title: Novel modeling of reference values of cardiovascular risk factors in children aged 7 to 20 years.
abstract: OBJECTIVE
  Most of the cardiovascular risk factors strongly associated with obesity and overweight vary with age and gender. However, few reference values are available for healthy European children. Our objective was to establish pediatric reference ranges for waist circumference, systolic and diastolic blood pressures, fasting lipid levels (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), glucose, and insulin.
  
  
  METHODS
  A representative sample of 1976 healthy French individuals (1004 female participants and 972 male participants) aged 7 to 20 years was used to obtain age- and gender-specific normal ranges for each of the above-listed cardiovascular risk factors, based on the Royston and Wright method.
  
  
  RESULTS
  Mean waist circumference increased with age in both genders and was slightly higher in males than in females. Whereas systolic blood pressure increased gradually with age, with the increase being steeper in males than in females, no gender effect was found for diastolic blood pressure, which was therefore modeled after pooling males and females. Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride values varied little with age and gender. Glucose and insulin levels revealed pubertal peaks, which were sharper in females than in males, reflecting the normal insulin resistance during puberty.
  
  
  CONCLUSIONS
  These ranges can be used as references for European children to monitor cardiovascular risk factors and to plan interventions and education programs.
authors.affiliation: Inserm, Centre d’Investigation Clinique-Epidémiologie Clinique, CIE 5, Hôpital Robert Debré, Paris, France. helene.mellerio@inserm.fr
authors.forename: Hélène
authors.initials: H
authors.lastname: Mellerio
authors.forename: Corinne
authors.initials: C
authors.lastname: Alberti
authors.forename: Céline
authors.initials: C
authors.lastname: Druet
authors.forename: Florence
authors.initials: F
authors.lastname: Capelier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Mercat
authors.forename: Emilie
authors.initials: E
authors.lastname: Josserand
authors.forename: Sylviane
authors.initials: S
authors.lastname: Vol
authors.forename: Jean
authors.initials: J
authors.lastname: Tichet
authors.forename: Claire
authors.initials: C
authors.lastname: Lévy-Marchal
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D002648:Child; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D010353:Patient Education as Topic / Q000379:methods*; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids