Original ArticleDiagnostic Performance of Waist Circumference Measurements for Predicting Cardiometabolic Risk in Mexican Children
Section snippets
INTRODUCTION
Childhood obesity is one of the most serious problems of the 21st century, and its prevalence has continued to rise at an accelerated rate (1). In Mexico, the prevalence of overweight and obesity in children and adolescents is approximately 34.4% (2). It is well known that obesity increases the risk of developing cardiovascular and metabolic disorders. One of the challenges physicians face is the timely identification of individuals at risk (3–5). Obesity is associated with insulin resistance
METHODS
We conducted a cross-sectional study in the Pediatric Obesity Clinic at the Hospital General de México, Eduardo Liceaga in Mexico City. Children and adolescents 10 to 18 years of age were recruited. Patients with overweight or obesity who attended the clinic for the first time were invited to participate. Normal-weight children (BMI ≥ 5th and < 85th percentile) were recruited from 17 urban-area elementary schools located in Mexico City. We recruited normal-weight children with the intention of
RESULTS
The study included a total of 366 children and adolescents, 290 (79.2%) of whom were classified with overweight or obesity and 76 (20.8%) of whom were of normal weight. Demographic and biochemical characteristics of all participants and their cardiometabolic risk variables are shown in Table 1.
The frequencies of abnormal values for different parameters of cardiometabolic risk were 7.7% for arterial hypertension, 10.7% for impaired fasting glycemia (prediabetes), 37.4% for hypertriglyceridemia,
DISCUSSION
The increased prevalence of childhood obesity is associated with comorbidities, in particular those associated with the development of abdominal obesity such as insulin resistance and MS (18). Evidence has suggested that abdominal obesity predisposes individuals to cardiometabolic risk, that this risk is independent of BMI (19,20), and that physicians can evaluate abdominal fat clinically through the measurement of WC. Our results were consistent with those published in the international
CONCLUSION
WHtR >0.5 is a sensitive measure for identifying pediatric patients at risk of cardiometabolic alterations. Despite its low specificity, it is a useful diagnostic tool to detect a population at risk. Based on the results of our study, we recommend preferential use of the Klünder WC references over those of Fernández in a Mexican pediatric population. We concur with other authors regarding communicating a simple and useful message to the population as a preventive measure of cardiometabolic
ACKNOWLEDGMENT
This work was supported by a grant from CONACyT SALUD-2012-01-181786, Mexico.
DISCLOSURE
The authors have no multiplicity of interest to disclose.
REFERENCES (24)
- et al.
Visceral fat in white and African American prepubertal children
Am J Clin Nutr
(1997) - et al.
Evaluation of the feasibility of international growth standards for school-aged children and adolescents
J Nutr
(2007) - et al.
Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents
J Pediatr
(2004) - et al.
Waist circumference values according to height percentiles: a proposal to evaluate abdominal obesity in Mexican children and adolescents between 6 and 16 years of age
Arch Med Res
(2011) - et al.
The metabolic syndrome in children and adolescents
Lancet
(2007) - et al.
The hypertriglyceridemic waist, waist-to-height ratio, and cardiometabolic risk
J Pediatr
(2013) - et al.
Role of the waist/height ratio in the cardiometabolic risk assessment of children classified by body mass index
J Am Coll Cardiol
(2013) - et al.
How do different indices of obesity correlate with cardiometabolic disease risk factors in multiethnic youths?
Endocr Pract
(2009) Prioritizing areas for action in the field of population-based prevention of childhood obesity
(2012)- et al.
Resultados nacionales. Encuesta Nacional de Salud y Nutrición; 2012
Cuernavaca Morelos
(2012)