Effectiveness of a body shape index in predicting pediatric high blood pressure

Systematic Evaluation of Adiposity Indices as Predictors of Hypertension Risk in Children and Adolescents

Objective

To systemically examine the concomitant impact of adiposity indices on hypertension in children and adolescents.

Methods

A community-based cohort study by China Health and Nutrition Survey (2009-2011) included 262 children and adolescents aged 7-17. Anthropometric and lipid profiles were analyzed for hypertension risk using logistic and cross-lagged models.

Results

Of the 227 participants (mean age, 16.5 [2.3] years), 147 (53.9%) were boys. Over a two-year period, 26.4% developed hypertension, 5.3% had elevated systolic blood pressure (SBP), and 25.6% had elevated diastolic blood pressure (DBP). After adjusting for covariates, higher body mass index (BMI), waist circumference (WC), hip circumference (HC), triceps skinfold thickness (TST), and body roundness index (BRI) were associated with increased hypertension risk. Incorporating these measures into a BP-based model improved the AUC for hypertension prediction from 0.551 (95% CI: 0.463, 0.640) to 0.670 (95% CI: 0.592, 0.748). A longitudinal relationship were observed between these adiposity indices and hypertension symptoms.

Conclusions

The study suggests anthropometry parameters are superior to blood lipid indicators in predicting the occurrence of hypertension in children. Abdominal obesity, as indicated by WC, HC, and BRI, accounts for a significant portion of the risk for hypertension, particularly in children aged 7 to 12 years.

Tri-ponderal mass index and left ventricular hypertrophy in a cohort of caucasian children and adolescents with obesity

BACKGROUND

Pediatric obesity is a global emerging burden for society; among its health-related consequences there are hypertension (HTN) and left ventricular hypertrophy (LVH). Several anthropometric indices have been investigated for the early identification of cardiovascular risk in children. The aim of the present study was to assess whether tri-ponderal mass index (TMI) was associated with LVH in a cohort of Caucasian children and adolescents with obesity.

METHODS

In this observational study, 63 children and adolescents with obesity aged 7-to-16 years were enrolled. During outpatient visits, adiposity, and cardio-metabolic indices (BMI z-score, WHR, TMI, ABSI) were collected. All subjects underwent a 24-hour ambulatory blood pressure monitoring (ABPM) and transthoracic echocardiography.

RESULTS

Children and adolescents with obesity with LVH had significantly higher BMI z-score (p = 0.009), WHR (p = 0.006) and TMI (p = 0.026) compared to children without LVH. WC and WHR were the only indices significantly associated with left ventricular mass index (LVMI).

CONCLUSION

Left ventricular remodeling is associated with the cardio-metabolic risk markers WC and WHR, but not with the adiposity index TMI among children with obesity.

Predictive ability of traditional and novel anthropometric measurement indices for cardio-metabolic diseases in Chinese adults: China Health and Nutrition Survey (CHNS) cohort study

BACKGROUND AND AIMS

Cardio-metabolic diseases has been shown to be strongly associated with obesity. The aim of this study was to compare the predictive value of traditional and novel anthropometric measurement indices for cardio-metabolic diseases risk and evaluate whether new indicators can provide important information in addition to traditional indicators.

METHODS AND RESULTS

China Health and Nutrition Survey (CHNS) data were obtained for this study. Baseline information for healthy participants was gathered from 1997 to 2004. The incidence of cardio-metabolic diseases was collected from 2009 to 2015 for cohort analysis. The predictive ability of each index for the risk of cardio-metabolic diseases was evaluated with time-dependent ROC analysis. Body mass index (BMI) showed the greatest predictive ability for cardio-metabolic disease incidence among all traditional and novel indices (Harrell's C statistic (95% CI): 0.7386 (0.7266-0.7507) for hypertension, 0.7496 (0.7285-0.7706) for diabetes, 0.7895 (0.7593-0.8196) for stroke and 0.7581 (0.7193-0.7969) for myocardial infarction). The addition of novel indices separately into the BMI model did not improve the predictive ability. Novel anthropometric measurement indices such as a body shape index (ABSI), abdominal volume index (AVI) and triponderal mass index (TMI), had a certain prediction ability for adults with BMI <24 kg/m² compared to those with BMI ≥24 kg/m².

CONCLUSION

No strong evidence supports novel anthropometric measurement indices were better than BMI in the prediction of cardio-metabolic diseases incidence among Chinese adults. Novel anthropometric measurement indices, mainly for abdominal obesity, may have a high predictive effect for adults with BMI <24 kg/m².