Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study

Background: Although body fat patterning has been related to adverse health outcomes in adults, its importance in children and adolescents is less cer tain. Objective: We examined the relation of circumference (waist and hip) and sk infold-thickness (subscapular and triceps) measurements to lipid and insuli n concentrations among 2996 children and adolescents aged 5-17 y. Design: This was a community-based, cross-sectional study conducted in 1992 -1994. Results: A central or abdominal distribution of body fat was related to adv erse concentrations of triacylglycerol, LDL cholesterol, HDL cholesterol, a nd insulin; these associations were independent of race, sex, age, weight, and height. These associations were observed whether fat patterning was cha racterized by using 1) waist circumference alone (after adjustment for weig ht and height), 2) waist-to-hip ratio, or 3) principal components analysis. Compared with a child at the 10th percentile of waist circumference, a chi ld at the 90th percentile was estimated to have, on average, higher concent rations of LDL cholesterol (0.17 mmol/L), triacylglycerol (0.11 mmol/L), an d insulin (6 pmol/L) and lower concentrations of HDL cholesterol (-0.07 mmo l/L). These differences, which were independent of weight and height, were significant at the 0.001 level and were consistent across race-sex groups. Conclusions: These findings emphasize the importance of obtaining informati on on body fat distribution, waist circumference in particular, in children . Waist circumference, which is relatively easy to measure, may help to ide ntify children likely to have adverse concentrations of lipids and insulin.