title: Simultaneous prediction of hyperglycemia and dyslipidemia in school children in Santa Catarina State, Brazil based on waist circumference measurement.
abstract: OBJECTIVE
  Waist circumference (WC) is highly associated with metabolic risk factor clusters (RFC) for chronic non-communicable diseases (NCDs). In this study, we evaluated the use of WC measurements to detect hyperglycemia and dyslipidemia in children and adolescents using the WC cutoff points reported in the Bogalusa Heart study and the New Zealand study.
  
  
  METHODS
  Students (n=1011; aged 6 to 14years) were enrolled in a cross-sectional study. Anthropometric indices, fasting glucose, and lipid profiles were measured. The associations between WC measures and serum parameters were investigated by logistic regression models, and the clinical accuracy of the studied parameters was assessed using receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  The prevalence of increased WC was 30.2% using the New Zealand cutoff points and 13.7% using the Bogalusa cutoff values. In general, children with increased WC exhibited higher concentrations of total cholesterol, triglycerides, LDL-cholesterol, and non-HDL-cholesterol and lower levels of HDL-cholesterol. The areas under the ROC curves (AUC) of the WC measurements were 0.770 (95% CI: 0.744-0.797) and 0.600 (95% CI: 0.569-0.631) using, respectively, the New Zealand and Bogalusa cutoff points for WC, indicating the prediction of simultaneous hyperglycemia, increased levels of non-HDL-cholesterol, and reduced HDL-cholesterol for students with increased WC. There was a significant difference between AUC values (P=0.001). Furthermore, the sensitivity of using WC for detecting RFC in students was 2.0 to 2.5-fold higher with the New Zealand study cutoff values for WC than with those from the Bogalusa study. Logistic regression analysis revealed that increased WC was associated with simultaneous hyperglycemia and dyslipidemia after controlling for differences in sex and age (P<0.01 for all).
  
  
  CONCLUSIONS
  Children and adolescents exhibited a high prevalence of increased WC associated with other RFCs for NCDs. Increased WC may be used to screen and identify students with elevated clusters of metabolic risk factors for NCDs.
authors.affiliation: Post-Graduation Program in Pharmacy, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil; Health Division of the Santa Catarina Government, Brazil.
authors.forename: Nilton
authors.initials: N
authors.lastname: Rosini
authors.forename: Marcos J
authors.initials: MJ
authors.lastname: Machado
authors.forename: Ivonir Z
authors.initials: IZ
authors.lastname: Webster
authors.forename: Solange A Z O
authors.initials: SA
authors.lastname: Moura
authors.forename: Luciana da S
authors.initials: Lda S
authors.lastname: Cavalcante
authors.forename: Edson L
authors.initials: EL
authors.lastname: da Silva
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D008078:Cholesterol, LDL; D014280:Triglycerides; D002784:Cholesterol
keywords: CVDs; Glycemia; HDL-c; LDL-c; Lipid profile; NCDs; RFC; Risk factors; School children; TC; TG; WC; Waist circumference; aOR; adjusted odds ratio; cardiovascular diseases; high-density lipoprotein cholesterol; low-density lipoprotein cholesterol; non-communicable diseases; risk factor clusters; total cholesterol; triglycerides; waist circumference