Sardinha Luís B, Santos Diana A, Silva Analiza M, Grøntved Anders, Andersen Lars B, Ekelund Ulf
Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal.
Centre of Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
PLoS One. 2016 Feb 22;11(2):e0149351. doi: 10.1371/journal.pone.0149351. eCollection 2016.
There is controversial evidence on the associations between anthropometric measures with clustering of cardiovascular disease risk factors in pediatric ages. We aimed to examine the associations between body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with clustered cardiometabolic risk factors and to determine whether these anthropometric variables can be used to discriminate individuals with increased cardiometabolic risk (increased clustered triglycerides, HDL-cholesterol, systolic and diastolic blood pressure, and HOMA-IR).
The study sample of 4255 (2191 girls and 2064 boys) participants (8-17 years) was derived from pooled cross-sectional data comprising five studies. Outcomes included a continuous cardiometabolic risk factor z-score [corresponding to the sum of z-scores for triglycerides, HDL-cholesterol, systolic and diastolic blood pressure (mean arterial pressure), and HOMA-IR] and children with ≥1.0 SD in this score were defined as being at risk for clustering cardiometabolic risk factors.. Exposure variables were BMI, WC, WHtR. Statistics included mixed-effect regression and ROC analysis.
All anthropometric variables were associated with clustered risk and the magnitudes of associations were similar for BMI, WC, and WHtR. Models including anthropometric variables were similar in discriminating children and adolescents at increased risk with areas under the ROC curve between 0.70 and 0.74. The sensitivity (boys: 80.5-86.4%; girls: 76.6-82.3%) was markedly higher than specificity (boys: 51.85-59.4%; girls: 60.8%).
The magnitude of associations for BMI, WC, and WHtR are similar in relation to clustered cardiometabolic risk factors, and perform better at higher levels of BMI. However, the precision of these anthropometric variables to classify increased risk is low.
关于儿童期人体测量指标与心血管疾病危险因素聚集之间的关联，证据存在争议。我们旨在研究体重指数（BMI）、腰围（WC）和腰高比（WHtR）与聚集性心脏代谢危险因素之间的关联，并确定这些人体测量变量是否可用于鉴别心脏代谢风险增加（聚集性甘油三酯、高密度脂蛋白胆固醇、收缩压和舒张压以及胰岛素抵抗指数增加）的个体。
该研究样本包括4255名参与者（8至17岁，其中2191名女孩和2064名男孩），来自五项研究的汇总横断面数据。结局指标包括连续的心脏代谢危险因素z评分[对应于甘油三酯、高密度脂蛋白胆固醇、收缩压和舒张压（平均动脉压）以及胰岛素抵抗指数的z评分总和]，该评分≥1.0标准差的儿童被定义为有聚集性心脏代谢危险因素的风险。暴露变量为BMI、WC、WHtR。统计方法包括混合效应回归和ROC分析。
所有人体测量变量均与聚集性风险相关，BMI、WC和WHtR的关联程度相似。包含人体测量变量的模型在鉴别风险增加的儿童和青少年方面相似，ROC曲线下面积在0.70至0.74之间。敏感性（男孩：80.5 - 86.4%；女孩：76.6 - 82.3%）明显高于特异性（男孩：51.85 - 59.4%；女孩：60.8%）。
BMI、WC和WHtR与聚集性心脏代谢危险因素的关联程度相似，且在较高BMI水平时表现更好。然而，这些人体测量变量用于分类增加的风险时精度较低。
