Predictive capacity of anthropometric indicators for dyslipidemia screening in children and adolescents.

OBJECTIVE To analyze the predictive capacity of anthropometric indicators and their cut-off values for dyslipidemia screening in children and adolescents. METHODS This was a cross-sectional study involving 1139 children and adolescents, of both sexes, aged 6-18 years. Body weight, height, waist circumference, subscapular, and triceps skinfold thickness were measured. The body mass index and waist-to-height ratio were calculated. Children and adolescents exhibiting at least one of the following lipid alterations were defined as having dyslipidemia: elevated total cholesterol, low high-density lipoprotein, elevated low-density lipoprotein, and high triglyceride concentration. A receiver operating characteristic curve was constructed and the area under the curve, sensitivity, and specificity was calculated for the parameters analyzed. RESULTS The prevalence of dyslipidemia was 62.1%. The waist-to-height ratio, waist circumference, subscapular, body mass index, and triceps skinfold thickness, in this order, presented the largest number of significant accuracies, ranging from 0.59 to 0.78. The associations of the anthropometric indicators with dyslipidemia were stronger among adolescents than among children. Significant differences between accuracies of the anthropometric indicators were only observed by the end of adolescence; the accuracy of waist-to-height ratio was higher than that of subscapular (p=0.048) for females, and the accuracy of waist circumference was higher than that of subscapular (p=0.029) and body mass index (p=0.012) for males. In general, the cut-off values of the anthropometric predictors of dyslipidemia increased with age, except for waist-to-height ratio. Sensitivity and specificity varied substantially between anthropometric indicators, ranging from 75.6 to 53.5 and from 75.0 to 50.0, respectively. CONCLUSIONS The anthropometric indicators studied had little utility as screening tools for dyslipidemia, especially in children.

[1]  A. Kengne,et al.  Optimal Waist-to-Height Ratio Values for Cardiometabolic Risk Screening in an Ethnically Diverse Sample of South African Urban and Rural School Boys and Girls , 2013, PloS one.

[2]  Adolescents Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report , 2011, Pediatric Clinical Practice Guidelines & Policies.

[3]  R. Tracy,et al.  Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. , 1998, The New England journal of medicine.

[4]  L. Saxe,et al.  Population Estimates: 2012 , 2013 .

[5]  C. Bouchard,et al.  Body mass index, waist circumference, and clustering of cardiovascular disease risk factors in a biracial sample of children and adolescents. , 2004, Pediatrics.

[6]  R. Kelishadi,et al.  Paediatric metabolic syndrome and associated anthropometric indices: The CASPIAN Study , 2006, Acta paediatrica.

[7]  Claire C. Gordon,et al.  Stature, recumbent length, and weight , 1988 .

[8]  B. Duncan,et al.  [I guidelines of prevention of atherosclerosis in childhood and adolescence]. , 2005, Arquivos brasileiros de cardiologia.

[9]  S. Daniels Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report , 2011, Pediatrics.

[10]  [Cardiovascular risk and associated factors in schoolchildren in Belém, Pará State, Brazil]. , 2014, Cadernos de saude publica.

[11]  D. Simons-Morton,et al.  Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report , 2016, Pediatric Clinical Practice Guidelines & Policies.

[12]  T. Cole,et al.  Establishing a standard definition for child overweight and obesity worldwide: international survey , 2000, BMJ : British Medical Journal.

[13]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[14]  T. Olds,et al.  Anthropometrica : a textbook of body measurement for sports and health courses , 1996 .

[15]  S. Srinivasan,et al.  Dynamic changes of serum lipoproteins in children during adolescence and sexual maturation. , 1981, American journal of epidemiology.

[16]  J. Caputo,et al.  Waist-to-height ratio and body mass index as indicators of cardiovascular risk in youth. , 2013, The Journal of school health.

[17]  J. Lamounier,et al.  Sociodemographic, anthropometric and dietary determinants of dyslipidemia in preschoolers. , 2013, Jornal de pediatria.

[18]  S. Barreto,et al.  IV Diretriz Brasileira sobre Dislipidemias e Prevenção da Aterosclerose: Departamento de Aterosclerose da Sociedade Brasileira de Cardiologia , 2007 .

[19]  A. Staiano,et al.  Ethnic and sex differences in body fat and visceral and subcutaneous adiposity in children and adolescents , 2012, International Journal of Obesity.

[20]  Simone Augusta Ribas,et al.  Factores de riesgo cardiovascular y los factores asociados en escolares en Belém, Pará, Brasil , 2014 .

[21]  Paul Poirier,et al.  Overview of epidemiology and contribution of obesity to cardiovascular disease. , 2014, Progress in cardiovascular diseases.

[22]  J. Macinko,et al.  The Brazilian health system: history, advances, and challenges , 2011, The Lancet.

[23]  T. Lohman,et al.  Anthropometric Standardization Reference Manual , 1988 .

[24]  B. Duncan,et al.  [IV Brazilian Guideline for Dyslipidemia and Atherosclerosis prevention: Department of Atherosclerosis of Brazilian Society of Cardiology]. , 2007, Arquivos Brasileiros de Cardiologia.

[25]  L. Grummer-Strawn,et al.  Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: the Bogalusa Heart Study. , 2007, The American journal of clinical nutrition.

[26]  D. Botter,et al.  [Additional cardiovascular risk factors associated with excess weight in children and adolescents: the Belo Horizonte heart study]. , 2006, Arquivos brasileiros de cardiologia.

[27]  A. Diniz,et al.  Lipid profile of schoolchildren from Recife, PE. , 2010, Arquivos brasileiros de cardiologia.

[28]  D. Simons-Morton,et al.  Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report , 2011, Pediatrics.

[29]  C. Ogden,et al.  Anthropometric reference data for children and adults: U.S. population, 1999-2002. , 2005, Advance data.

[30]  E. Montañés,et al.  Circunferencia de cintura, dislipidemia e hipertensión arterial en prepúberes de ambos sexos , 2007 .

[31]  E. L. da Silva,et al.  Simultaneous prediction of hyperglycemia and dyslipidemia in school children in Santa Catarina State, Brazil based on waist circumference measurement. , 2013, Clinical biochemistry.