Using LMS tables to determine waist circumference and waist-to-height ratios in Colombian children and adolescents: the FUPRECOL study

Abstract

BackgroundWaist circumference (WC) and waist-to-height ratio (WHtR) are often used as indices predictive of central obesity. The aims of this study were: 1) to obtain smoothed centile charts and LMS tables for WC and WHtR among Colombian children and adolescents; 2) to evaluate the utility of these parameters as predictors of overweight and obesity.MethodA cross-sectional study was conducted of a sample population of 7954 healthy Colombian schoolchildren [3460 boys and 4494 girls, mean age 12.8 (±2.3) years]. Weight, height, body mass index (BMI), WC and WHtR were measured, and percentiles were calculated using the LMS method (Box-Cox, median and coefficient of variation). Appropriate cut-off points of WC and WHtR for overweight and obesity, according to International Obesity Task Force definitions, were selected using receiver operating characteristic (ROC) analysis. The discriminating power of WC and WHtR is expressed as area under the curve (AUC).ResultsReference values for WC and WHtR are presented. Mean WC increased and WHtR decreased with age for both genders. A moderate positive correlation was observed between WC and BMI (r = 0.756, P < 0.01) and between WHtR and BMI (r = 0.604, P < 0.01). ROC analysis revealed strong discrimination power in the identification of overweight and obesity for both measures in our sample population. Overall, WHtR was a slightly better predictor of overweight/obesity (AUC 95% CI 0.868–0.916) than WC (AUC 95% CI 0.862–0.904).ConclusionThis paper presents the first sex and age-specific WC and WHtR percentiles for Colombian children and adolescents aged 9.0–17.9 years. The LMS tables obtained, based on Colombian reference data, can be used as quantitative tools for the study of obesity and its comorbidities.

Comparison of Obesity-Related Parameters as Predictors of High Pulse Wave Velocity in Middle-Aged and Elderly People in China: A Multicenter Cross-Sectional Community-Based Study

“…Compared to reference populations from 1992 to 2015, overweight and obesity have increased by 17% and 9%, respectively [2]. High body weight and inadequate body fat distribution are associated with chronic diseases such as hypertension, cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus [3,4]. Physiologic changes caused by excess body fat include activation of the sympathetic nervous system and renin-angiotensin aldosterone system as well as endothelial dysfunction, which can lead to hypertension [5]; and increased insulin resistance, hypertriglyceridemia, decreased levels of high-density lipoprotein cholesterol, and changes in leptin levels and blood pressure are directly linked to a higher risk of cardiovascular disease [6][7][8][9][10].…”

“…Perhaps the rst step is to know how to evaluate these indicators. Body fatness and overweight have been widely studied using body mass index (BMI), which is body weight divided by the square of height (kg/m 2 ) [3,14]. However, a well-known disadvantage of BMI is that it does not differentiate between fat mass (FM) and fat-free mass (FFM), and does not take fat distribution into account [4,15].…”

“…Abdominal fat-i.e., surrounding the heart, liver, and kidneys-is as pathogenic as overall obesity, but is associated with a higher disease burden [11]. Visceral fat accumulation has adverse health effects, and increases the risk of cardiovascular disease to a greater extent than subcutaneous fat [3,[14][15][16]. In fact, waist-to-height ratio (WHtR) and waist circumference (WC) may be better indicators of abdominal obesity as they can be easily measured and can also re ect overall obesity [4].…”

Circunferência da Cintura, uma Medida Simples para a Obesidade Infantil?

“…Estudos descrevendo valores de percentis para CC têm apresentado resultados diferentes, uma vez que os valores de CC podem ser influenciados por idade, sexo e grupos étnicos, 9 - 11 dificultando o estabelecimento de valores de referência globais para essa medida antropométrica.…”

“…Studies describing percentile values of WC have reported different results; WC measurements may be affected by age, sex and ethnicity, 9 - 11 which makes the establishment of global reference values difficult.…”