The method of determining abdominal obesity by waist circumference in Ukrainian children

Abstract

Background. The prevalence of obesity in children has a trend of constant growth. A third of the pediatric population suffers from excess body weight and obesity, which are associated with such pathological conditions as hypertension, insulin resistance, hyperglycemia, type 2 diabetes, dyslipidemia, metabolic syndrome (MS) and early cardiovascular dysfunction. Waist circumference (WC) measurement is a simple noninvasive screening tool to identify children with abdominal obesity, MS, and increased cardiovascular risk. The purpose of the study was to develop age- and gender-specific WC percentiles for Ukrainian children aged 10–17 years and to determine possible WC cut-offs for detecting abdominal obesity. Materials and methods. 1566 children aged 10–17 were examined, 759 boys and 807 girls. According to the WHO protocol, WC was measured using a flexible centimeter tape in a standing position midway between the lower rib and the upper front edge of the ilium. The threshold point for detecting abdominal obesity was WC ≥ 90th percentile of the distribution according to age and sex (IDF Consensus, 2007). Results. Age and gender percentiles of WC and cut-off at the level of the 90th percentile in Ukrainian children and adolescents are presented. The importance of gender assessment of WC lies in the reliable difference of indicators in children aged 10–12 and 15–17 years and growth of parameters with age in both boys and girls. The need for age assessment of WC is due to increasing the 90th percentile indicators in girls aged 10–17 from 76 to 90.5 cm and in boys from 75.9 to 94 cm. The data obtained can serve as a source for screening and identifying children with abdominal obesity, increased metabolic risk and a better understanding of current trends in childhood obesity. It has been suggested that new WC reference values should be added to clinical examinations to help pediatricians and family physicians reduce cardiovascular risk in children. Conclusions. In the diagnosis of MS in children, it is recommended to use the proposed specific percentiles of WC for sex and age, the values of which ≥ 90th percentile of the distribution should be utilized for detection of abdominal obesity and further diagnosis of MS. Measuring and evaluating WC in routine pediatric examinations is important.