Abstract
ABSTRACTObjective: To conduct a systematic review of the literature on the ability of anthropometric indicators to predict clustered cardiometabolic risk factors (CMRF) in children and adolescents.Data source: Studies published from June 1st, 2011 to May 31st, 2016 in the PubMed, SciELO and LILACS databases were analyzed. The research was based on keywords derived from the terms “anthropometric indicators” AND “cardiometabolic risk factors”. Observational studies on the ability of anthropometric indicators as predictors of clustered CMRF in children and adolescents in Portuguese, English and Spanish languages were included. Studies with a specific group of obese patients or with other diseases were not included.Data synthesis: Of the 2,755 articles retrieved, 31 were selected for systematic review. Twenty-eight studies analyzed body mass index (BMI) as a predictor of clustered CMRF. Only 3 of the 25 cross-sectional studies found no association between anthropometric indicators and clustered CMRF. The results of six studies that compared the predictive ability of different anthropometric measures for clustered CMRF were divergent, and it was not possible to define a single indicator as the best predictor of clustered CMRF. Only six articles were cohort studies, and the findings suggested that changes in adiposity during childhood predict alterations in the clustered CMRF in adolescence.Conclusions: BMI, waist circumference and waist-to-height ratio were predictors of clustered CMRF in childhood and adolescence and exhibited a similar predictive ability for these outcomes. These findings suggest anthropometric indicators as an interesting screening tool of clustered CMRF at early ages.
Highlights
Body mass index (BMI) has been used for decades to assess overweight and obesity.[1]
According to the systematic review conducted with articles published until 2014, with the objective of verifying the association between abdominal obesity and cardiometabolic risk factors (CMRF) in children and adolescents, regardless of the definition used for abdominal obesity and the methods used for anthropometric measurements, central fat deposition in children and adolescents increases the risk of CMRF.[4]
The findings of the review showed that waist-to-height ratio (WHtR) and waist perimeter (WP) were more strongly associated with isolated CMRF than BMI.[5]
Summary
Body mass index (BMI) has been used for decades to assess overweight and obesity.[1]. According to the systematic review conducted with articles published until 2014, with the objective of verifying the association between abdominal obesity and CMRF in children and adolescents, regardless of the definition used for abdominal obesity and the methods used for anthropometric measurements, central fat deposition in children and adolescents increases the risk of CMRF.[4] Two other important systematic reviews were published in 2010.5,6 Browning et al.[5] sistematically reviewed studies that support WHtR as a predictor of CMRF in adults and children, besides reporting relations between WHtR, BMI or WP, or both. 13 were conducted with children and adolescents – all cross-sectional analyses. The findings of the review showed that WHtR and WP were more strongly associated with isolated CMRF than BMI.[5] A systematic review conducted by Reilly et al.,[6] who analyzed studies comparing the accuracy (area under the curve – AUC) of BMI and WP to predict CMRF, showed that the AUC of both measurements in the CMRF diagnosis were similar.[6]
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