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Body mass index and waist circumference in midchildhood and adverse cardiovascular disease risk clustering in adolescence^1,2,3

¹ From the Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia (SPG, SS, JWL, and CTC), and the University of Sydney, Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead Clinical School, Westmead, Australia (SPG, LAB, SS, and CTC)

Background: Body mass index (BMI) may not indicate the level of central adiposity associated with the clustering of cardiovascular disease (CVD) risk factors. Hence, it has been recommended that waist circumference be used as an alternative measure.

Objective: The objective was to investigate whether waist circumference in midchildhood is more effective at predicting cardiovascular disease risk clustering in adolescence than is BMI.

Design: Anthropometric measurements were made in 342 children aged 8 y. Seven years later, anthropometric measurements were made in 290 participants, and metabolic profiles were determined in 172 participants.

Results: At 15 y, between 9.4% and 11.0% of adolescents were defined as having CVD risk clustering. Children who were overweight or obese at 8 y of age were 7 times (odds ratio: 6.9; 95% CI: 2.5, 19.0; P < 0.001) as likely to have CVD risk clustering in adolescence than were their peers who were not overweight or obese. Those with an increased waist circumference at 8 y were 4 times (3.6; 1.0, 12.9; P = 0.061) as likely to have CVD risk clustering in adolescence than were children with a smaller waist circumference. Neither BMI nor waist circumference were predictive of CVD risk clustering if adiposity was not included as a risk factor.

Conclusions: The association between measures of adiposity in midchildhood and later adverse CVD risk is a result of the tracking of adiposity status. Our results do not support the need to measure waist circumference in children, in addition to BMI, to identify those at increased risk of CVD risk factor clustering in adolescence.

Key Words: Body mass index • waist circumference • metabolic syndrome • longitudinal study • children