title: Associations of pubertal stage and body mass index with cardiometabolic risk in Hong Kong Chinese children: A cross-sectional study.
abstract: BACKGROUND
  Puberty is associated with a clustering of cardiometabolic risk factors (CMRFs) during adolescence that are manifested in later life. Although anthropometric variables such as body mass index (BMI) can predict cardiometabolic risk in children and adolescents, it is not clear whether there is an interaction between pubertal stage and BMI associated with cardiometabolic risk in this age group. This paper examines the association of pubertal stage and BMI with CMRFs in Hong Kong Chinese children.
  
  
  METHODS
  A cross-sectional school-based study was conducted among 1985 (95.1%) students aged 6 to 18 years. Fasting lipid profile and plasma glucose, blood pressure, body weight, body height and waist circumference were measured. A self-reported pubertal stage questionnaire was used to assess pubertal stage of participants. Two cardiometabolic risk scores, alpha and beta, were constructed to quantify cardiometabolic risk. Cardiometabolic risk score alpha refers to the sum of z-scores of sex-specific, age-adjusted waist circumference, height-adjusted systolic and diastolic blood pressure, fasting plasma glucose, triglyceride and low-density lipoprotein cholesterol, and minus z-score of sex-specific age-adjusted high-density lipoprotein cholesterol. Cardiometabolic risk score beta includes all components of risk score alpha except waist circumference.
  
  
  RESULTS
  The interaction of BMI z-score (ZBMI) and pubertal stage demonstrated a further increase in variance explained in both the cardiometabolic risk scores alpha and beta (0.5% and 0.8% respectively) in boys and (0.7% and 0.5% respectively) in girls.
  
  
  CONCLUSIONS
  Pubertal stage has an interaction effect on the association of cardiometabolic risk by BMI in boys and may have a similar but lesser effect in girls.
authors.affiliation: The School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China. noelptchan@hku.hk.
authors.forename: Noel P T
authors.initials: NP
authors.lastname: Chan
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, 7th floor, Esther Lee Building, Shatin, N.T., Hong Kong SAR, China. kchoi@cuhk.edu.hk.
authors.forename: Kai C
authors.initials: KC
authors.lastname: Choi
authors.affiliation: Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China. tony-nelson@cuhk.edu.hk.
authors.forename: E Anthony S
authors.initials: EA
authors.lastname: Nelson
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China. jchan@cuhk.edu.hk.
authors.forename: Juliana C
authors.initials: JC
authors.lastname: Chan
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China. alicekong@cuhk.edu.hk.
authors.forename: Alice P S
authors.initials: AP
authors.lastname: Kong
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology* / Q000209:etiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012741:Sexual Maturation; D011795:Surveys and Questionnaires; D055815:Young Adult