Comparison of anthropometric indices in predicting metabolic syndrome components in children

The International Diabetes Federation (IDF) defines metabolic syndrome among children. In addition to the abdominal obesity (waist circumference ≥90 percentile of locally representative sample), the risk criteria for metabolic syndrome includes elevated blood pressure, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C) levels, and elevated fasting glucose. In this study, we compared the association of anthropometric indices with metabolic syndrome risk criteria in 9-year-old children.

A cross-sectional study of 9-year-old children (n=1,194) was performed in 2007-2008. Using the international cutoff points and percentiles, we determined subjects with elevated blood pressure, hypertriglyceridemia (≥90 percentile), low HDL-C (≤ 10 percentile), and elevated fasting glucose (≥100 mg/dL). We compared several anthropometric indices [triceps skin-fold thickness (SFT), waist circumference, hip circumference, waist-to-hip ratio, body mass index (BMI) and waist-to-height ratio] and their association with metabolic syndrome risk criteria other than waist circumference among 9-year-old children.

Metabolic syndrome risk criteria were commonly observed among 9-year-old children: 244 students (20.4%) had hypertriglyceridemia and/or low HDL-C, 362 students (30.3%) had elevated blood pressure, and 254 (21.3%) students were overweight or obese. Among covariates of SFT, BMI, waist circumference, waist-to-hip, or waist-to-height ratio categories, the BMI category was the only significant predictor of having two or more metabolic syndrome risk variables [odds ratio (OR)=3.5, 95% confidence interval (CI) 1.69-7.41, P=0.001 for boys and OR=4.7, 95% CI 1.61-13.55, P=0.005 for girls].

Assessing anthropometric indices is crucial for early detection and prevention of metabolic syndrome among children and adolescents. Age- and sex-specific cutoff points of BMI can be used to screen for the metabolic syndrome and related risk criteria among 9-year-old children.