors; however, a WHtR ≥ 0.5 was superior in detecting an increased risk of elevated LDL-c.
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143
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Causes and solutions to “globesity”: The new fa(s)t alarming global epidemic. Food Chem Toxicol 2018; 121:173-193. [DOI: 10.1016/j.fct.2018.08.071] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/10/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
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144
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Sgambat K, Roem J, Mitsnefes M, Portale AA, Furth S, Warady B, Moudgil A. Waist-to-height ratio, body mass index, and cardiovascular risk profile in children with chronic kidney disease. Pediatr Nephrol 2018; 33:1577-1583. [PMID: 29872963 PMCID: PMC6281775 DOI: 10.1007/s00467-018-3987-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/10/2018] [Accepted: 05/21/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cardiovascular (CV) risk is high in children with chronic kidney disease (CKD), and further compounded in those who are overweight. Children with CKD have a unique body habitus not accurately assessed by body mass index (BMI). Waist-to-height ratio (WHr), a better predictor of CV risk in populations with short stature, has not been investigated in children with CKD. METHODS Analysis of 1723 visits of 593 participants enrolled in the Chronic Kidney Disease in Children (CKiD) study was conducted. CKiD participants had BMI and WHr measured and classified as follows: (1) lean (WHr ≤ 0.49, BMI < 85th percentile); (2) WHr-overweight (WHr > 0.49, BMI < 85th percentile); (3) BMI-overweight (WHr ≤ 0.49, BMI ≥ 85th percentile); or (4) overweight by both BMI and WHr. Left ventricular mass index (LVMI), fasting lipids, fibroblast growth factor 23 (FGF23), blood pressure, and glucose were measured as markers of CV risk. Linear mixed-effects regression was used to evaluate differences in CV markers between overweight and lean groups. RESULTS Participants were 12.2 years old, 60% male, and 17% African-American. Approximately 15% were overweight by WHr but not by BMI. Overweight status by WHr-only or both WHr and BMI was associated with lower high-density lipoprotein (HDL) and higher LVMI, triglycerides, and non-HDL cholesterol compared to lean. CV markers of participants overweight by BMI-only were similar to those of lean children. CONCLUSIONS WHr-adiposity is associated with an adverse CV risk profile in children with CKD. A significant proportion of children with central adiposity are missed by BMI. WHr should be utilized as a screening tool for CV risk in this population.
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Affiliation(s)
- Kristen Sgambat
- Department of Nephrology, Children's National Health System, 111 Michigan Avenue NW, Washington, DC, 20010, USA.
| | - Jennifer Roem
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark Mitsnefes
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Susan Furth
- The Children's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, PA, USA
| | | | - Asha Moudgil
- Department of Nephrology, Children's National Health System, 111 Michigan Avenue NW, Washington, DC, 20010, USA
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145
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Ochoa Sangrador C, Ochoa-Brezmes J. Waist-to-height ratio as a risk marker for metabolic syndrome in childhood. A meta-analysis. Pediatr Obes 2018; 13:421-432. [PMID: 29700992 DOI: 10.1111/ijpo.12285] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/14/2018] [Accepted: 02/21/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Individuals with abdominal obesity have a higher cardiovascular risk, regardless of the degree of global overweight. OBJECTIVE To estimate the accuracy of the Waist/height ratio (WtHR) as a risk marker for metabolic syndrome (MS) in children or adolescents. METHODS Published cohort or cross-sectional studies (Pubmed, Embase-SCOPUS and CINAHL) were searched, with no limits of time. Studies providing Waist/height ratio and clustered criteria of metabolic syndrome were included. RESULTS Thirty-one studies (66,912 subjects) were selected. Overall, a high WtHR (≥0.5) was associated with a four-fold increased risk of clustered criteria of MS (odds ratio [OR] 4.15, 95% confidence interval [95% CI]: 2.69 to 6.42) and two-fold increased risk when adjusted by general obesity (adjusted OR 2.26, 95% CI: 1.29 to 3.98). The WtHR, as a quantitative measure, showed a pooled area under the curve of 0.76 (95% CI: 0.71 to 0.80) and, as a dichotomous measure, with a cut-off point close to 0.5, a sensitivity of 60% (95% CI: 50% to 68.8%) and a specificity of 79% (95% CI: 71.6% to 83.9%). CONCLUSIONS Measuring WtHR may be considered in regular health checks of children and adolescents, as it can measure cardiovascular risk regardless of the degree of general obesity.
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Affiliation(s)
| | - J Ochoa-Brezmes
- School of Medicine, University of Valladolid, Valladolid, Spain
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146
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Hampe CS, Shaffer ML, Roth CL. Associations between Liver Enzyme Levels and Parameters of the Metabolic Syndrome in Obese Children. Horm Res Paediatr 2018; 88:265-273. [PMID: 28898874 DOI: 10.1159/000479868] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 07/24/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Obesity is strongly associated with insulin resistance, hypertension, dyslipidemia, and therefore risk for metabolic syndrome (MetS), which is an increasing problem in youth. The potential role of elevated liver enzyme levels in this context needs to be further investigated. METHODS This paper provides a post hoc analysis of a cross-sectional study of 77 obese nondiabetic children (51% female; median age 11.7 years; BMI >97th percentile) enrolled at the University of Bonn, Bonn, Germany. Anthropometric parameters, lipid profiles, glycemic control, and liver enzyme levels were evaluated. Glucose and insulin levels were determined during an oral glucose tolerance test (OGTT). Gender- and age-specific cutoff values were used to assess MetS. RESULTS A high prevalence of hypertension (51%), dyslipidemia (52%), elevated liver enzyme levels (51%), and hyperglycemia (24%) was found. There was considerable overlap between the presence of different MetS risk factors in individuals, and 40% of the participants had ≥3 of a maximum of 5 MetS risk factors. Elevated liver enzyme levels were significantly associated with reduced insulin sensitivity, as the OGTT-insulin response was significantly higher in participants with elevated transaminases (p = 0.01). This association was independent of hyperglycemia and dyslipidemia (p = 0.03). CONCLUSIONS We conclude that liver enzyme levels are related to insulin sensitivity in obese children and could therefore be an indirect indicator for MetS. Testing for disturbed glucose metabolism should be considered for obese children with elevated liver enzymes.
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Affiliation(s)
- Christiane S Hampe
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Michele L Shaffer
- Seattle Children's Research Institute, Center for Clinical and Translational Research, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Christian L Roth
- Center for Integrative Brain Research, Seattle Children's Hospital and Research Institute, Seattle, Washington, USA.,Pediatric Endocrinology, Seattle Children's Hospital and Research Institute, Seattle, Washington, USA
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147
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Njuieyon F, Cuadro-Alvarez E, Martin E, Lachaume N, Mrsic Y, Henaff F, Maniassom C, Defo A, Elenga N. Mother's obesity and high child's waist circumference are predictive factors of severe child's obesity: an observational study in French Guiana. BMC Pediatr 2018; 18:188. [PMID: 29885650 PMCID: PMC5994247 DOI: 10.1186/s12887-018-1158-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 05/24/2018] [Indexed: 12/20/2022] Open
Abstract
Background This study aims to describe the predictive factors of severe obesity in children followed in French Guiana. Methods In this observational study, the patients from the French Guianese Childhood Obesity Group database were prospectively included, after giving a statement of patient’s non opposition. Results Our group classifications revealed that 36 of 150 (24%) participants were classified as being metabolically abnormal obesity“ (MAO), while 114 of 150 (76%) were categorized as metabolically normal obesity” (MNO). MAO-patients were older. Their mothers had more severe obesity. We also observed that their systolic blood pressure was higher. The median Z-score BMI of children with MAO was 4, 9 [4, 05–5, 38], which shows a more obese condition than the MNO group. The median waist-to-height ratio (WTHR) of our study population was high, either 0.63 [0.54–0.59]. No significant differences in the term of pregnancy, father’s obesity, gender, birth weight, feeding, diastolic blood pressure and WTHR were found between the two groups. The predictors of MAO status, after adjusting for age and sex, were mother’s obesity and high child’s waist circumference. Among the comorbidity, there were two Down syndrome, one Cornelia de Lange syndrome, one Nephrotic Syndrome and one Epilepsy. The leptin hormone and insulin levels were higher in MAO than in MNO, while 25-OH D-vitamin was higher in MNO. Conclusion This study indicates the need to incorporate waist circumference into routine clinical practice, in addition to traditional measures of weight, height, body mass index and waist-to-height ratio.
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Affiliation(s)
- Falucar Njuieyon
- Department of Pediatric Medicine and Surgery, Cayenne Hospital, Rue des flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Emma Cuadro-Alvarez
- Department of Pediatric Medicine and Surgery, Cayenne Hospital, Rue des flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Elise Martin
- Department of Pediatric Medicine and Surgery, Cayenne Hospital, Rue des flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Noémie Lachaume
- Department of Pediatric Medicine and Surgery, Cayenne Hospital, Rue des flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Yajaira Mrsic
- Department of Pediatric Medicine and Surgery, Cayenne Hospital, Rue des flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Fanny Henaff
- Department of Pediatric Medicine and Surgery, Cayenne Hospital, Rue des flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Chimène Maniassom
- Department of Pediatric Medicine and Surgery, Cayenne Hospital, Rue des flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Antoine Defo
- Department of Pediatric Medicine and Surgery, Cayenne Hospital, Rue des flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Narcisse Elenga
- Department of Pediatric Medicine and Surgery, Cayenne Hospital, Rue des flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana. .,Department of Pediatric Medicine and Surgery, Regional Hospital, Rue des Flamboyants BP 6006, 97306, Cayenne Cedex, French Guiana.
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148
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Probability and Body Composition of Metabolic Syndrome in Young Adults: Use of the Bayes Theorem as Diagnostic Evidence of the Waist-to-Height Ratio. STATS 2018. [DOI: 10.3390/stats1010003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Metabolic syndrome (MS) directly increases the risk of cardiovascular diseases. Childhood and adulthood have been the most studied in MS, leaving aside the young adult population. This study aimed to compare the epidemiological probabilities between MS and different anthropometric parameters of body composition. Using a cross-sectional study with the sample of 1351 young adults, different body composition parameters were obtained such as Waist Circumference (WC), Body Mass Index (BMI), Body Fat% (BF%), Waist-to-Height Ratio (WHtR), and Waist-Hip Ratio. The Bayes Theorem was applied to estimate the conditional probability that any subject developed MS with an altered anthropometric parameter of body composition. Areas under receiver operating characteristic curves (AUCs) and adjusted odds ratios of the five parameters were analyzed in their optimal cutoffs. The conditional probability of developing MS with an altered anthropometric parameter was 17% in WHtR, WC, and Waist-hip R. Furthermore, body composition parameters were adjusted by age, BMI, and gender. Only WHtR (OR = 9.43, CI = 3.4–26.13, p < 0.0001), and BF% (OR = 3.18, CI = 1.42–7.13, p = 0.005) were significant, and the sensitivity (84%) and the AUCs (86%) was higher in WHtR than other parameters. In young adults, the WHtR was the best predictor of metabolic syndrome.
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149
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Predictive Value of Adiposity Level, Metabolic Syndrome, and Insulin Resistance for the Risk of Nonalcoholic Fatty Liver Disease Diagnosis in Obese Children. Can J Gastroenterol Hepatol 2018; 2018:9465784. [PMID: 29854716 PMCID: PMC5944281 DOI: 10.1155/2018/9465784] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/08/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in obese children. Early diagnosis and treatment are essential for curing or slowing down the disease progression. The aim of the study was to assess the prevalence of NAFLD in this population and to identify anthropometrical and metabolic risk factors for NAFLD prediction and its development. MATERIAL AND METHODS The study included 108 obese children. Anthropometric measurements, NAFLD diagnosis (based on ALT level and/or liver ultrasound), and metabolic syndrome (MS) components were assessed in all patients. Patients were divided into groups with and without NAFLD. RESULTS NAFLD was diagnosed in 49 (45%) patients with similar prevalence in boys (27; 55.10%) and girls [22 (44.9%), p = 0.089]. NAFLD patients had significantly greater waist circumference, WHR, and WHtR and significantly higher total cholesterol, triglyceride, and fasting insulin concentrations as well as higher glucose and insulin concentrations in 120 minutes of OGTT and higher HOMA-IR levels compared to group of patients without NAFLD. In NAFLD patients, MS was significantly more likely to be diagnosed than in group without NAFLD (40.82% versus 22.81%, p = 0.04), but among the MS components only hypertriglyceridemia was significantly more frequently diagnosed in the group with NAFLD (p = 0.002). Among analysed parameters the best independent risk factor for NAFLD was fasting insulin concentration with the cut-off point = 18,9 uIU/ml (AUC = 0.829). CONCLUSIONS NAFLD is a very common disease in obese children. NAFLD predictive risk factors include increased waist circumference, elevated WHR and WHtR, and elevated total cholesterol, triglycerides, and fasting insulin as well as elevated glucose and insulin concentration in the OGTT and HOMA-IR index. NAFLD increases the risk of potential cardiovascular complications expressed by diagnosis of metabolic syndrome. The best independent predictive risk factor for diagnosing NAFLD in obese children is fasting insulin > 18.9 uIU/ml.
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150
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Merianos AL, Jandarov RA, Khoury JC, Mahabee-Gittens EM. Tobacco Smoke Exposure Association With Lipid Profiles and Adiposity Among U.S. Adolescents. J Adolesc Health 2018; 62:463-470. [PMID: 29224987 PMCID: PMC5866739 DOI: 10.1016/j.jadohealth.2017.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 09/13/2017] [Accepted: 10/06/2017] [Indexed: 01/19/2023]
Abstract
PURPOSE We investigated the association between tobacco smoke exposure (TSE) as measured by serum cotinine and lipoprotein cholesterols and adiposity in adolescents. METHODS We performed a secondary analysis of 1999-2012 National Health and Nutrition Examination Survey data including participants 12-19 years old. We examined TSE: unexposed (<.05 ng/mL), passively exposed (.05-2.99 ng/mL), and actively exposed (≥3 ng/mL); lipid profiles: total cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, low-density lipoprotein cholesterol (LDL-C), and triglycerides; and adiposity: body mass index z-score (BMIZ), waist circumference (WC), and waist-to-height ratio (WHtR). Covariates were age, sex, race/ethnicity, income, diet, and physical activity. Multiple regression models were used to assess the association between TSE and lipid profile variables separately, and then TSE and adiposity measures separately, adjusting for covariates. We performed logistic regression to examine the association of TSE with body mass index and WHtR classifications. RESULTS Of the 11,550 participants, 41.7% were unexposed to tobacco smoke, 40.5% were passively exposed, and 17.8% were actively exposed. Compared with unexposed, participants with active TSE had lower total cholesterol, lower HDL-C, and higher triglycerides; higher BMIZ, higher WC, and higher WHtR; participants with passive TSE had lower HDL-C, higher total cholesterol, and higher LDL-C; higher BMIZ, higher WC, and higher WHtR. Participants actively exposed were at increased odds of being obese or WHtR ≥.65, and those passively exposed were at increased odds of being overweight, obese, or WHtR ≥.65. CONCLUSIONS Active TSE and passive TSE are differentially associated with factors within the lipid profile and adiposity, independent of covariates. TSE prevention efforts should start as early as childhood and continue throughout adolescence and adulthood.
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Affiliation(s)
- Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, Ohio.
| | - Roman A Jandarov
- Division of Biostatistics and Bioinformatics, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Jane C Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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