Cardiovascular risk factors in overweight and obese Chinese children: a comparison of weight-for-height index and BMI as the screening criterion.
BACKGROUND
Childhood obesity is a widespread and growing problem in the world. Body mass index (BMI) and weight-for-height criterion have been used to determine childhood obesity. No data was available to evaluate cardiovascular risk factors in overweight and obese Chinese children screened by weight-for-height index and Chinese newly developed BMI criterion.


OBJECTIVE
To evaluate cardiovascular risk factors in overweight and obese Chinese children by using Chinese BMI and weight-for-height index as screening criterion.


METHODS
A total of 215 children aged 7.5-13 years were recruited from 3 primary schools in Guangzhou, PR China. Measurements included body weight, height, waist and hip circumference, fasting serum glucose, insulin, total triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (apo A), apolipoprotein B (apo B). Chinese BMI and weight-for- height criterion were used to classify overweight and obesity.


RESULTS
According to Chinese BMI criterion, 65 from 108 obese children originally identified by weight-for-height were reclassified as obese and other 41 children were classified as overweight. Compared with non-obese children, obese children screened by Chinese BMI and weight-for-height index had increased levels of TG, LDL-C, apo B, insulin; decreased levels of HDL-C, apo A; and significantly higher prevalence of hypertriglyceridemia and high LDL-C. Children identified as overweight by Chinese BMI criterion had also shown high TG, LDL-C, apo B, insulin levels, low HDL-C, apo A levels, and significantly higher prevalence of hypertriglyceridemia than the normal weight children.


CONCLUSIONS
Our study reveals that overweight and/or obesity screened by both Chinese new BMI and weight-for-height criterion are associated with increased levels of cardiovascular risk factors (e.g., elevated serum TG, LDL, apo B, and reduced HDL-C, apo A levels). Using Chinese BMI criterion may underestimate the prevalence of childhood obesity but it could be adopted as a unique tool for screening children's overweight in population-based screening programs.
Zhang
Cai-Xia
CX
Dept of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
Tse
Lap-Ah
LA
Deng
Xue-Qing
XQ
Jiang
Zhuo-Qin
ZQ
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood*; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D050177:Overweight / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D049629:Waist-Hip Ratio
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids