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Feng X, Zhu J, Hua Z, Yao S, Tong H. Comparison of obesity indicators for predicting cardiovascular risk factors and multimorbidity among the Chinese population based on ROC analysis. Sci Rep 2024; 14:20942. [PMID: 39251694 PMCID: PMC11383956 DOI: 10.1038/s41598-024-71914-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 09/02/2024] [Indexed: 09/11/2024] Open
Abstract
To date, the best obesity-related indicators (ORIs) for predicting hypertension, dyslipidaemia, Type 2 diabetes mellitus (T2DM) and multimorbidity are still controversial. This study assessed the ability of 17 ORIs [body mass index (BMI), body fat percentage (BF%), c-index, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), a body shape index (ABSI), body adiposity index (BAI), waist circumference (WC), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), abdominal volume index (AVI), triglyceride glucose index (TYG), lipid accumulation product (LAP), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), waist triglyceride index (WTI) and cardiometabolic index (CMI)] to predict hypertension, dyslipidemia, T2DM, and multimorbidity in populations aged 40-69 years. From November 2017 to December 2022, 10,432 compliant residents participated in this study. Receiver operating characteristic curves were used to assess the ability of ORIs to predict target diseases across the whole population and genders. The DeLong test was used to analyse the heterogeneity of area under curves (AUCs). Multivariable logistic regression was used to analyse the association of ORIs with hypertension, dyslipidaemia, T2DM, and multimorbidity. The prevalence of hypertension, dyslipidaemia, T2DM, and multimorbidity was 67.46%, 39.36%, 12.54% and 63.58%, respectively. After excluding ORIs associated with the target disease components, in the whole population, CVAI (AUC = 0.656), BMI (AUC = 0.655, not significantly different from WC and AVI), CVAI (AUC = 0.645, not significantly different from LAP, CMI, WHR, and WTI), and TYG (AUC = 0.740) were the best predictor of hypertension, dyslipidemia, T2DM, and multimorbidity, respectively (all P < 0.05). In the male population, BF% (AUC = 0.677), BMI (AUC = 0.698), CMI (AUC = 0.648, not significantly different from LAP and CVAI), and TYG (AUC = 0.741) were the best predictors (all P < 0.05). In the female population, CVAI (AUC = 0.677), CUN-BAE (AUC = 0.623, not significantly different from BF%, WC, WHR, WHtR, BRI and BMI), CVAI (AUC = 0.657, not significantly different from WHR), TYG (AUC = 0.740) were the best predictors (all P < 0.05). After adjusting for all covariates, all ORIs were significantly associated with hypertension, dyslipidaemia, T2DM, and multimorbidity (all P < 0.05), except for ABSI and hypertension and BAI and T2DM, which were insignificant. Ultimately, after considering the heterogeneity of prediction of ORIs among different populations, for hypertension, BF% was the best indicator for men and CVAI for the rest of the population. The best predictors of dyslipidaemia, T2DM, and multimorbidity were BMI, CVAI and TYG, respectively. Screening for common chronic diseases in combination with these factors may help to improve the effectiveness.
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Affiliation(s)
- Xiang Feng
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China.
| | - Jinhua Zhu
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China.
- Department of Gastroenterology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210000, China.
| | - Zhaolai Hua
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Shenghua Yao
- Department of Gastroenterology, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Haiyuan Tong
- Department of Non-Communicable Disease Prevention and Control, Yangzhong Centre for Disease Control and Prevention, Yangzhong, 212200, China
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Chan KS, Farah NM, Yeo GS, Teh KC, Lee ST, Makbul IAA, Jamil NA, Sharif R, Wong JE, Khouw I, Poh BK. Association of adiposity, serum vitamin D, and dietary quality with cardiometabolic risk factors in children aged 6-12 years: findings from SEANUTS II Malaysia. Appl Physiol Nutr Metab 2024. [PMID: 39251408 DOI: 10.1139/apnm-2023-0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
Increased cardiometabolic risk among children is increasingly becoming a concern, with evidence indicating that obesity, diet, and serum 25-hydroxyvitamin D (25(OH)D) are associated with cardiometabolic risk. However, such studies among Malaysian children are scarce. Thus, this study explores the associations between adiposity, dietary quality, and 25(OH)D, with cardiometabolic risk factors among Malaysian children aged 4-12 years. Data of 479 children (mean age: 8.2 ± 2.3 years old, 52% females) from the South East Asian Nutrition Surveys (SEANUTS II) Malaysia, were included in this analysis. Adiposity (percentage of body fat) was assessed with bioelectrical impedance technique. Dietary quality was assessed using 24 h dietary recall and calculated as mean adequacy ratio. Vitamin D was assessed based on serum 25-hydroxyvitamin D (25(OH)D). Measurements of cardiometabolic risk factors included waist circumference (WC), mean arterial pressure (MAP), fasting blood glucose (FBG), high-density lipoprotein (HDL), triglyceride, and high-sensitivity C-reactive protein, and cardiometabolic risk cluster score (siMS) was calculated. Overall, higher adiposity was positively associated with all cardiometabolic risk factors (WC, ß = 0.907; 95% CI = 0.865, 0.948; MAP, ß = 0.225; 95% CI = 0.158, 0.292; HDL, ß = -0.011; 95% CI = -0.014, -0.009; Triglyceride, ß = 0.012; 95% CI = 0.009, 0.016; FBG, ß = 0.006; 95% CI = 0.002, 0.011) and siMS score (ß = 0.033; 95% CI = 0.029, 0.037). Serum 25(OH)D was inversely associated with siMS score (ß = -0.002; 95% CI = -0.004, -0.000008) and positively associated with HDL (ß = 0.002; 95% CI = 0.0001, 0.003). Our findings suggest that adiposity is a key determinant of adverse cardiometabolic risk factors in children, while serum 25(OH)D may be associated with overall cardiometabolic health. Interventions to reduce obesity are needed to mitigate the deleterious consequences of cardiometabolic dysregulation in children.
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Affiliation(s)
- Kai Sze Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Nor Mf Farah
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
- Obesity-UKM Research Group, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Giin Shang Yeo
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Kuan Chiet Teh
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Shoo Thien Lee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
- Faculty of Health and Life Sciences, Management and Science University, 40150 Shah Alam, Selangor, Malaysia
| | | | - Nor Aini Jamil
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Razinah Sharif
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Jyh Eiin Wong
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
- Obesity-UKM Research Group, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Ilse Khouw
- FrieslandCampina, Amersfoort, the Netherlands
| | - Bee Koon Poh
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
- Obesity-UKM Research Group, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
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Zhang J, Olsen A, Halkjær J, Petersen KE, Tjønneland A, Overvad K, Dahm CC. Self-reported and measured anthropometric variables in association with cardiometabolic markers: A Danish cohort study. PLoS One 2023; 18:e0279795. [PMID: 37498855 PMCID: PMC10374072 DOI: 10.1371/journal.pone.0279795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/09/2023] [Indexed: 07/29/2023] Open
Abstract
General obesity is a recognized risk factor for various metabolically related diseases, including hypertension, dyslipidemia, and pre-diabetes. In epidemiological studies, anthropometric variables such as height and weight are often self-reported. However, misreporting of self-reported data may bias estimates of associations between anthropometry and health outcomes. Further, few validation studies have compared self-reported and measured waist circumference (WC). This study aimed to quantify the agreement between self-reported and measured height, weight, body mass index (BMI), WC, and waist-to-height ratio (WHtR), and to investigate associations of these anthropometric measures with cardiometabolic biomarkers. A total of 39,514 participants aged above 18 years were included into the Diet, Cancer, and Health-Next Generation Cohort in 2015-19. Self-reported and measured anthropometric variables, blood pressure, and cardiometabolic biomarkers (HbA1c, lipid profiles, C-reactive protein and creatinine) were collected by standard procedures. Pearson correlations (r) and Lin's concordance correlations were applied to evaluate misreporting. Misreporting by age, sex and smoking status was investigated in linear regression models. Multivariable regression models and Receiver Operating Characteristic analyses assessed associations of self-reported and measured anthropometry with cardiometabolic biomarkers. Self-reported height was overreported by 1.07 cm, and weight was underreported by 0.32 kg on average. Self-reported BMI and WC were 0.42 kg/m2 and 0.2 cm lower than measured, respectively. Self-reported and measured height, weight, BMI, WC and WtHR were strongly correlated (r = 0.98, 0.99, 0.98, 0.88, 0.86, respectively). Age, sex, smoking, and BMI contributed to misreporting of all anthropometric measures. Associations between self-reported or measured anthropometric measures and cardiometabolic biomarkers were similar in direction and strength. Concordance between self-reported and measured anthropometric measures, including WC, was very high. Self-reported anthropometric measures were reliable when estimating associations with cardiometabolic biomarkers.
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Affiliation(s)
- Jie Zhang
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anja Olsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jytte Halkjær
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Kułaga Z, Świąder-Leśniak A, Kotowska A, Litwin M. Population-based references for waist and hip circumferences, waist-to-hip and waist-to-height ratios for children and adolescents, and evaluation of their predictive ability. Eur J Pediatr 2023:10.1007/s00431-023-05001-4. [PMID: 37140701 DOI: 10.1007/s00431-023-05001-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/11/2023] [Accepted: 04/22/2023] [Indexed: 05/05/2023]
Abstract
Childhood obesity is a public health problem globally as well as in Poland. This paper aimed to provide age- and sex-specific waist circumference, hip circumference, waist-to-height ratio and waist-to-hip ratio normative values for Polish children and adolescents aged 3 - 18 years for more precise monitoring of abdominal fat accumulation. The waist circumference, hip circumference, waist-to-height ratio and waist-to-hip ratio references were constructed with the lambda-mu-sigma (LMS) method using data from two nationally representative health surveys: the OLA study and the OLAF study, the largest available paediatric surveys in Poland which provided measured height, weight, waist, hip and blood pressure for 22,370 children and adolescents aged 3 - 18 years. The predictive ability of newly established references for overweight/obesity as defined by the International Obesity Task Force criteria and elevated blood pressure was tested with receiver operating characteristic. Abdominal obesity cut-offs linked to adult cardiometabolic cut-offs were established. Reference values for waist circumference, hip circumference, waist-to-height ratio and waist-to-hip ratio are presented, as well as waist circumference, waist-to-height ratio and waist-to-hip ratio cut-off values linked to adult's cut-offs of cardiometabolic risk. The predictive value for overweight and obesity of population-based waist, hip and waist-to-height ratio references was outstanding-area under the receiver operating characteristic curve > 0.95 in both sexes, whereas with regard to the elevated blood pressure predictive ability was low-area under the receiver operating characteristic curve < 0.65. Conclusion: This paper presents the first waist, hip, waist-to-height ratio and waist-to-hip ratio references for Polish children and adolescents aged 3-18 years. The 90th and 95th percentile and cut-offs linked to adult thresholds for cardiometabolic risk are proposed as cut-offs for abdominal obesity. What is Known: • Waist circumference, waist-to-height ratio and waist-to-hip ratio are used to assess abdominal obesity in children and adults. • In Poland, there is no abdominal obesity and hip circumference references for children and adolescents from 3 to 18 years of age. What is New: • Population-based references of central obesity indices and hip references for children and youth aged 3-18 years and cardiometabolic risk thresholds for children and adolescents linked to adult's cut-offs were established.
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Affiliation(s)
- Zbigniew Kułaga
- Public Health Department, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland.
| | - Anna Świąder-Leśniak
- Laboratory of Anthropology, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland
| | - Aneta Kotowska
- Public Health Department, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland
| | - Mieczysław Litwin
- Department of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland
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Kangan RZ, Cheah WL, Hazmi H. Prevalence and associated factors of hypertension among primary school children: A cross-sectional study in Kuching, Sarawak. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2023; 18:6. [PMID: 36992958 PMCID: PMC10042247 DOI: 10.51866/oa.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Introduction Hypertension is an emerging health concern among children owing to its increasing prevalence and association with obesity. However, hypertension screening is uncommon, and childhood hypertension-related data are limited. This cross-sectional study determined the prevalence and associated factors of hypertension among primary school children in Kuching, Sarawak. Method Standard procedures and validated equipment were used to measure blood pressure and anthropometric indicators. The body mass index (BMI)-for-age and waist-to-height ratio (WHtR) were calculated. Questionnaires were used to obtain family sociodemographic data and health history. Results A total of 1,314 children aged 6-12 years were enrolled, of whom 107 (8.1%) and 178 (13.5%) were hypertensive and pre-hypertensive, respectively. The chi-squared test indicated that hypertension was significantly associated with male sex (P<0.05), >1 standard deviation BMI-for-age (P<0.001), percentage of excess body fat (BF)(P<0.001), 5th to 95th height percentile (P<0.001), >90th excess waist circumference (WC) percentile (P<0.001), >90th WHtR percentile (P<0.001), clerical, service, sales and skilled parental work (P<0.05), excess weight (P<0.05) and cardiovascular disease (P<0.01). Multivariate logistic regression analysis showed that the percentage of excess BF [odds ratio (OR): 4.84, 95% confidence interval (CI): 2.01-11.66] and excess WC (OR: 2.33, 95% CI: 1.15-4.72) were significantly related to hypertension after adjusting for sex and age. Conclusion The prevalence of hypertension among the study population is higher than that among children worldwide. Childhood hypertension-related factors must be identified to aid in routine blood pressure screening, which is crucial for early detection and intervention to reduce future morbidity burden.
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Affiliation(s)
- Roslinda Zakiah Kangan
- Department of Community Medicine & Public Health, Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Whye Lian Cheah
- Department of Community Medicine & Public Health, Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia.
| | - Helmy Hazmi
- Department of Community Medicine & Public Health, Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
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Zhang F, Han Y, Wang H, Li Y, Yan Z. Diagnostic test accuracy of waist-to-height ratio as a screening tool for cardiovascular risk in children and adolescents: a meta-analysis. Ann Hum Biol 2022; 49:217-227. [PMID: 36121693 DOI: 10.1080/03014460.2022.2126523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
CONTEXT Waist-to-height ratio (WHtR) is a controversial evaluation index of cardiovascular risk factors (CVRFs) in children and adolescents. OBJECTIVE To assess the accuracy of WHtR as a measure to screen for clusters of at least one CVRF (CVRF1), two CVRFs (CVRF2), and three CVRFs (CVRF3) in different ages, sexes, regions and cut-offs. METHODS The PubMed, Web of Science, EBSCOhost, Springer, Taylor & Francis Online, Wiley Online Library, Wanfang, and CNKI databases were searched for eligible publications up to June 2021. The QUADAS-2 checklist was used to assess the methodology of the included studies. RESULTS Twenty-two studies that evaluated 85281 children and adolescents aged 5-19 years were included in the meta-analysis. The AUSROC values were 0.56 (95% CI: 0.54-0.57), 0.82 (95% CI: 0.81-0.83), and 0.89 (95% CI: 0.89-0.90) for CVRF1, CVRF2, and CVRF3, respectively. Higher AUSROC values were found for adolescents (12-19 years), that is, 0.91 (95% CI: 0.88-0.93), 0.90 (95% CI: 0.87-0.92) for males, and 0.91 (95% CI: 0.90-0.91) for a cut-off of ≥ 0.51 in the identification of CVRF3. CONCLUSION WHtR can be used as an accurate screening tool for CVRF3 and CVRF2 in children and adolescents, and it is recommended to select different cut-offs according to different ages, sexes, and regions.
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Affiliation(s)
- Fusheng Zhang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China.,School of Physical Education, Zhaotong University, Zhaotong, China
| | - Yanbai Han
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Hongli Wang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Yong Li
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Zhiwei Yan
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Shenyang, China
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Sekgala MD, Opperman M, Mpahleni B, Mchiza ZJR. Anthropometric indices and cut-off points for screening of metabolic syndrome among South African taxi drivers. Front Nutr 2022; 9:974749. [PMID: 36034933 PMCID: PMC9406286 DOI: 10.3389/fnut.2022.974749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Detecting the early onset of metabolic syndrome (MetS) allows for quick intervention which may slow progression to a variety of health consequences, hence, determining the best measurement to detect MetS is essential. Aim This research aimed at examining the MetS predictive power of anthropometric indices, such as body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), body shape index (ABSI), body roundness index (BRI), percentage body fat (%BF), conicity index (CI), and Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE) to determine the cut-off points to identify male South African taxi drivers with MetS. Method A cross-sectional study was conducted among 185 male taxi drivers. Their weight, height, WC, blood lipid profile were measured. International Diabetes Federation (IDF) definition was used to define MetS. Receiver Operating Characteristic (ROC) curves were used to compare the predictive ability of Anthropometric indices to detect MetS. Results The mean age of the participants was 39.84 years. Overall, 41.6% (N = 77) of the participants presented with MetS. The mean values for BMI, WC, WHtR, %BF, BRI, CUN-BAE, ABSI and CI were 28.60 ± 6.20 kg/m2, 99.13 ± 17.59 cm, 0.58 ± 0.10, 27.28 ± 8.28%, 5.09 ± 2.33, 27.78 ± 8.34, 0.08 ± 0.01 and 1.70 ± 0.19, respectively. The mean values for these indices were significantly (p < 0.001) higher in participants with MetS. The highest area under the curve (AUC) outcomes for screening MetS were for the %BF and CUN-BAE, followed by the BMI and WHtR, and lastly the BRI. All these anthropometric indices had outstanding discriminatory powers for predicting MetS with AUCs and sensitivity values above 80%. The BMI, WHtR, %BF, BRI, and CUN-BAE, had cut-off points for detection of metS in South African men at 28.25 kg/m2, 0.55, 25.29%, 4.55, and 27.10, respectively. Based on the logistic regression models abnormal BMI, WHtR, %BF, BRI, CUN-BAE, TG, FBG, systolic BP, diastolic BP and WC showed increased risk of MetS. Conclusion While the %BF, CUN-BAE, BMI, WC, WHtR, BRI, CI and CUN-BAE could predict MetS among South African male taxi drivers, these indices were less effective in predicting the individual MetS risk factors such as TG, BP, and FBG.
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Affiliation(s)
- Machoene Derrick Sekgala
- School of Public Health, University of the Western Cape, Bellville, South Africa.,Human and Social Capabilities, Human Sciences Research Council, Cape Town, South Africa
| | - Maretha Opperman
- Functional Food Research Unit, Department of Biotechnology and Consumer Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Buhle Mpahleni
- Functional Food Research Unit, Department of Biotechnology and Consumer Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Zandile June-Rose Mchiza
- School of Public Health, University of the Western Cape, Bellville, South Africa.,Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
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Tao JM, Wei W, Ma XY, Huo YX, Hu MD, Li XF, Chen X. Diagnostic accuracy of anthropometric indices for discriminating elevated blood pressure in pediatric population: a systematic review and a meta-analysis. BMC Pediatr 2022; 22:19. [PMID: 34983442 PMCID: PMC8725266 DOI: 10.1186/s12887-021-03062-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood obesity is more likely to increase the chance of many adult health problems. Numerous studies have shown obese children to be more prone to elevated blood pressure (BP) and hypertension. It is important to identify an obesity anthropometric index with good discriminatory power for them in pediatric population. METHODS MEDLINE/PubMed, Web of Science, and Cochrane databases were retrieved comprehensively for eligible studies on childhood obesity and hypertension/elevated BP through June 2021. The systematic review and meta-analysis of studies used receiver operating characteristics (ROC) curves for evaluating the discriminatory power of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) in distinguishing children with elevated BP and hypertension. RESULTS 21 cross-sectional studies involving 177,943 children and 3-19 years of age were included in our study. Meta-analysis showed that the pooled area under the reporting receiver-operating characteristic curves (AUC) and 95% confidence intervals (CIs) for BMI, WC, and WHtR to detect hypertension of boys were 0.68 (0.64, 0.72), 0.69 (0.64, 0.74), 0.67 (0.63, 0.71), for elevated BP, the pooled AUCs and 95% CIs were 0.67 (0.61, 0.73), 0.65 (0.58, 0.73), 0.65 (0.61, 0.71). The pooled AUCs and 95% CIs for BMI, WC and WHtR of predicting hypertension were 0.70 (0.66, 0.75), 0.69 (0.64, 0.75), 0.67 (0.63, 0.72) in girls, the pooled AUCs and 95% CIs of predicting elevated BP were 0.63 (0.61, 0.65), 0.62 (0.60, 0.65), 0.62 (0.60, 0.64) respectively. There was no anthropometric index was statistically superior in identifying hypertension and elevated BP, however, the accuracy of BMI predicting hypertension was significantly higher than elevated BP in girls (P < 0.05). The subgroup analysis for the comparison of BMI, WC and WHtR was performed, no significant difference in predicting hypertension and elevated BP in pediatric population. CONCLUSIONS This systematic review showed that no anthropometric index was superior in identifying hypertension and elevated BP in pediatric population. While compared with predicting elevated BP, all the indicators showed superiority in predicting hypertension in children, the difference was especially obvious in girls. A better anthropometric index should be explored to predict children's early blood pressure abnormalities.
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Affiliation(s)
- Jun-Min Tao
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Wei Wei
- Department of Neurosurgery, Affiliated Dalian Municipal Central Hospital, Dalian Medical University, Dalian, 116033, China
| | - Xiao-Yang Ma
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Ying-Xiang Huo
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Meng-Die Hu
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Xiao-Feng Li
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Xin Chen
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China.
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Zong X, Bovet P, Xi B. A Proposal to Unify the Definition of the Metabolic Syndrome in Children and Adolescents. Front Endocrinol (Lausanne) 2022; 13:925976. [PMID: 35846321 PMCID: PMC9276932 DOI: 10.3389/fendo.2022.925976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/30/2022] [Indexed: 01/19/2023] Open
Affiliation(s)
- Xin’nan Zong
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing, China
- *Correspondence: Xin’nan Zong,
| | - Pascal Bovet
- Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
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DeLacey S, Josefson JL. A Mini-Review of Pediatric Anthropometrics as Predictors of Future Insulin Resistance. Front Endocrinol (Lausanne) 2022; 13:826430. [PMID: 35185801 PMCID: PMC8848350 DOI: 10.3389/fendo.2022.826430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/07/2022] [Indexed: 12/16/2022] Open
Abstract
The impact of rising rates of childhood obesity is far reaching. Metabolic syndrome in children is increasing, yet for most children the consequences of excess adiposity will manifest in adulthood. Excess early fat accrual is a risk factor for future insulin resistance. However, certain types of fat and patterns of fat distribution are more relevant than others to metabolic risk. Therefore, adiposity measures are important. The link between childhood obesity and future insulin resistance was initially established with body mass index (BMI), but BMI is an in imperfect measure of adiposity. It is worthwhile to evaluate other anthropometrics as they may more accurately capture metabolic risk. While measures such as waist to height ratio are established as superior screening measures in adulthood - the findings are not as robust in pediatrics. Emerging evidence suggests that alternative anthropometrics may be slightly superior to BMI in identifying those youth most at risk of developing insulin resistance, but the clinical significance of that superiority appears limited. Increasing study is needed in longitudinal and varied cohorts to identify which pediatric anthropometric best predicts adult insulin resistance. We review alternative anthropometrics as predictors of future insulin resistance and identify current gaps in knowledge and potential future directions of inquiry.
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Affiliation(s)
- Sean DeLacey
- Department of Pediatrics, Division of Endocrinology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- *Correspondence: Sean DeLacey,
| | - Jami L. Josefson
- Department of Pediatrics, Division of Endocrinology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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11
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Costa-Urrutia P, Colistro V, Franco-Trecu V, Granados J, Álvarez Fariña R, Rodríguez-Arellano ME. Dyslipidemia, Obesity, and Ethnicity in Mexican Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12659. [PMID: 34886385 PMCID: PMC8656470 DOI: 10.3390/ijerph182312659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/23/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to assess lipid disorders in children from five ethnic groups, both urban and indigenous, from northern and central Mexico. We measured the lipid profile to determine the ability of the body mass index (BMI) to discriminate an abnormally high lipid level using receiving operating characteristics (ROC). We analyzed the association and interaction of obesity and ethnicity with lipid disorders using generalized linear models in 977 children. The highest prevalence of lipid disorders (high TG, high TC, high LDL, high APOB, and dyslipidemia) was found in central Mexico-Mexico City and urban northern Mexico. The BMI performed better at predicting low HDL in Seris, a northern indigenous group (0.95, CI: 0.69-0.85), and Mexico City (0.75, CI: 0.69-0.82), and high LDL in Puebla (central Mexico, 0.80, CI: 0.69-0.85). Obesity significantly (p < 0.05) increases lipid disorders by around two times (OR~2) for almost all lipid markers. Obesity and ethnic interaction increase the lipid disorders by more than five times for different lipid markers and ethnic groups (high total cholesterol OR = 5.31; low HDL OR = 5.11, and dyslipidemia OR = 5.68). Lipid disorders are not restricted to children with high BMIs, but obesity exacerbates these. The emerging lipid disorder risk depends on the ethnic group.
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Affiliation(s)
- Paula Costa-Urrutia
- Laboratorio de Medicina Genómica del Hospital Regional Lic. Adolfo López Mateos, ISSSTE, Ciudad de México 01030, Mexico
| | - Valentina Colistro
- Departamento de Métodos Cuantitativos, Facultad de Medicina, Universidad de la República, Avda, General Flores 2125, Montevideo 11800, Uruguay;
| | - Valentina Franco-Trecu
- Departamento de Ecología y Evolución, Facultad de Ciencias, Universidad de la República, Iguá 4225, Montevideo 11400, Uruguay;
| | - Julio Granados
- Departamento de Trasplantes, División de Inmunogenética, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avda, Vasco de Quiroga, Ciudad de México 14080, Mexico;
| | - Rafael Álvarez Fariña
- Ciencias del Deporte, Universidad Anáhuac, Av. Universidad Anáhuac 46, Col. Lomas Anáhuac, Huixquilucan, Naucalpan de Juárez 52786, Mexico;
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12
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Lai X, Fu S, Lin J, Huang S, Yu T, Li X, Pan D, Liu Y, Chen Y, Yu X, Peng J, Zhang B, Feng X, Lin C, Liu S. Association of Obesity and Body Fat Percentage with Pubertal State in Six- to Nine-Year-Old Chinese Females. Child Obes 2021; 17:525-533. [PMID: 34190651 DOI: 10.1089/chi.2020.0247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: An early trend in the mean age of pubertal onset appears in adolescents, but the association between body fat percentage (BF%) of children and precocious puberty is unclear. The aim of the study was to analyze the association of sexual development with BF% in girls. Methods: A total of 407 females were included in this cross-sectional study. BF% was measured by Inbody S10, International Obesity Task Force was used to judge overweight or obesity, and early puberty was defined as a younger age than the median age in each of the pubertal Tanner stages. Logistic regression analysis was used to test relationships between pubertal states and independent variables, including age, weight, waist circumference (WC), type of school, and residency. Results: Females with early puberty exhibited higher anthropometry data (such as weight, BMI, BF%) than females with normal maturation (p < 0.001). Weight, BMI, WC, BF% residency, and school type were related to pubertal state (p < 0.001). Females with higher BF% were more likely to exhibit early puberty (odds ratio = 1.138, 95% confidence interval = 1.046-1.237). The students who lived in urban areas and studied in public schools had a lower risk of early puberty. Moreover, BF% continuously increased with age in 6- to 9-year-old girls. Conclusions: Females with higher BF% may be more likely to exhibit early puberty. In future studies, more research is needed to analyze this mechanism of how BF% influences puberty development.
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Affiliation(s)
- Xin Lai
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Simao Fu
- Zhongshan Hospital of Sun-Yat-Sen University, Zhongshan, China
| | - Jianfei Lin
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sizhe Huang
- Health Care Center for Primary and Secondary Schools, Zhongshan, China
| | - Tingting Yu
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoqing Li
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongxue Pan
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yifan Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yao Chen
- Department of Endocrine and Genetic Metabolic Diseases, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaodan Yu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianming Peng
- Boai Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China
| | - Bihong Zhang
- Boai Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China
| | - Xiaowen Feng
- Zhejiang Nutriease Health Technology Company Limited, Hangzhou, China
| | - Cuilan Lin
- Boai Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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13
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de Lima TR, Sui X, de Lima LRA, Silva DAS. Muscle strength and its association with cardiometabolic variables in adolescents: does the expression of muscle strength values matter? World J Pediatr 2021; 17:597-608. [PMID: 34533773 DOI: 10.1007/s12519-021-00460-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND We investigate the association between different muscle strength (MS) indices with cardiometabolic variables in adolescents. METHODS Cross-sectional study comprising 351 adolescents (male 44.4%, age 16.6 ± 1.0 years) from Brazil. MS was assessed by handgrip strength and analyzed in five different ways: absolute MS and MS normalized for body weight, body mass index (BMI), height, and fat mass, respectively. Cardiometabolic variables investigated as outcomes were systolic and diastolic blood pressure (DBP), waist circumference (WC), high-sensitive C-reactive protein (hs-CRP), lipid and glucose metabolism markers. Multiple linear regression models adjusted for confounding factors were used. RESULTS Absolute MS and/or MS normalized for height was directly associated with WC [up to 32.8 cm, standard error (SE) = 4.7] and DBP (up to 8.8 mmHg, SE = 0.8), and inversely associated with high-density lipoprotein cholesterol (up to -8.0 mg/dL, SE = 14.1). MS normalized for body weight, BMI or fat mass was inversely associated with WC (up to -17.5 cm, SE = 2.2). According to sex, MS normalized for fat mass was inversely associated with triglycerides (male: 0.02 times lower, SE = 0.01; female: 0.05 times lower, SE = 0.01) and homeostatic model assessment for insulin resistance (male: 0.02 times lower, SE = 0.01; female: 0.06 times lower, SE = 0.01), and inversely associated with hs-CRP only among male (0.03 times lower, SE = 0.01). CONCLUSION When normalized for body weight, BMI or fat mass, MS was superior to absolute MS or MS normalized for height in representing adequately cardiometabolic variables among adolescents.
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Affiliation(s)
- Tiago Rodrigues de Lima
- Research Center in Kinanthropometry and Human Performance, Federal University of Santa Catarina, Trinity University Campus, Florianópolis, SC, CEP 88010-970, Brazil.
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Luiz Rodrigo Augustemak de Lima
- Research Group On Biodynamics of Human Performance and Health, Institute of Physical Education and Sport, Federal University of Alagoas, Maceió, Brazil
| | - Diego Augusto Santos Silva
- Research Center in Kinanthropometry and Human Performance, Federal University of Santa Catarina, Trinity University Campus, Florianópolis, SC, CEP 88010-970, Brazil
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Al Hourani HM, Alkhatib B. Anthropometric indices of obesity as predictors of high blood pressure among school children. Clin Exp Hypertens 2021; 44:11-19. [PMID: 34664528 DOI: 10.1080/10641963.2021.1969662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hypertension is related to increased body fat, which can be evaluated by anthropometric indicators. The aim of this study was to determine the predictive power of anthropometric indicators and to establish their cutoff points as discriminators of high blood pressure. METHODS A cross-sectional study was conducted on 793 schoolchildren aged 10-14 years. Six anthropometric indices were used: body mass index-z-score (BMI-z-score), waist circumference (WC), waist-toheight ratio (WHtR), a body shape index (ABSI), body roundness index (BRI) and conicity index (CI). Elevated blood pressure (EBP) and hypertension (HTN) were characterized by values ≥ 90th and <95th percentile and ≥ 95th percentile for systolic and/or diastolic blood pressure, respectively. The predictive power of anthropometric indices was analyzed by sex using the receiver operating characteristic curve (ROC). RESULTS The prevalence of EBP and HTN was 11.0% and 14.8%, respectively. According to the analyses of the ROC curve, WC provided the largest area under the curve (AUC) value, while CI showed the lowest AUC value in predicting elevated blood pressure in the total sample. The BMI z-score provided the largest area under the curve (AUC) value (0.722), followed by WHtR (0.709) and BRI (0.709), in predicting hypertension in boys. CONCLUSIONS BMI z-score and WC may be the best predictors of EBP and BMI z-score for HTN among Jordanian schoolchildren.
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Affiliation(s)
- Huda M Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Science, Philadelphia University, Amman, Jordan
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15
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Jiang Y, Dou Y, Chen H, Zhang Y, Chen X, Wang Y, Rodrigues M, Yan W. Performance of waist-to-height ratio as a screening tool for identifying cardiometabolic risk in children: a meta-analysis. Diabetol Metab Syndr 2021; 13:66. [PMID: 34127061 PMCID: PMC8201900 DOI: 10.1186/s13098-021-00688-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/08/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To provide the latest evidence of performance and robustness of waist-to-height ratio (WHtR) in discriminating clusters of cardiometabolic risk factors (CMRs) and promote WHtR in routine primary health care practice in children, a meta-analysis was used. METHODS Searches was performed in eight databases from inception to July 03, 2020. Inclusion criteria were: (1) observational study, (2) children and adolescents, (3) provided WHtR measurements, (4) had CMRs as outcomes, and (5) diagnostic studies. Exclusion criteria were: (1) non-original articles, (2) unable to extract 2 × 2 contingency tables, (3) not in English or Chinese language, (4) populations comprising clinical patients, or (5) duplicate articles. WHtR cutoff points, 2 × 2 contingency tables were extracted from published reports. Outcomes included: CMR clusters of at least three CMRs (CMR3), two (CMR2), one (CMR1), and CMR components. Bivariate mixed-effects models were performed to estimate the summarised area under the curves (AUSROC) with 95% CIs and related indexes. We conducted subgroup analyses by sex and East Asian ethnicity. RESULTS Fifty-three observational studies were included. The AUSROC reached 0.91 (95% CI: 0.88-0.93), 0.85 (95% CI: 0.81, 0.88) and 0.75 (95% CI: 0.71, 0.79) for CMR3, CMR2, and CMR1, respectively. The pooled sensitivity and specificity for CMR3 reached 0.84 and exceeded 0.75 for CMR2. For CMR1, the sensitivity achieved 0.55 with 0.84 for specificity. We had similar findings for our subgroup and sensitivity analyses. CONCLUSIONS WHtR shows good and robust performance in identifying CMRs clustering across racial populations, suggesting its promising utility in public health practice globally.
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Affiliation(s)
- Yuan Jiang
- Department of Clinical Epidemiology and Clinical Trial Unit, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
- Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases (2018RU002), Chinese Academy of Medical Sciences, Shanghai, China
| | - Yalan Dou
- Department of Clinical Epidemiology and Clinical Trial Unit, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
| | - Hongyan Chen
- Department of Clinical Epidemiology and Clinical Trial Unit, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
| | - Yi Zhang
- Department of Clinical Epidemiology and Clinical Trial Unit, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
- Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases (2018RU002), Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaotian Chen
- Department of Clinical Epidemiology and Clinical Trial Unit, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
- Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases (2018RU002), Chinese Academy of Medical Sciences, Shanghai, China
| | - Yin Wang
- Department of Clinical Epidemiology and Clinical Trial Unit, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
- Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases (2018RU002), Chinese Academy of Medical Sciences, Shanghai, China
| | - Myanca Rodrigues
- Health Research Methodology Graduate Program, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Weili Yan
- Department of Clinical Epidemiology and Clinical Trial Unit, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China.
- Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases (2018RU002), Chinese Academy of Medical Sciences, Shanghai, China.
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16
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Xu HQ, Sun JQ, Liu Y, Tian L, Liu JM, Shi JP, Liu M, Zheng XY. Cutpoints for Muscle Mass and Strength Derived from Weakness or Mobility Impairment and Compared with Other Diagnostic Criteria in Community-Dwelling Elderly People. Calcif Tissue Int 2021; 108:324-345. [PMID: 33247326 DOI: 10.1007/s00223-020-00778-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/04/2020] [Indexed: 10/22/2022]
Abstract
We identified the strength cutpoints concerning mobility impairment, then identified the muscle mass cutpoints concerning weakness, and compared the results with other diagnostic criteria to develop the clinical diagnostic criteria associated with functional impairment. In 7583 elderly people, classification and regression tree (CART) and receiver operating characteristic curve (ROC) analyses were used for determining cutpoints for handgrip strength (HGS) and appendicular lean mass (ALM) indices associated with slowness or weakness. Logistic regressions were then used to quantify the strength of the association between muscle mass (or strength) categories and weakness (or slowness). The CART second cutpoints of muscle mass and strength indices were lower than those specified by the ROC method and were between those cutpoints determined by the 20th and Mean-2SD methods. After adjusting for covariates, the associations remained significant in handgrip strength categories defined by the CART and ROC cutpoints and HGS/BMI categories defined by the CART, ROC, and 20th cutpoints in men and women (P < 0.05), ALM, ALM/Ht2 categories defined by all four cutpoints (P < 0.05) and ALM/BMI categories defined by CART and ROC cutpoints in men (P < 0.05), and ALM and ALM/Ht2 categories defined by the CART cutpoints in women (P < 0.05). Our approaches resulted in a definition of weak strength as handgrip strength or HGS/BMI less than 26.55 kg or 1.114 in men and less than 16.45 kg or 0.697 in women and then defined ALM, ALM/Ht2, or ALM/BMI less than 18.92 kg, 7.08 kg/m2, or 0.795 in men and less than 15.04 kg, 5.99 kg/m2, or 0.517 in women as low lean mass.
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Affiliation(s)
- Hong-Qi Xu
- Research Center of Sports and Health Science, School of Sports Science and Physical Education, Northeast Normal University, 5268 Renmin Street, Changchun, 130024, Jilin Province, China
| | - Jia-Qi Sun
- Research Field of Medical Instruments and Bioinformation Processing, College of Instrumentation & Electrical Engineering, Jilin University, Changchun, Jilin Province, China
| | - Yu Liu
- Jurong Center for Disease Control and Prevention, Jurong, Jiangsu Province, China
| | - Liao Tian
- Research Center of Sports and Health Science, School of Sports Science and Physical Education, Northeast Normal University, 5268 Renmin Street, Changchun, 130024, Jilin Province, China
| | - Jing-Min Liu
- Research Center of Sports and Health Science, Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Ji-Peng Shi
- Research Center of Sports and Health Science, School of Sports Science and Physical Education, Northeast Normal University, 5268 Renmin Street, Changchun, 130024, Jilin Province, China.
| | - Min Liu
- Jurong Center for Disease Control and Prevention, Jurong, Jiangsu Province, China
| | - Xiu-Yuan Zheng
- Research Center of Sports and Health Science, Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
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Marques A, Henriques-Neto D, Peralta M, Martins J, Gomes F, Popovic S, Masanovic B, Demetriou Y, Schlund A, Ihle A. Field-Based Health-Related Physical Fitness Tests in Children and Adolescents: A Systematic Review. Front Pediatr 2021; 9:640028. [PMID: 33748047 PMCID: PMC7973114 DOI: 10.3389/fped.2021.640028] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/15/2021] [Indexed: 12/26/2022] Open
Abstract
Physical fitness (PF) is a multi-component construct and a biomarker of health. Worse PF is related to vulnerability and predicts worse academic achievements. Thus, assessing PF is important to monitor health in youth. This systematic review aimed to identify and inform physical education, health professionals and entities about existing PF batteries and field-tests that can be used in school settings. A comprehensive literature search was carried out in five electronic databases (Academic Search Complete, Education Resources Information Center, PubMed, Scopus, and Web of Science) to identify PF battery protocols that can be carried out in the school setting. Overall, 24 PF batteries were identified. Regarding the PF components assessed, only cardiorespiratory fitness and upper body strength were contemplated in all batteries. Middle-body strength and lower body strength were presented in most batteries (21 and 19 of 24, respectively). Agility (16 of 24) and body composition (16 of 24) were also considered in several batteries, although to a lesser extent. Flexibility (14 of 24) and speed (12 of 24) were the PF components less represented in the batteries. Among the 24 identified PF batteries, 81 PF tests assessing the different PF components were encountered. The advances in the PF field-based assessment in school settings and health in youth resulted in the amplification of the number of existing batteries. Considering the connection between PF and health and the opportunity that the school setting provides to assess fitness in children and adolescents, there is a need for standardization and a consensus of PF assessments in this specific setting.
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Affiliation(s)
- Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | | | - Miguel Peralta
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - João Martins
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - Fernando Gomes
- Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Bojan Masanovic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Annegret Schlund
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Andreas Ihle
- Cognitive Aging Lab, Department of Psychology, University of Geneva, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
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18
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Gao D, Li Y, Yang Z, Ma Y, Chen M, Dong Y, Zou Z, Ma J. The Association Between Single-Child Status and Risk of Abdominal Obesity: Result From a Cross-Sectional Study of China. Front Pediatr 2021; 9:697047. [PMID: 34490158 PMCID: PMC8417322 DOI: 10.3389/fped.2021.697047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/19/2021] [Indexed: 01/17/2023] Open
Abstract
Background: Obesity has become a serious problem threatening the health of children and adolescents, and China's one-child policy has affected family structure and parenting practice, which may result in several adverse health outcomes. The present study aims to investigate the association between single-child status and the risk of abdominal obesity in Chinese adolescents and also to compare the differences in the risk of unideal energy-related behaviors. Methods: Data were obtained from a school-based cross-sectional survey conducted in seven provinces of China, in 2012. A total of 31,291 students aged 7-17 years were recruited in this study. Anthropometric measurements were conducted to assess height and waist circumference, and questionnaires were used to obtain information of single-child status, parental educational attainment, parental weight status, and offspring energy-related behaviors. Multivariate logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals (95% CI) of single-child status and odds of childhood abdominal obesity and energy-related behaviors. Results: The prevalence of abdominal obesity was 18.2% in single children, which was higher than that of non-single children (13.7%). The prevalence was also higher in single children in different sex and residence subgroups. Logistic regression models showed that single children had 1.33 times (OR: 1.33, 95% CI: 1.24-1.43, P < 0.001) higher odds of abdominal obesity compared to non-single children. Single children had 1.08 times higher odds of physical inactivity (OR: 1.08, 95% CI: 1.03-1.14, P = 0.004), 1.13 times higher odds of excessive sugar-sweetened beverages (SSBs) consumption (OR: 1.13, 95% CI: 1.05-1.23, P = 0.002), and 1.08 times more likely to eat out (OR: 1.08, 95% CI: 1.02-1.13, P = 0.006). Those associations were more remarkable in single girls. Conclusion: Being a single child may be associated with a higher odds of childhood abdominal obesity and unhealthy energy-related behaviors. Future interventions and strategies to prevent abdominal obesity should focus on this high-risk population.
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Affiliation(s)
- Di Gao
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yanhui Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Zhaogeng Yang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Ying Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.,Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
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Tabary M, Cheraghian B, Mohammadi Z, Rahimi Z, Naderian MR, Danehchin L, Paridar Y, Abolnejadian F, Noori M, Mard SA, Masoudi S, Araghi F, Shayesteh AA, Poustchi H. Association of anthropometric indices with cardiovascular disease risk factors among adults: a study in Iran. Eur J Cardiovasc Nurs 2020; 20:358-366. [PMID: 33620478 DOI: 10.1093/eurjcn/zvaa007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/14/2020] [Accepted: 09/25/2020] [Indexed: 11/13/2022]
Abstract
AIMS Cardiovascular diseases (CVDs) are the leading cause of death in the world. Many modifiable risk factors have been reported to synergistically act in the development of CVDs. We aimed to compare the predictive power of anthropometric indices, as well as to provide the best cut-off point for these indicators in a large population of Iranian people for the prediction of CVDs and CVD risk factors. METHODS AND RESULTS All the data used in the present study were obtained from Khuzestan comprehensive health study (KCHS). Anthropometric indices, including BMI (body mass index), WC (waist circumference), HC (hip circumference), WHR (waist-to-hip ratio), WHtR (waist-to-height ratio), ABSI (a body shape index), as well as CVD risk factors [dyslipidaemia, abnormal blood pressure (BP), and hyperglycaemia] were recorded among 30 429 participants. WHtR had the highest adjusted odds ratios amongst anthropometric indices for all the risk factors and CVDs. WC had the highest predictive power for dyslipidaemia and hyperglycaemia [area under the curve (AUC) = 0.622, 0.563; specificity 61%, 59%; sensitivity 69%, 60%; cut-off point 87.95, 92.95 cm, respectively], while WHtR had the highest discriminatory power for abnormal BP (AUC = 0.585; specificity 60%; sensitivity 65%; cut-off point 0.575) and WHR tended to be the best predictor of CVDs (AUC = 0.527; specificity 58%; sensitivity 64%; cut-off point 0.915). CONCLUSION In this study, we depicted a picture of the Iranian population in terms of anthropometric measurement and its association with CVD risk factors and CVDs. Different anthropometric indices showed different predictive power for CVD risk factors in the Iranian population.
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Affiliation(s)
- Mohammadreza Tabary
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Cheraghian
- Department of Biostatistics and Epidemiology, School of Public Health, Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Digestive Diseases Research Institute, North Kargar Street, Tehran 1411713135, Iran
| | - Zahra Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Reza Naderian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Cardiovascular Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Yousef Paridar
- School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Farhad Abolnejadian
- Clinical Allergy Immunology and Allergy Shoshtar Faculty of Medical Sciences, Shoshtar, Iran.,Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Seyed Ali Mard
- Alimentary Tract Research Center, Physiology Research Center, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sahar Masoudi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Digestive Diseases Research Institute, North Kargar Street, Tehran 1411713135, Iran
| | - Farnaz Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Shayesteh
- Alimentary Tract Research Center, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Digestive Diseases Research Institute, North Kargar Street, Tehran 1411713135, Iran
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Vaquero-Álvarez M, Molina-Luque R, Fonseca-Pozo FJ, Molina-Recio G, López-Miranda J, Romero-Saldaña M. Diagnostic Precision of Anthropometric Variables for the Detection of Hypertension in Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4415. [PMID: 32575484 PMCID: PMC7345709 DOI: 10.3390/ijerph17124415] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/12/2020] [Accepted: 06/17/2020] [Indexed: 12/20/2022]
Abstract
Introduction: High blood pressure (HBP) is a health problem the prevalence of which has increased in young populations. Overweight and obesity in early ages have been directly related to its development. Due to the impact of HBP, it is necessary to provide tools that facilitate its early diagnosis, with useful anthropometric variables being those that assess obesity. The objective of this paper was to determine the diagnostic accuracy of anthropometric variables to detect HBP. Methods: A cross-sectional study was conducted on 265 students aged 6-16. The diagnosis of HBP was made following the criteria proposed by the Spanish Association of Pediatrics. Through different statistical methods, the association between anthropometric variables of general obesity with HBP was analyzed. Results: Waist circumference (WC) showed the best diagnostic capacity (area under the receiver operating characteristic curve = 0.729), with a sensitivity and specificity of 72.2% and 76%, respectively, for a cut-off point of 73.5 cm. In the adjusted multivariate analysis, an association was found between HBP and anthropometric variables: WC (odds ratio (OR) = 10.7), body mass index (OR = 7.5), waist-to-height ratio (OR = 5.5) and body fat percentage (OR = 5.3) (p < 0.05). Conclusions: The anthropometric variables studied showed a moderate predictive capacity for HBP, highlighting WC, which showed the strongest association with HBP in the infant and child population.
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Affiliation(s)
| | - Rafael Molina-Luque
- Department of Nursing, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (G.M.-R.); (M.R.-S.)
| | - 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, 14004 Córdoba, Spain;
| | - Guillermo Molina-Recio
- Department of Nursing, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (G.M.-R.); (M.R.-S.)
| | - José López-Miranda
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain;
| | - Manuel Romero-Saldaña
- Department of Nursing, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (G.M.-R.); (M.R.-S.)
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Shirley MK, Alves Pereira-Freire J, de Macêdo Gonçalves Frota K, Oliveira Lemos J, Wells JC, Arnaud Rosal Lopes Rodrigues L, Monteles Nascimento L, Queiroz Ribeiro V, de Carvalho Rondó PH. Evaluation of neck circumference as a predictor of elevated cardiometabolic risk outcomes in 5–8-year-old Brazilian children. CHILD AND ADOLESCENT OBESITY 2020. [DOI: 10.1080/2574254x.2020.1738837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Meghan K. Shirley
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Jonathan C.K. Wells
- Childhood Nutrition Research Centre, University College London Great Ormond Street Institute of Child Health, London, UK
| | | | | | - Valdenir Queiroz Ribeiro
- Brazilian Agricultural Research Corporation (Empresa Brasileira de Pesquisa Agropecuária), Teresina, Brazil
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