title: Association between WHO cut-offs for childhood overweight and obesity and cardiometabolic risk.
abstract: OBJECTIVE
  To examine the association between cardiovascular risk and childhood overweight and obesity using the BMI cut-offs recommended by the WHO.
  
  
  METHODS
  Children were classified as normal weight, overweight and obese according to the WHO BMI-for-age reference. Blood pressure, lipids, glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and uric acid levels were compared across BMI groups. ANOVA and tests of linearity were used to assess overall mean differences across groups. Crude and adjusted odds ratios were calculated for adverse plasma levels of biochemical variables.
  
  
  METHODS
  Paediatric care centres.
  
  
  METHODS
  Children (n 149) aged 8-18 years.
  
  
  RESULTS
  About 37 %, 22 % and 41 % of children were classified respectively as normal weight, overweight and obese. There were significant linear mean differences between BMI groups in systolic blood pressure, HDL-cholesterol, TAG, insulin, HOMA-IR and uric acid. Obese children were 10·6 times more likely than normal-weight children to have hypertension; OR for other associations were 60·2 (high insulin), 39·5 (HOMA-IR), 27·9 (TAG), 16·0 (HDL-cholesterol), 4·3 (LDL-cholesterol) and 3·6 (uric acid). Overweight children were more likely than normal-weight children to have hypertension (OR = 3·5), high insulin (OR = 28·2), high HOMA-IR (OR = 23·3) and high TAG (OR = 16·1). Nearly 92 % and 57 % of the obese and overweight children, respectively, had one or more risk factor.
  
  
  CONCLUSIONS
  Obesity and overweight defined using the WHO BMI-for-age cut-offs identified children with higher metabolic and vascular risk. These results emphasize the importance of prevention of overweight and obesity in childhood to reduce cardiovascular risk.
authors.affiliation: Department of Nutrition, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. deonism@who.int
authors.forename: Mercedes
authors.initials: M
authors.lastname: de Onis
authors.forename: Cecilia
authors.initials: C
authors.lastname: Martínez-Costa
authors.forename: Francisco
authors.initials: F
authors.lastname: Núñez
authors.forename: Georges
authors.initials: G
authors.lastname: Nguefack-Tsague
authors.forename: Angeles
authors.initials: A
authors.lastname: Montal
authors.forename: Juan
authors.initials: J
authors.lastname: Brines
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D016000:Cluster Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D050177:Overweight / Q000150:complications / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood; D014944:World Health Organization
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007328:Insulin; D014527:Uric Acid