Background Several authors have correlated the increase of cardiovascular risk with the nutritional status, however there are different criteria for the classification of overweight and obesity in children. Objectives To evaluate the performance of three nutritional classification criteria in children, as definers of the presence of obesity and predictors of high blood pressure in schoolchildren. MethodsEight hundred and seventeen children ranging 6 to 13 years old, enrolled in public schools in the municipality of Vila Velha (ES) were submitted to anthropometric evaluation and blood pressure measurement. The classification of the nutritional status was established by two international criteria (CDC/NCHS 2000 and IOTF 2000) and one Brazilian criterion (Conde e Monteiro 2006). ResultsThe prevalence of overweight was higher when the criterion of Conde e Monteiro (27%) was used, and inferior by the IOTF (15%) criteria. High blood pressure was observed in 7.3% of children. It was identified a strong association between the presence of overweight and the occurrence of high blood pressure, regardless of the test used (p < 0.001). The test showing the highest sensitivity in predicting elevated BP was the Conde e Monteiro (44%), while the highest specificity (94%) and greater overall accuracy (63%), was the CDC criterion. ConclusionsThe prevalence of overweight in Brazilian children is higher when using the classification criterion of Conde e Monteiro, and lower when the criterion used is IOTF. The Brazilian classification criterion proved to be the most sensitive predictor of high BP risk in this sample.
Objective: Sitting height (SH) is an important parameter in the evaluation of children with grow th and pubertal disorders. Besides this, it has been viewed as a biomarker of cardiovascular risk, which is increased in adults with relatively short legs. So, the aim of this study was to evaluate the relationship between body proportions and cardiovascular risk markers in children. Subjects and methods: Eight hundred and seventeen children aged 6-13 years were evaluated. Weight, height, sitting-height (SH), sitting-height/height (SH/H), body mass index (BMI) and blood pressure (BP) were assessed and converted to standard deviation scores (SDS) for age and sex. Statistical analyses were performed. Results: There was a positive association of BMI SDS with SH and SH/H SDS (p < 0.001). Overweight children showed SH 0.8 SDS superior to eutrophic children (p < 0.001). SH SDS was also directly related to BP SDS, but this association was not independent of the association between obesity and BP when assessed by multiple regression analyzes. Conclusion: Measures of SH are strongly associated with BMI and BP in children, although the association between SH and BP is probably dependent on the association of both those variables with BMI. This is (an) important information for correct interpretation of SH values in children. Arq Bras Endocrinol Metab. 2014;58(8):802-6 Keywords Sitting height; obesity; hypertension; children RESUMO Objetivo: A altura sentada (sitting height, SH) é um importante parâmetro na avaliação de crianças com distúrbios do crescimento e da puberdade. Além disso, tem sido vista como um marcador de risco cardiovascular, aumentado em adultos com pernas relativamente curtas. O objetivo deste estudo foi avaliar a relação entre proporções corporais e marcadores de risco cardiovascular em crianças. Sujeitos e métodos: Oitocentas e dezessete crianças de 6 a 13 anos foram avaliadas. Peso, altura, altura sentada (SH), altura sentada/total (SH/H), índice de massa corpó-rea (IMC) e pressão arterial (PA) foram avaliados e convertidos em Z escores ajustados para sexo e idade. Análises estatísticas apropriadas foram desenvolvidas. Resultados: Houve associação positiva do Z-IMC com o SH e o SH/H (p < 0,001). Crianças com excesso de peso demonstraram Z-SH 0,8 superior ao de crianças eutróficas (p < 0,001). O Z-SH também apresentou correlação direta com o Z-PA, mas essa associação não foi independente da relação entre IMC e PA quando analisada por meio de regressão linear múltipla. Conclusão: Medidas de SH são fortemente associadas ao IMC e PA em crianças, embora a associação entre SH e PA seja provavelmente dependente da associação de ambas as variáveis com o IMC. Essa é uma importante informação para a correta interpretação dos valores de SH em crianças. Arq Bras Endocrinol Metab. 2014;58(8):802-6 Descritores Altura sentada; obesidade; hipertensão; crianças
Overweight and family history constitute the main risk markers of high BP in children. The low frequency of BP measurement in children observed in this municipality contributes to the underdiagnosis of the disease, with irreversible consequences for these individuals.
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