title: A population-based cross-sectional study of the association between facial morphology and cardiometabolic risk factors in adolescence.
abstract: OBJECTIVE
  To determine whether facial morphology is associated with fasting insulin, glucose and lipids independent of body mass index (BMI) in adolescents.
  
  
  METHODS
  Population-based cross-sectional study.
  
  
  METHODS
  Avon Longitudinal Study of Parents and Children (ALSPAC), South West of England.
  
  
  METHODS
  From the ALSPAC database of 4747 three-dimensional facial laser scans, collected during a follow-up clinic at the age of 15, 2348 white British adolescents (1127 males and 1221 females) were selected on the basis of complete data on cardiometabolic parameters, BMI and Tanner's pubertal stage.
  
  
  METHODS
  Fasting insulin, glucose and lipids (triglycerides, high-density lipoprotein cholesterol (HDLc) and low-density lipoprotein cholesterol (LDLc)).
  
  
  RESULTS
  On the basis of the collection of 63 x, y and z coordinates of 21 anthropometric landmarks, 14 facial principal components (PCs) were identified. These components explained 82% of the variation in facial morphology and were used as exposure variables. With adjustment for age, gender and pubertal stage, seven PCs were associated with fasting insulin, none with glucose, three with triglycerides, three with HDLc and four with LDLc. After additional adjustment for BMI, four PCs remained associated with fasting insulin, one with triglycerides and two with LDLc. None of these associations withstood adjustment for multiple comparisons.
  
  
  CONCLUSIONS
  These initial hypotheses generating analyses provide no evidence that facial morphology is importantly related to cardiometabolic outcomes. Further examination might be warranted. Facial morphology assessment may have value in identifying other areas of disease risk.
authors.affiliation: Department of Applied Clinical Research and Public Health, School of Dentistry, Cardiff University, Cardiff, UK.
authors.forename: Jelena
authors.initials: J
authors.lastname: Djordjevic
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
authors.forename: Alexei I
authors.initials: AI
authors.lastname: Zhurov
authors.forename: Arshed M
authors.initials: AM
authors.lastname: Toma
authors.forename: Rebecca
authors.initials: R
authors.lastname: Playle
authors.forename: Stephen
authors.initials: S
authors.lastname: Richmond
keywords: Epidemiology; Preventive Medicine; Statistics & Research Methods