Savva S C, Tornaritis M, Savva M E, Kourides Y, Panagi A, Silikiotou N, Georgiou C, Kafatos A
Research and Education Program of Child Health, Cyprus.
Int J Obes Relat Metab Disord. 2000 Nov;24(11):1453-8. doi: 10.1038/sj.ijo.0801401.
Visceral adipose tissue is associated with increased risk for cardiovascular disease risk factors and morbidity from cardiovascular diseases. Waist measurement and waist-to-height ratio (WHtR) have been used as proxy measures of visceral adipose tissue, mainly in adults.
To validate body mass index (BMI), waist circumference and WHtR as predictors for the presence of cardiovascular disease risk factors in children of Greek-Cypriot origin.
A total of 1,037 boys and 950 girls with mean age 11.4+/-0.4 y were evaluated. Dependent variables for the study were total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholestrol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and systolic (SBP) and diastolic (DBP) blood pressure.
When children were divided into two groups according to the 75th percentile for BMI, waist circumference and WHtR, all dependent variables had higher mean values in the highest percentile groups in WHtR groups and almost all variables in BMI and waist circumference groups. Adjusted odds ratios for predicting pathological values of cardiovascular disease risk factors were slightly higher for the highest WHtR group for predicting lipid and lipoprotein pathological values and for the highest BMI groups in predicting high blood pressure measurement. Using stepwise multiple regression analysis to explain the variance of the dependent variables, waist circumference was the most significant predictor for all variables both for boys and girls, whereas BMI had the lowest predictive value for the detection of cardiovascular disease risk factors.
Waist circumference and WHtR are better predictors of cardiovascular disease risk factors in children than BMI. Further studies are necessary to determine the cutoff points for these indices for an accurate prediction of risk factors.
内脏脂肪组织与心血管疾病危险因素及心血管疾病发病率增加相关。腰围和腰高比（WHtR）已被用作内脏脂肪组织的替代指标，主要用于成年人。
验证体重指数（BMI）、腰围和WHtR作为希腊裔塞浦路斯儿童心血管疾病危险因素存在的预测指标。
共评估了1037名男孩和950名女孩，平均年龄为11.4±0.4岁。研究的因变量为总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）以及收缩压（SBP）和舒张压（DBP）。
当根据BMI、腰围和WHtR的第75百分位数将儿童分为两组时，在WHtR组的最高百分位数组中，所有因变量的平均值较高，在BMI和腰围组中几乎所有变量也是如此。预测心血管疾病危险因素病理值的调整优势比，在最高WHtR组预测脂质和脂蛋白病理值时略高，在最高BMI组预测高血压测量值时略高。使用逐步多元回归分析来解释因变量的方差，腰围是男孩和女孩所有变量的最显著预测指标，而BMI在检测心血管疾病危险因素方面的预测价值最低。
腰围和WHtR比BMI更能预测儿童心血管疾病危险因素。有必要进行进一步研究以确定这些指标的切点，以便准确预测危险因素。
