Evaluating BMI And Waist Circumference Cutpoints To Identify Urban Female Adolescents At Risk For Metabolic Syndrome

Abstract

INTRODUCTION Adolescent obesity and related metabolic syndrome are growing problems in the United States. Screening techniques are needed to identify those at risk for developing metabolic syndrome in order to initiate preventive or treatment therapies. Recent research by Katzmarzyk et al (2004) suggests age, race and gender specific body mass index (BMI) and waist circumference cutpoints to help identify those at risk for metabolic syndrome. PURPOSE To determine whether the previously-published BMI and waist circumference cutpoints are associated with multiple risk factors in a sample of urban, predominantly African American adolescent high school girls. METHODS Baseline data were collected from 190 ninth grade females, (84% African American) enrolled in a physical activity intervention trial. Seven variables associated with metabolic syndrome were ascertained and included in this analysis; blood pressure (systolic and diastolic), fasting glucose, cholesterol, LDL, HDL and triglycerides. Risk status was individually determined for each variable based on published data, current health guidelines or the 20% least favorable values determined from this sample. Participants were separated into two groups high risk (meeting the criteria for 3 or more risk measures) or not at risk (meeting the criteria for less than 3 risk measures). RESULTS 64% of participants exceeded the Katzmarzyk et al cutpoint for BMI; 59% exceeded the cutpoint for waist circumference. The sample high risk prevalence for metabolic syndrome was 17%. Participants who exceeded the BMI cutpoint and categorized as high risk was 22%. 7% exceeded the BMI cutpoint but did not have a high risk profile (p=.008). Of those classified within the high risk category, 88% also exceeded the BMI cutpoint. Participants who exceeded the waist circumference cutpoint and categorized as high risk was 23%. 9% exceeded the waist circumference cutpoint but did not have a high risk profile (p=.01). Of those classified within high risk category, 82% also exceeded the waist circumference cutpoint. CONCLUSIONS Both BMI and waist circumference cutpoints provide useful measures for screening urban adolescent females at risk of developing metabolic syndrome and can help identify those in need of additional medical and lifestyle modification. This study was supported by ROI HL63861.