Obesity indicators and cardiometabolic status in 4-y-old children1–3

Abstract

Background: In adults and adolescents, obesity is positively associated with cardiovascular disease risk factors; however, evidence in preschool children is scarce. Objective: The objective was to assess the relations between obesity indicators and cardiometabolic risk factors in 324 Chilean children 4 y of age. Design: We collected anthropometric measurements and calculated general indicators of obesity [weight, body mass index (BMI), sum of 4 skinfold thicknesses, percentage fat, and body fat index] and central obesity (waist circumference, waist-to-hip ratio, waist-toheight ratio, and truncal fatness based on skinfold thickness). We measured blood sample concentrations of C-reactive protein, interleukin- 6, homeostasis model assessment of insulin resistance, triglycerides, and total, LDL, and HDL cholesterol. We used correlation and multiple linear regression analyses. Results: The prevalence of obesity (BMI-for-age z score .2, World Health Organization 2006), central obesity ( 90th percentile, third National Health and Nutrition Examination Survey), and lipid disorders was high (13%, 11%, and 20%, respectively), and 70% of the children had at least one cardiometabolic risk factor. Most correlations between obesity and central obesity indicators were moderate to strong (0.40 , r , 0.96). Obesity was positively but weakly associated with C-reactive protein in both sexes and with homeostasis model assessment of insulin resistance only in girls (all r , 0.3, P , 0.05). Obesity indicators were unrelated to interleukin-6 and lipid concentrations (P . 0.05). Overall, obesity indicators explained, at most, 8% of the variability in cardiometabolic risk factors. Conclusions: Obesity and central obesity were common, and most of the children had at least one cardiometabolic risk factor, particularly lipid disorders. Obesity and central obesity indicators were highly intercorrelated and, overall, were weakly related to cardiometabolic status. At this age, body mass index and waist circumference were poor predictors of cardiometabolic status.