Waist circumference and cardiovascular risk factors in prepubertal children

Objective: Intra-abdominal fat has been identified as being the most clinic ally relevant type of fat in humans. Therefore, an assessment of body-fat d istribution could possibly identify subjects with the highest risk of adver se lipid profile and hypertension. Few data on the relationship between bod y-fat distribution and cardiovascular risk factors are available in childre n, especially before puberty. Research Methods and Procedures: This cross-sectional study was undertaken to explore the relationship between anthropometric variables, lipid concent rations, and blood pressure (BP) in a sample of 818 prepubertal children (a ges 3 to 11 years) and to assess the clinical relevance of waist circumfere nce in identifying prepubertal children with higher cardiovascular risk. He ight, weight, triceps and subscapular skinfolds, waist circumference, and B P were measured. Plasma levels for triacylglycerol, total cholesterol, high -density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol , apolipoprotein Al (ApoAl), and apolipoprotein B (ApoB) were determined. Results: Females were fatter than males (5.8 [3.5] vs. 4.8 [3.3] kg of fat mass; p < 0.01). Males had higher HDL cholesterol and ApoA1/ApoB plasma con centrations than females (p < 0.001 and p < 0.01, respectively). Waist circ umference had a higher correlation with systolic and diastolic BP (r = 0.40 and 0.29, respectively; p < 0.001) than triceps (r = 0.35 and 0.21, respec tively; p < 0.001) and subscapular (v = 0.28 and 0.16, respectively; p < 0. 001) skinfolds and relative body weight (0.33 and 0.23, respectively; p < 0 .001). Multivariate linear model analysis showed that ApoA1/ApoB, HDL chole sterol, total cholesterol/HDL cholesterol, and systolic as well as diastoli c BP were significantly associated with waist circumference and triceps and subscapular skinfolds, independently of age, gender, and body mass index. Discussion: Waist circumference as well as subscapular and triceps skinfold s may be helpful parameters in identifying prepubertal children with an adv erse blood-lipids profile and hypertension. However, waist circumference, w hich is easy to measure and more easily reproducible than skinfolds, may be considered in clinical practice. Children with a waist circumference great er than the 90th percentile are more likely to have multiple risk factors t han children with a waist circumference that is less than or equal to the 9 0th percentile.