Parameters of childhood obesity and their relationship to cardiovascular risk factors in healthy prepubescent children

OBJECTIVE: To investigate which of the currently applied parameters to asse ss childhood overweight best predict cardiovascular risk factors. DESIGN: Cross-sectional study comparing five different methods to define ov erweight with respect to their power to predict cardiovascular risk factors . SUBJECTS: A total of 838 healthy children from the Prevention-Education-Pro gram (Nuremberg, Germany; age 4-9y, 405 boys, 433 girls). MEASUREMENTS: Obesity parameters-body mass index (BMI), ponderal index (PI) , the sum of triceps and subscapular skinfold thickness (SR?, percentage bo dy fat (%BF) using SFT and two different regression formulas (Slaughter, %B F-SL; Dezenberg, %BF-DZ). Overweight defined by the 90th age- and sex-speci fic percentile of each obesity parameter. Comparison of LDL- and HDL-choles terol, apolipoprotein-B (apo-B), triglycerides CTC), fibrinogen and blood p ressure values (SBP/DBP) between normal-weight and overweight children. RESULTS: When overweight is defined by BMI or PI, all cardiovascular risk f actors are significantly (P < 0.01) different between overweight and normal -weight children (BMI: TC + 20.5%, HDL-chol. - 8.6%, LDL-chol. + 9.6%, apo- B + 6.8%, SBP + 7.4%, DBP + 8.6%, fibrinogen + 13.2%; PI: TG + 24.3%, HDL-c hol. - 6.1%, LDL-chol. + 9.0%, apo-B + 7.4%, SBP + 5.9%, DBP + 6.7%, fibrin ogen + 13.9%), while SFT, %BF-SL and %BF-DZ did not predict all cardiovascu lar risk factors. A sex-specific analysis showed that in girls BMI and PI b oth predict cardiovascular risk factors, while in boys this is only valid f or BMI. CONCLUSION: In prepubescent children, height-to-weight indices such as BMI or PI better predict cardiovascular risk factors than obesity parameters us ing skinfold measurement. The BMI may be superior to the PI as the associat ion between BMI and cardiovascular risk factors is less affected by gender.