title: Waist circumference as a screening tool for the identification of adolescents with the metabolic syndrome phenotype.
abstract: OBJECTIVE
  Most published definitions of the metabolic syndrome (MetS) in children and adolescents include increased waist circumference (WC) in their criteria. To assess the clinical relevance of WC in identifying adolescents with the MetS phenotype and adverse fitness patterns, we divided a cohort of 15-year-old schoolchildren in quartiles for WC, and compared the subjects of the extreme quartiles for the presence of cardiovascular (CVD) risk factors, their clustering, insulin resistance and body fitness.
  
  
  METHODS
  From the original cohort of 635 adolescents investigated for childhood CVD risk, anthropometric parameters, blood pressure, fitness indexes, and serum fasting glucose, insulin and lipids were analyzed in 105 adolescents of the highest (> or =75th percentile) and 102 of the lowest (< or =25th percentile) WC quartile.
  
  
  RESULTS
  Adolescents with WC > or =75th percentile presented with significantly higher fasting insulin (17+/-0.9 vs. 9.1+/-1.0 microIU/mL), triglycerides (78.0+/-3.4 vs. 62.3+/-3.3 mg/dL), LDL-cholesterol (106.8+/-2.8 vs. 96.1+/-2.8 mg/dL), homeostasis model assessment index (HOMA-IR) (3.29+/-1.8 vs. 1.81+/-0.2), systolic blood pressure (125.6+/-1.1 vs. 116.0+/-1.1 mm Hg), and diastolic blood pressure (78.0+/-0.9 vs. 71.5+/-0.9 mm Hg) and significantly lower HDL-cholesterol (46.2+/-1.2 vs. 53.4+/-1.1 mg/dL) and physical fitness as compared with their peers with WC < or =25th percentile. Clustering of three CVD factors pointing to a full MetS phenotype was found for 13.5% of the 15 year olds with WC>75th percentile.
  
  
  CONCLUSIONS
  Our findings suggest that WC > or =75th percentile is associated with the MetS phenotype and reduced activity in adolescence, and confirm the clinical relevance of WC as a tool for the identification of adolescents with increased CVD risk.
authors.affiliation: Department of Paediatrics, University Hospital of Heraklion. bitmar@hol.gr
authors.forename: Maria
authors.initials: M
authors.lastname: Bitsori
authors.forename: Manolis
authors.initials: M
authors.lastname: Linardakis
authors.forename: Maria
authors.initials: M
authors.lastname: Tabakaki
authors.forename: Anthony
authors.initials: A
authors.lastname: Kafatos
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D016000:Cluster Analysis; D015331:Cohort Studies; D005260:Female; D006115:Greece; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D016017:Odds Ratio; D010641:Phenotype; D010809:Physical Fitness; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids