Association between obesity indices and cardiovascular risk factors in late adolescence in the Seychelles

BMC Pediatrics

Gary Myers³  Bharathi Viswanathan²  Tiphaine Arlabosse¹  Pascal Bovet² 

[1] Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland;Section of Noncommunicable Diseases, Ministry of Health, Victoria, Republic of Seychelles;Department of Child Neurology, University of Rochester Medical Center, Rochester, NY, USA

关键词: Africa;    Young adults;    Adolescents;    Youth;    Screening;    Cardiovascular risk factors;    Body mass index (BMI);    Obesity;   

Others  :  1170614
DOI  :  10.1186/1471-2431-12-176

 received in 2012-05-19, accepted in 2012-11-04,  发布年份 2012

【 摘 要 】

Background

The ability of different obesity indices to predict cardiovascular risk is still debated in youth and few data are available in sub Saharan Africa. We compared the associations between several indices of obesity and cardiovascular risk factors (CVRFs) in late adolescence in the Seychelles.

Methods

We measured body mass index (BMI), waist circumference, waist/hip ratio (WHiR), waist/height ratio (WHtR) and percent fat mass (by bioimpedance) and 6 CVRFs (blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides, fasting blood glucose and uric acid) in 423 youths aged 19–20 years from the general population.

Results

The prevalence of overweight/obesity and several CVRFs was high, with substantial sex differences. Except for glucose in males and LDL-cholesterol in females, all obesity indices were associated with CVRFs. BMI consistently predicted CVRFs at least as well as the other indices. Linear regression on BMI had standardized regression coefficients of 0.25-0.36 for most CVRFs (p<0.01) and ROC analysis had an AUC between 60%-75% for most CVRFs. BMI also predicted well various combinations of CVRFs: 36% of male and 16% of female lean subjects (BMI P90).

Conclusion

There was an elevated prevalence of obesity and of several CVRFs in youths in Seychelles. BMI predicted single or combined CVRFs at least as well as other simple obesity indices.

【 授权许可】

   
2012 Bovet et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Han JC, Lawlor DA, Kimm SY: Childhood obesity. Lancet 2010, 375(9727)):1737-1748. Epub 2010/05/11
• [2]Tirosh A, Shai I, Afek A, Dubnov-Raz G, Ayalon N, Gordon B, et al.: Adolescent BMI trajectory and risk of diabetes versus coronary disease. N Engl J Med 2011, 364(14):1315-1325. Epub 2011/04/08
• [3]Reilly JJ, Kelly J: Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes (Lond) 2011, 35(7):891-898.
• [4]Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, et al.: Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 2011, 365(20):1876-1885. Epub 2011/11/18
• [5]Reilly JJ, Methven E, McDowell ZC, Hacking B, Alexander D, Stewart L, et al.: Health consequences of obesity. Arch Dis Child 2003, 88(9):748-752.
• [6]Freedman DS, Dietz WH, Srinivasan SR, Berenson GS: The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 1999, 103(6 Pt 1)):1175-1182. Epub 1999/06/03
• [7]Knowles KM, Paiva LL, Sanchez SE, Revilla L, Lopez T, Yasuda MB, et al.: Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults. Int J Hypertens 2011, 2011:931402. Epub 2011/02/19
• [8]Dobbelsteyn CJ, Joffres MR, MacLean DR, Flowerdew G: A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys. Int J Obes Relat Metab Disord 2001, 25(5):652-661. Epub 2001/05/22
• [9]Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al.: Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case–control study. Lancet 2005, 366(9497):1640-1649. Epub 2005/11/08
• [10]Ashwell M, Gunn P, Gibson S: Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 2011. Epub 2011/11/24
• [11]Lee CM, Huxley RR, Wildman RP, Woodward M: Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol 2008, 61(7):646-653. Epub 2008/03/25
• [12]Gomez-Ambrosi J, Silva C, Galofre JC, Escalada J, Santos S, Millan D, et al.: Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity. Int J Obes (Lond) 2011. Epub 2011/05/19
• [13]Lindsay RS, Hanson RL, Roumain J, Ravussin E, Knowler WC, Tataranni PA: Body mass index as a measure of adiposity in children and adolescents: relationship to adiposity by dual energy x-ray absorptiometry and to cardiovascular risk factors. J Clin Endocrinol Metab 2001, 86(9):4061-4067. Epub 2001/09/11
• [14]Reilly JJ, Kelly J, Wilson DC: Accuracy of simple clinical and epidemiological definitions of childhood obesity: systematic review and evidence appraisal. Obes Rev 2010, 11(9):645-655. Epub 2010/01/12
• [15]Lawlor DA, Benfield L, Logue J, Tilling K, Howe LD, Fraser A, et al.: Association between general and central adiposity in childhood, and change in these, with cardiovascular risk factors in adolescence: prospective cohort study. BMJ 2010, 341:c6224. Epub 2010/11/27
• [16]Nyamdorj R, Pitkaniemi J, Tuomilehto J, Hammar N, Stehouwer CD, Lam TH, et al.: Ethnic comparison of the association of undiagnosed diabetes with obesity. Int J Obes (Lond) 2010, 34(2):332-339. Epub 2009/11/04
• [17]Fezeu L, Balkau B, Sobngwi E, Kengne AP, Vol S, Ducimetiere P, et al.: Waist circumference and obesity-related abnormalities in French and Cameroonian adults: the role of urbanization and ethnicity. Int J Obes (Lond) 2010, 34(3):446-453. Epub 2010/01/13
• [18]Nyamdorj R, Qiao Q, Soderberg S, Pitkaniemi J, Zimmet P, Shaw J, et al.: Comparison of body mass index with waist circumference, waist-to-hip ratio, and waist-to-stature ratio as a predictor of hypertension incidence in Mauritius. J Hypertens 2008, 26(5):866-870. Epub 2008/04/10
• [19]Wai WS, Dhami RS, Gelaye B, Girma B, Lemma S, Berhane Y, et al.: Comparison of Measures of Adiposity in Identifying Cardiovascular Disease Risk Among Ethiopian Adults. Obesity (Silver Spring) 2011. Epub 2011/05/07
• [20]Chiolero A, Paradis G, Madeleine G, Hanley JA, Paccaud F, Bovet P: Discordant secular trends in elevated blood pressure and obesity in children and adolescents in a rapidly developing country. Circulation 2009, 119(4):558-565. Epub 2009/01/21
• [21]Myers GJ, Davidson PW, Cox C, Shamlaye CF, Tanner MA, Marsh DO, et al.: Summary of the Seychelles child development study on the relationship of fetal methylmercury exposure to neurodevelopment. Neurotoxicology 1995, 16(4):711-716. Epub 1995/01/01
• [22]Guthold R, Louazani SA, Riley LM, Cowan MJ, Bovet P, Damasceno A, et al.: Physical activity in 22 African countries: results from the World Health Organization STEPwise approach to chronic disease risk factor surveillance. Am J Prev Med 2011, 41(1):52-60. Epub 2011/06/15
• [23]Zou KH, O'Malley AJ, Mauri L: Receiver-operating characteristic analysis for evaluating diagnostic tests and predictive models. Circulation 2007, 115(5):654-657. Epub 2007/02/07
• [24]Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report Pediatrics 2011, 128(Suppl 5:):S213-S256. Epub 2011/11/16
• [25]Bovet P, Romain S, Shamlaye C, Mendis S, Darioli R, Riesen W, et al.: Divergent fifteen-year trends in traditional and cardiometabolic risk factors of cardiovascular diseases in the Seychelles. Cardiovasc Diabetol 2009, 8:34. Epub 2009/06/30 BioMed Central Full Text
• [26]WHO: Global status report on noncommunicable diseases 2011. Geneva: WHO; 2011.
• [27]Magnussen CG, Koskinen J, Chen W, Thomson R, Schmidt MD, Srinivasan SR, et al.: Pediatric metabolic syndrome predicts adulthood metabolic syndrome, subclinical atherosclerosis, and type 2 diabetes mellitus but is no better than body mass index alone: the Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study. Circulation 2010, 122(16):1604-1611. Epub 2010/10/06
• [28]The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents Pediatrics 2004, 114(2 Suppl 4th Report):555-576. Epub 2004/08/03
• [29]Libman IM, Barinas-Mitchell E, Bartucci A, Chaves-Gnecco D, Robertson R, Arslanian S: Fasting and 2-hour plasma glucose and insulin: relationship with risk factors for cardiovascular disease in overweight nondiabetic children. Diabetes Care 2010, 33(12):2674-2676. Epub 2010/12/01
• [30]Howe LD, Tilling K, Benfield L, Logue J, Sattar N, Ness AR, et al.: Changes in ponderal index and body mass index across childhood and their associations with fat mass and cardiovascular risk factors at age 15. PLoS One 2010, 5(12):e15186. Epub 2010/12/21
• [31]Lin SX, Carnethon M, Szklo M, Bertoni A: Racial/ethnic differences in the association of triglycerides with other metabolic syndrome components: the Multi-Ethnic Study of Atherosclerosis. Metab Syndr Relat Disord 2011, 9(1):35-40. Epub 2010/10/21
• [32]Grayson PC, Kim SY, LaValley M, Choi HK: Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis care & research 2011, 63(1):102-110. Epub 2010/09/09
• [33]Bouchard C: BMI, fat mass, abdominal adiposity and visceral fat: where is the 'beef'? Int J Obes (Lond) 2007, 31(10):1552-1553. Epub 2007/06/06
• [34]Wald NJ, Hackshaw AK, Frost CD: When can a risk factor be used as a worthwhile screening test? BMJ 1999, 319(7224):1562-1565. Epub 1999/12/11
• [35]Barton M: Screening for obesity in children and adolescents: US Preventive Services Task Force recommendation statement. Pediatrics 2010, 125(2):361-367. Epub 2010/01/20
• [36]Williams CL, Hayman LL, Daniels SR, Robinson TN, Steinberger J, Paridon S, et al.: Cardiovascular health in childhood: A statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2002, 106(1):143-160. Epub 2002/07/03