Can waist circumference identify children with the metabolic syndrome?
OBJECTIVE
To determine in children the association between waist circumference (WC) and insulin resistance determined by homeostasis modeling (HOMA-IR) and proinsulinemia and components of the metabolic syndrome, including lipid profile and blood pressure (BP).


METHODS
Eighty-four students (40 boys) aged 6 to 13 years and matched for sex and age underwent anthropometric measurements; 40 were obese; 28, overweight; and 16, nonobese. Body mass index (BMI), WC, BP, and Tanner stage were determined. An oral glucose tolerance test, lipid profile, and insulin and proinsulin assays were performed. Children were classified as nonobese (BMI < 85th percentile), overweight (BMI, 85th-94th percentile), and obese (BMI > or = 95th percentile).


RESULTS
There was univariate association (P < .01) between WC and height (r = 0.73), BMI (r = 0.96), Tanner stage (r = 0.67), age (r = 0.56), systolic BP (r = 0.64), diastolic BP (r = 0.61), high-density lipoprotein cholesterol level (r = 0.45), triglyceride level (r = 0.28), proinsulin level (r = 0.59), and HOMA-IR (r = 0.59). Multiple linear regression analysis using HOMA-IR as the dependent variable showed that WC (beta coefficient = 0.050 [95% confidence interval, 0.028 to 0.073]; P = .001) and systolic BP (beta coefficient = 0.033 [95% confidence interval, 0.004 to 0.062]; P = .004) were significant independent predictors for insulin resistance adjusted for diastolic BP, height, BMI, acanthosis nigricans, and high-density lipoprotein cholesterol level.


CONCLUSIONS
Waist circumference is a predictor of insulin resistance syndrome in children and adolescents and could be included in clinical practice as a simple tool to help identify children at risk.
Hirschler
Valeria
V
Durand Hospital of Buenos Aires, Buenos Aires, Argentina. vhirschler@intramed.net.ar
Aranda
Claudio
C
Calcagno
Maria de Luján
Mde L
Maccalini
Gustavo
G
Jadzinsky
Mauricio
M
D000052:Acanthosis Nigricans / Q000503:physiopathology; D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D009765:Obesity / Q000503:physiopathology; D012044:Regression Analysis; D049629:Waist-Hip Ratio
D008076:Cholesterol, HDL