Central obesity highlights adolescent CVD risk factors

31 August 2010

MedWire News: Central adiposity predicts the presence of cardiovascular disease (CVD) risk factors in adolescents, say German researchers.

Their community-based study revealed that central adiposity, defined by waist circumference or the waist-to-height ratio, could predict dyslipidemia, hypertension, and hyperglycemia.

Central adiposity predicted a nearly four-fold increased risk in the clustering of seven non-anthropometric CVD risk factors.

It was also associated with a more than seven-fold increased risk for an elevated ratio of triglycerides to high-density lipoprotein (HDL) cholesterol, which the researchers say was used as a surrogate for insulin resistance.

Peter Schwandt (Arteriosklerose-Präventions-Institut, Munich) and colleagues examined whether anthropometric measures could detect traditional CVD risk factors in 3038 adolescents, aged 12 to 18 years, living in Nuremburg, Germany, of whom 1639 were male.

The anthropometric measures studied included body mass index (BMI), waist-to-hip ratio, skinfold thickness, waist circumference, waist-to-height ratio, and central adiposity. These were compared with nine cardiometabolic risk variables.

Central obesity, defined as a waist circumference in or above the 90th percentile or a waist-to-height ratio of at least 0.5, or both, was identified in 13.7% of males and 13.4% of females.

It was the only anthropometric variable that significantly predicted increased risk for all seven non-anthropometric CVD risk factors. These included: hypertension (odds ratio [OR]= 2.5), elevated triglycerides (OR=4.9), low-density lipoprotein cholesterol (OR=2.0), and non-HDL cholesterol (OR=2.1), a triglyceride/HDL cholesterol ratio of at least 3.5 (OR=7.2), and low HDL cholesterol (OR=1.6) and fasting glucose (OR=1.3) levels.

General adiposity only detected hyperglycemia (OR=1.8) and hypertension (OR=4.9), skinfold thickness in or above the 90th percentile predicted elevated triglycerides (OR=2.3), and elevated triglyceride/HDL cholesterol ratio (OR=3.9), and waist-to-hip ratio indicated hypertriglyceridemia only (OR=2.3).

Central obesity was associated with a higher OR for the clustering of at least three CVD nonanthropometric risk factors compared with waist-to-height ratio and the sum of skinfold thickness (OR=3.8 vs 2.7 and 1.9, respectively).

Reporting in the journal Atherosclerosis, the researchers say: “These findings might justify the definition of central adiposity as an increased waist-to-height ratio and/or increased waist circumference and the use of this simple anthropometric measure for predicting modifiable CV risk factors in community-wide adolescent screening.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Atherosclerosis 2010; 211: 667–671