Pediatric Original Article | Published:

Comparison of anthropometric measurements in children to predict metabolic syndrome in adolescence: analysis of prospective cohort data

International Journal of Obesity volume 39, pages 10701078 (2015) | Download Citation

Abstract

Objectives:

The optimal screening measures for obesity in children remain controversial. Our study aimed to determine the anthropometric measurement at age 10 years that most strongly predicts the incidence of cardio-metabolic risk factors at age 13 years.

Subjects/Methods:

This was a prospective cohort study of a population-based cohort of 438 children followed between age 7 and 13 years of age. The main exposure variables were adiposity at age 10 years determined from body mass index (BMI) Z-score, waist circumference (WC) Z-score, waist-to-hip ratio and waist-to-height ratio. Outcome measures included systolic (SBP) and diastolic blood pressure (DBP), fasting high-density (HDL-c) and low-density lipoprotein cholesterol (LDL-c), triglycerides, insulin and glucose (homeostasis model of assessment, HOMA), and the presence of metabolic syndrome (MetS).

Results:

WC Z-score at age 10 years was a stronger predictor of SBP (β 0.21, R2 0.38, P<0.001 vs β 0.30, R2 0.20, P<0.001) and HOMA (β 0.51, R2 0.25, P<0.001 vs 0.40, R2 0.19, P<0.001) at age 13 years compared with BMI Z-score. WC relative to height and hip was stronger predictors of cardio- metabolic risk than BMI Z-score or WC Z-score. The relative risk (RR) of incident MetS was greater for an elevated BMI Z-score than for an elevated WC (girls: RR 2.52, 95% confidence interval (CI): 1.46–4.34 vs RR 1.56, 95% CI 1.18–2.07) and (boys: RR 2.86, 95% CI 1.79–4.62 vs RR 2.09, 95% CI 1.59–2.77).

Conclusions:

WC was a better predictor of SBP and HOMA compared with BMI or WC expressed relative to height or hip circumference. BMI was associated with higher odds of MetS compared with WC. Thus, BMI and WC may each be clinically relevant markers of different cardio-metabolic risk factors, and important in informing obesity-related prevention and treatment strategies.

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Acknowledgements

We would like to acknowledge the children and their families for their participation in the SAGE cohort study. We would also like to thank the Pediatric allergy and immunology research group specifically, Mrs Rishma Choonidas, Mr Saiful Huq, Mrs Brenda Gerwing and Mr Henry Huang who provided insight and guidance into data collection, storage and interpretation. Funding for the SAGE cohort was provided by CIHR and AllerGen NCE (PIs Becker and Kozyrskyj wave 1 data collection; Co-PI Becker wave 2 data collection).

Author information

Affiliations

  1. Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada

    • B A Wicklow
    • , A Becker
    •  & E A C Sellers
  2. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada

    • B A Wicklow
    • , A Becker
    •  & E A C Sellers
  3. Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

    • D Chateau
  4. Department of Community Health Sciences, Manitoba Center for Health Policy, Winnipeg, Manitoba, Canada

    • D Chateau
  5. Department of Psychology, Stockholm University, Stockholm, Sweden

    • K Palmer
  6. Department of Pediatrics and Dentistry, University of Alberta, Edmonton, Alberta, Canada

    • A Kozyrskij

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to B A Wicklow.

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DOI

https://doi.org/10.1038/ijo.2015.55

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