title: Comparison of anthropometric measurements in children to predict metabolic syndrome in adolescence: analysis of prospective cohort data.
abstract: OBJECTIVE
  The optimal screening measures for obesity in children remain controversial. Our study aimed to determine the anthropometric measurement at age 10 years that most strongly predicts the incidence of cardio-metabolic risk factors at age 13 years.
  
  
  METHODS
  This was a prospective cohort study of a population-based cohort of 438 children followed between age 7 and 13 years of age. The main exposure variables were adiposity at age 10 years determined from body mass index (BMI) Z-score, waist circumference (WC) Z-score, waist-to-hip ratio and waist-to-height ratio. Outcome measures included systolic (SBP) and diastolic blood pressure (DBP), fasting high-density (HDL-c) and low-density lipoprotein cholesterol (LDL-c), triglycerides, insulin and glucose (homeostasis model of assessment, HOMA), and the presence of metabolic syndrome (MetS).
  
  
  RESULTS
  WC Z-score at age 10 years was a stronger predictor of SBP (β 0.21, R(2) 0.38, P<0.001 vs β 0.30, R(2) 0.20, P<0.001) and HOMA (β 0.51, R(2) 0.25, P<0.001 vs 0.40, R(2) 0.19, P<0.001) at age 13 years compared with BMI Z-score. WC relative to height and hip was stronger predictors of cardio- metabolic risk than BMI Z-score or WC Z-score. The relative risk (RR) of incident MetS was greater for an elevated BMI Z-score than for an elevated WC (girls: RR 2.52, 95% confidence interval (CI): 1.46-4.34 vs RR 1.56, 95% CI 1.18-2.07) and (boys: RR 2.86, 95% CI 1.79-4.62 vs RR 2.09, 95% CI 1.59-2.77).
  
  
  CONCLUSIONS
  WC was a better predictor of SBP and HOMA compared with BMI or WC expressed relative to height or hip circumference. BMI was associated with higher odds of MetS compared with WC. Thus, BMI and WC may each be clinically relevant markers of different cardio-metabolic risk factors, and important in informing obesity-related prevention and treatment strategies.
authors: 1] Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada [2] Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
authors: B A
authors: BA
authors: Wicklow
authors: 1] Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada [2] Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
authors: A
authors: A
authors: Becker
authors: 1] Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada [2] Department of Community Health Sciences, Manitoba Center for Health Policy, Winnipeg, Manitoba, Canada.
authors: D
authors: D
authors: Chateau
authors: Department of Psychology, Stockholm University, Stockholm, Sweden.
authors: K
authors: K
authors: Palmer
authors: Department of Pediatrics and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors: A
authors: A
authors: Kozyrskij
authors: 1] Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada [2] Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
authors: E A C
authors: EA
authors: Sellers
mesh_terms: D001794:Blood Pressure; D001827:Body Height; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D009765:Obesity / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides