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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Waist circumference and body mass index in Chinese children: cutoff values for predicting cardiovascular risk factors
R Y T Sung1, C C W Yu, K C Choi
1Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China. yntzsung@chuk.edu.hk
Insights
This study establishes waist circumference (WC) and body mass index (BMI) reference charts for Chinese children, proposing risk thresholds to identify cardiovascular disease risk factors. These findings aid in early detection and management of childhood obesity-related health issues.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Public Health Nutrition
Background:
- Childhood body mass index (BMI) and waist circumference (WC) correlate with cardiovascular (CV) risk factors, tracking into adulthood.
- Waist circumference (WC) specifically measures central obesity linked to CV risk factors.
- Established reference standards for WC and risk thresholds for WC and BMI are lacking in Chinese children.
Purpose of the Study:
- To create reference percentile charts for WC in Hong Kong Chinese children.
- To determine the relationship between WC, BMI, and CV risk factors.
- To propose WC and BMI threshold values predictive of CV risk factors in this population.
Main Methods:
- Measurements of weight, height, and circumferences (waist, hip) were taken from 2593 randomly sampled Hong Kong school children (ages 6-12).
- Relationships between WC, BMI, waist/hip ratio, waist/height ratio, and six age-adjusted CV risk factors were analyzed in 1055 children.
- Receiver-operating characteristic (ROC) analysis identified optimal age- and sex-specific WC and BMI thresholds for predicting CV risk.
Main Results:
- WC percentile charts were successfully constructed.
- WC showed a slightly stronger correlation with CV risk factors than BMI, particularly with insulin and systolic blood pressure.
- Optimal WC and BMI thresholds, around the 85th percentile, were identified for predicting four CV risk factors, with specific cutoff values provided for girls and boys.
Conclusions:
- This study presents the first WC reference data for Chinese children.
- Proposed WC risk cutoff values are similar to those for American children, despite differences in waist size.
- WC percentiles can serve as a valuable indicator of population-level cardiovascular risk in Chinese children.
Background:
Body mass index (BMI) and waist circumference (WC) correlate with cardiovascular (CV) risk factors in childhood which track into adulthood. WC provides a measure of central obesity, which has been specifically associated with CV risk factors. Reference standards for WC, and for WC and BMI risk threshold values are not established in Chinese children.
Objectives:
To construct reference percentile charts of WC, establish relationships between WC, BMI and other risk factors, and propose WC and BMI threshold values predictive of CV risk factors in Hong Kong ethnic Chinese children.
Methods:
Weight, height, waist and hip circumference were measured in 2593 (52% boys, 47% girls) randomly sampled Hong Kong school children aged 6-12 years. In 958 of these and 97 additional overweight children (n=1055), the relationships between WC, BMI, waist/hip and waist/height ratio and six age-adjusted CV risk factors (>85% percentile levels of blood pressure (BP), fasting triglycerides, low-density lipoprotein (LDL) cholesterol, glucose and insulin levels, and <15% percentile levels of high-density lipoprotein (HDL) cholesterol) were studied. Receiver-operating characteristic analysis was employed to derive optimal age-adjusted sex-specific WC and BMI thresholds for predicting these measures of risk.
Results:
WC percentiles were constructed. WC correlated slightly more than BMI with CV risk factors and most strongly with insulin and systolic BP, but poorly or not with LDL and glucose. Optimal WC and BMI risk thresholds for predicting four of these six CV risk factors were ca. the 85th percentiles (sensitivities approximately 0.8, specificities approximately 0.87) with age-specific cutoff values in girls/boys from approximately 57/58 to approximately 71/76 cm and 17/18 to 22/23 kg/m(2).
Conclusion:
These are the first set of WC reference data for Chinese children. WC risk cutoff values are proposed which, despite a smaller waist in Chinese children, are similar to those reported for American children. WC percentiles may reflect population risk.
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