Abstract
The goals of this study were to develop reference values for waist circumference (WC) in Brazilian children between 6-10 years old and to evaluate the WC performance in predicting cardiovascular risk factors and metabolic syndrome (MetS) in children. This is a population-based epidemiological cross-sectional study, in which 1,397 children participated, with a 6-10 years old probability sampling and from public and private schools in the city of Uberaba, Minas Gerais State, Brazil. WC was measured at the waist narrowest point (WC1) and at the umbilicus level (WC2). Blood samples and blood pressure were collected to determine the MetS diagnosis. There was a significant effect of age (p = 0.001), anatomical point (WC1 vs. WC2, p = 0.001) and sex-anatomical point interaction (p = 0.016) for WC. Smoothed sex- and age-specific 5th, 10th, 25th, 50th, 75th, 90th and 95th percentile curves of WC1 and WC2 were designed by the LMS method. WC was accurate to predict MetS, for all ages [area under the ROC curve (AUC) > 0.79 and p < 0.05], regardless of sex. This study presented percentile curves for WC at two anatomical points in a representative sample of Brazilian children. Furthermore, WC was shown to be a strong predictor of cardiovascular risk factors and MetS in children.
Highlights
Waist circumference (WC) is considered the most accurate anthropometric method to predict cardiovascular risk factors and metabolic syndrome (MetS) in children [1,2,3,4,5,6]
WC values increased with age in both sexes, regardless of the anatomical point
Our findings showed that WC1 and WC2 are screening tools to predict MetS risk in different ages and both sexes
Summary
Waist circumference (WC) is considered the most accurate anthropometric method to predict cardiovascular risk factors and metabolic syndrome (MetS) in children [1,2,3,4,5,6]. Children with the highest WC values had the largest mean values of body fat mass, intima-media thickness, body mass index (BMI), the lowest values of cardiorespiratory fitness and moderate and vigorous physical activity intensity 7. An increased WC may decrease aerobic capacity in children 8. Body fat distribution is not routinely measured in clinical practice. Routine clinical practices must incorporate WC measurements, in addition to traditional measurements, given that normal and overweight children who are central obese may not be identified as such through traditional methods 10
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