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Waist circumference predicts cardiovascular risk in young Australian children

Authors

  • Katie Watts,

    1. Telethon Institute for Child Health Research, Centre for Child Health Research,
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  • Lana M Bell,

    1. Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Subiaco, West Australia, Australia
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  • Susan M Byrne,

    1. Telethon Institute for Child Health Research, Centre for Child Health Research,
    2. School of Psychology, The University of Western Australia, Perth and
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  • Timothy W Jones,

    1. Telethon Institute for Child Health Research, Centre for Child Health Research,
    2. Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Subiaco, West Australia, Australia
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  • Elizabeth A Davis

    1. Telethon Institute for Child Health Research, Centre for Child Health Research,
    2. Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Subiaco, West Australia, Australia
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Dr Katie Watts, Telethon Institute for Child Health Research, PO Box 855, West Perth, WA 6872, Australia. Fax: +618 9489 7700; email: katiew@ichr.uwa.edu.au

Abstract

Aim:  It has been shown that compared with healthyweight children, overweight and obese primary school-aged children have a higher incidence of hyperinsulinism, dyslipidaemia and hypertension. It is therefore important to investigate clinically relevant markers of cardiovascular risk in children. Waist circumference is a simple, non-invasive anthropometric measure, but its association with cardiovascular risk profile in young Australian children is not clear.

Methods:  This study presents cross-sectional data from the Growth and Development Study. The sample included 70 healthy weight children, 50 overweight children and 28 obese children (n = 148, 9.6 ± 1.9 years). All children had a medical assessment which included a physical examination (waist circumference, blood pressure), and investigations including glycated haemoglobin, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, insulin, glucose and total homocysteine levels. An oral glucose tolerance test was performed in a subgroup of children (n = 119). Body mass index (BMI) was determined and BMI Z-scores calculated.

Results:  In a multilevel model, waist circumference was the only significant anthropometric predictor of lipid profile (high-density lipoprotein β = −0.01, P < 0.05; triglycerides β = 0.01, P < 0.005), systolic blood pressure (β = 0.29, P < 0.05), fasting insulin (β = 0.16, P < 0.005), insulin concentrations throughout the oral glucose tolerance (60 min β = 1.07, P < 0.005; 120 min β = 1.42, P < 0.001) and insulin resistance (homeostasis model assessment (HOMA-IR): β = 0.03, P < 0.05), with increasing waist circumference associated with increasing cardiovascular risk. In contrast, BMI Z-score was only predictive of 120-min glucose concentrations during the OGTT (β = 0.34, P < 0.05).

Conclusions:  Waist circumference is a better anthropometric indicator than BMI Z-score of cardiovascular risk in Australian primary school-aged children. Even in young children, measurement of waist circumference represents a simple, non-invasive screening tool to identify children with an increased cardiovascular risk profile.

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