Body Mass Index, Waist Circumference, and Waist-to-Height Ratio as Predictors of Cardiometabolic Risk in Childhood Obesity Depending on Pubertal Development
Body Mass Index, Waist Circumference, and Waist-to-Height Ratio as Predictors of Cardiometabolic Risk in Childhood Obesity Depending on Pubertal Development
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DOI：
10.1210/jc.2013-1389
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发表时间：
2013-08-01
影响因子：
5.8
通讯作者：
Holl, Reinhard W.
中科院分区：
文献类型：
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作者：
Blueher, Susann;Molz, Esther;Holl, Reinhard W.
内容：体重指数（BMI）、腰围（WC）和腰高比（WtHR）对儿童肥胖症心血管代谢风险的预测价值尚不清楚。目的：在一项多中心的肥胖青少年数据收集中分析BMI、WtHR或WC与心血管代谢风险标志物之间的关系。对1278例患者的BMI、WtHR和WC进行了回顾性评价（11-18岁，53%为男孩），来自德国/奥地利/瑞士肥胖症患者登记处。参数与胰岛素抵抗、空腹胰岛素、血压、转氨酶、血脂和尿酸的稳态模型评估相关，结果：胰岛素抵抗和空腹胰岛素与BMI的相关性最强，与年龄组和性别无关。血脂、转氨酶和尿酸与腰围的相关性最强，男孩的相关性更强。BMI和WC以及代谢指标和收缩压之间的相关性仅显示出微小的差异。在青春期发育的过程中，这种关系的模式发生了变化，其中青春期儿童的关系最为密切。没有一个参数显示依赖WtHR是上级BMI或WC.Conclusions：只有小额外的好处，在使用WC测量常规儿科护理除了BMI预测代谢风险。对于所有参数，青春期中期的关系最强，强调在青春期肥胖青少年中，人体测量指标（BMI和WC）最能预测心脏代谢合并症。WtHR在预测与儿童肥胖相关的代谢或心血管风险方面似乎并不上级BMI或WC。
Context: The predictive value of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WtHR) to define cardiometabolic risk is unclear in childhood obesity.Obective: The associations between BMI, WtHR, or WC and cardiometabolic risk markers were analyzed in a multicenter data collection of obese youth.Design and Subjects: BMI, WtHR, and WC were retrospectively evaluated in 1278 patients (11-18 years, 53% boys) from the German/Austrian/Swiss Adiposity Patients Registry.Main outcome measures: Parameters were correlated with homeostasis model assessment for insulin resistance, fasting insulin, blood pressure, transaminases, lipids and uric acid, applying adjusted regression models, with age group, pubertal stage and gender as covariates.Results: Homeostasis model assessment for insulin resistance and fasting insulin were most strongly correlated with BMI, independent of age group or gender. Lipids, transaminases, and uric acid were most strongly correlated with WC with stronger associations for boys. Correlations between BMI and WC as well as metabolic markers and systolic blood pressure showed only minor differences. The pattern of relationship changed during the course of pubertal development with the strongest associations for pubertal children. None of the parameters showed a dependency on WtHR that was superior to BMI or WC.Conclusions: There is only small additional benefit in using WC measurements for routine pediatric care in addition to BMI for predicting metabolic risk. For all parameters, the relationship is strongest during midpuberty, emphasizing that among obese pubertal adolescents, anthropometric measures (BMI and WC) best predict cardiometabolic comorbidities. WtHR does not seem to be superior to BMI or WC in predicting metabolic or cardiovascular risk related to childhood obesity.