Secular change in waist circumference and waist-height ratio and optimal cutoff of waist-height ratio for abdominal obesity among Korean children and adolescents over 10 years

Associations of overweight and obesity with cardiometabolic risk factor clusters among Korean adolescents

This study investigated the association between overweight, obesity, and cardiometabolic risk factor clusters in Korean adolescents. We included 2182 participants (1161 boys and 1021 girls) aged 12-18 years from the Korea National Health and Nutrition Examination Survey (2016-2021). Cardiometabolic risk factors include hypertension, high low-density lipoprotein cholesterol (LDL-C) level, low high-density lipoprotein cholesterol (HDL-C) level, hypertriglyceridemia, high fasting plasma glucose level, elevated alanine aminotransferase level, and hyperuricemia. The average age was 15.1 ± 0.1 years in both boys and girls. The proportion of subjects with ≥ 1, ≥ 2, and ≥ 3 cardiometabolic risk factors was 76.5%, 49.8%, and 22.7% in obese adolescents, and 60.5%, 24.0%, and 9.1%, in overweight adolescents, respectively. Compared to adolescents with underweight/normal weight, the odds ratios (ORs) and 95% confidence intervals for the clustering of cardiometabolic risk factors were at 2.76 (1.74-4.38) for ≥ 1; 3.75 (2.11-6.66) for ≥ 2; and 4.75 (1.70-13.25) for ≥ 3 factors in obese adolescents and 1.88 (1.26-2.81) for ≥ 1 factor in overweight adolescents. Overweight and obese adolescents exhibited high cardiometabolic risk clustering. Prevention and management of overweight/obesity in Korean adolescents are emerging to mitigate health risk associated with this condition.

Low-Density Lipoprotein Cholesterol Is Associated with Atopic Dermatitis in Korean Adolescents

INTRODUCTION

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases. Several studies have investigated the relationship between obesity and AD prevalence, but the results have been conflicting. This study investigated the association between obesity and AD in Korean adolescents.

METHODS

We used nationally representative data regarding 1,617 Korean adolescents aged 12-18 years, which were obtained from the cross-sectional Korea National Health and Nutrition Examination Survey 2017-2019. Multiple logistic regression analysis (including age, sex, region of residence, number of household members, economic status, lipid profile, and stress level) was used to evaluate the relationships of obesity and abdominal obesity with doctor-diagnosed AD.

RESULTS

Although the results were not statistically significant, obese adolescents were diagnosed with AD (20.8%) more often than non-obese adolescents (20.8% vs. 14.5%, p = 0.055). This tendency was more prominent in male adolescents than in female adolescents, but the finding was not statistically significant. Body mass index and the prevalence of abdominal obesity did not differ between the AD and non-AD groups. Adolescents with AD had significantly higher total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels, compared with adolescents who did not have AD. In the adjusted model, an LDL-C level ≥130 mg/dL was a risk factor for AD (adjusted odds ratio, 1.03; 95% confidence interval, 1.01-1.05).

CONCLUSIONS

A high LDL-C level may be a risk factor for AD. Proper management of dyslipidemia through lifestyle modification may aid in AD prevention and control. Further large-scale prospective studies are needed to assess the associations of AD with obesity and dyslipidemia.

Optimal cut-off value of waist circumference-to-height ratio to predict central obesity in children and adolescents: A systematic review and meta-analysis of diagnostic studies

Introduction

Waist circumference-to-height ratio (WHtR) is a simple anthropometric index with good screening power and fast interpretation for early detection of childhood abdominal obesity. This systematic review and meta-analysis aims to determine the best cut-off value of WHtR to use in clinical setting.

Methods

Comprehensive searches were conducted in PubMed, Scopus, and Web of Science by the end of March 2021. Observational studies investigated the best WHtR cut-off to detect abdominal obesity in children and adolescents were included. Thirteen articles (n = 180,119) were included in this systematic review and eight documents were included in the meta-analysis.

Results

The overall optimal cut-off was 0.49 with pooled sensitivity, specificity and diagnostic odds ratio (DOR) of 0.93 (95% confidence interval (CI): 0.93-0.96), 0.88 (95% CI: 0.85-0.91) and 102.6 (95% CI: 50.7-207.5), respectively. The optimal WHtR cut-off to predict abdominal obesity in girls and boys were both 0.49.

Discussion

The current study shows that we could use this cut-off as a simple index for predicting abdominal obesity in children and adolescents without the need for any charts in practice.

Secular changes in the waist, hips circumferences and selected associated indicators, among preschool children from Kraków (Poland), between 1983 and 2018

OBJECTIVES

Waist circumference and derived indicators are great for measuring the risk of abdominal obesity. The main aim of the study was to assess the changes in the waist, hips circumferences and selected associated indicators, among preschool children (3-7 years of age) from Kraków, Poland, between 1983, 2008 and 2018.

METHODS

The research was conducted in randomly selected kindergarten in Krakow (Poland). The 1983 cohort consisted of 1414 children and the 2008 and 2018 series included 1050 preschoolers each. Analyzed characteristics included waist and hip circumferences, body height, waist-to-hips ratio (WHR) and waist-to-height ratio (WHtR).

RESULTS

There was a negative secular trend regarding circumferences of the hips and waist, as well as WHtR. In girls, WHR was, the greatest in the 2018 cohort, while among boys there was a secular increase in the value of this parameter compared to the 2008 cohort, but not to the 1983 series.

CONCLUSIONS

The coexistence of currently noted trends with the previously described secular decrease in the prevalence of overweight/obesity and increase in trunk adiposity in the same population, suggests that WHR is preferable to body mass index in assessing the risk associated with excess adiposity in the population examined in the presented study.

Overview of pediatric obesity: diagnosis, epidemiology, and significance

Background: The prevalence of pediatric obesity has increased over the past several decades worldwide and in Korea. Childhood obesity has become a serious social problem.Current Concepts: Diagnosis of obesity is based on body mass index (BMI) in children and adolescents aged ≥2 years. Overweight and obese are defined as BMI ≥85th percentile to <95th percentile and BMI ≥95th percentile, respectively, corresponding to sex and age. Obesity is further classified as Class I (BMI ≥95th percentile to <120% of 95th percentile), Class II (BMI ≥120% of 95th percentile to <140% of 95th percentile), and Class III (BMI ≥140% of 95th percentile). Waist circumference and waist-height ratio are used to evaluate abdominal obesity. Pediatric obesity can cause childhood comorbidities, including type 2 diabetes, dyslipidemia, non-alcoholic fatty liver disease, and hypertension. Adult obesity, cardiovascular diseases, and other adult comorbidities, together with increased medical costs are additional consequences of pediatric obesity.Discussion and Conclusion: Prevention, diagnosis, and proper management of pediatric obesity are important.

Distribution of waist-to-height ratio and cardiometabolic risk in children and adolescents: a population-based study

This study was performed to evaluate the waist-to-height ratio (WHtR) distribution and assess its relationship with cardiometabolic risk in children and adolescents. A total of 8091 subjects aged 10–18 years were included from a nationally representative survey. Participants were classified into three groups: (1) < 85th, (2) ≥ 85th and < 95th, and (3) ≥ 95th percentile of WHtR. The WHtR distribution varied with sex and age. Whereas WHtR decreased from age 10–15 years in boys and from age 10–12 years in girls, it slightly increased thereafter. Compared to the < 85th percentile group, the WHtR ≥ 85th and < 95th percentile group had an odds ratio (OR) of 1.2 for elevated blood pressure (BP), 1.89 for elevated triglycerides (TGs), 1.47 for reduced high-density lipoprotein cholesterol (HDL-C) and 4.82 for metabolic syndrome (MetS). The ≥ 95th percentile group had an OR of 1.4 for elevated BP, 2.54 for elevated glucose, 2.22 for elevated TGs, 1.74 for reduced HDL-C, and 9.45 for MetS compared to the < 85th percentile group. Our results suggest that sex- and age-specific WHtR percentiles can be used as a simple clinical measurement to estimate cardiometabolic risk.

Waist circumference as a prognostic index of childhood abdominal obesity: findings in the Spanish population

Introduction

Introduction: early detection of childhood obesity plays a crucial role in the prevention of diseases during adulthood. At present, the most commonly used screening tool for detecting overweight/obesity in children is the percentile for age of body mass index, although this rate is unable to provide information about fat distribution. An emerging marker of abdominal fat distribution is waist circumference (WC). Objective: the aim of this study was to evaluate the differences between the different diagnostic criteria available to define overweight and obesity in order to establish the optimal WC cut-off values for the Spanish children population. Methods: a cross-sectional study was carried out in 8,241 schoolchildren aged 3 to 12 years from Villanueva de la Cañada (Madrid, Spain). WC (cm), weight (kg) and height (cm) were measured according to the recommendations of the Society for the Advancement of Kineanthropometry (ISAK). The values obtained for the diagnostic criteria (Spanish Orbegozo Foundation (OF), the International Obesity Task Force (IOTF), and the World Health Organization (WHO) were compared using McNemar's test for paired proportions. The kappa coefficient (κ) was used to assess the degree of agreement of the three classifications. We analyzed the validity of body mass index (BMI) and WC using the receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine cut-off values for WC that identify childhood obesity Results: overweight and obesity prevalences were calculated according to the OF, IOTF, and WHO criteria. There was a "substantial" agreement for the overweight and obesity categories between the Spanish criteria and IOTF (κ = 0.636), while agreement was "slight" between the Spanish criteria and those of WHO (κ = 0.198). The estimated cut-off WC criteria ranged from 54.5 to 88.0, varying according to sex and age. Conclusion: the proposed WC cut-off values, stated for the first time in a young Spanish population, are a simple and valid alternative as diagnostic criteria of abdominal obesity.