REVIEW   

Minerva Pediatrica 2018 August;70(4):371-82

DOI: 10.23736/S0026-4946.18.05175-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Efficacy of anthropometric measures for identifying cardiovascular disease risk in adolescents: review and meta-analysis

Michael LICHTENAUER ¹, Sean D. WHEATLEY ² ✉, Marrissa MARTYN-ST JAMES ³, Michael J. DUNCAN ⁴, Fernanda COBAYASHI ⁵, Gabriela BERG ⁶, Carla MUSSO ⁷, Mabel GRAFFIGNA ⁸, Jimena SOUTELO ⁹, Pascal BOVET ¹⁰, Anastasios KOLLIAS ¹¹, George S. STERGIOU ¹¹, Evangelos GRAMMATIKOS ¹², Claire GRIFFITHS ², Lee INGLE ¹³, Christian JUNG ¹⁴

¹ Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria; ² School of Sport, Carnegie Faculty, Leeds Beckett University, Leeds, UK; ³ School of Health & Related Research, University of Sheffield, Sheffield, UK; ⁴ Faculty of Health and Life Sciences, Coventry University, Coventry, UK; ⁵ Public Health Nutrition Program, School of Public Health, University of São Paulo, São Paulo, Brazil; ⁶ Lipids and Atherosclerosis Laboratory, Faculty of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina; ⁷ Division of Endocrinology, Milstein Hospital, Buenos Aires, Argentina; ⁸ Division of Endocrinology, Carlos Durand Hospital, Buenos Aires, Argentina; ⁹ Service Endocrinology, Churruca Visca Hospital, Buenos Aires, Argentina; ¹⁰ University Institute of Social and Preventive Medicine, Lausanne, Switzerland and Ministry of Health, Victory, Republic of Seychelles; ¹¹ Hypertension Center STRIDE-7, Third Department of Medicine, School of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece; ¹² Second Department of Pediatrics, P & A Kyriakou Children Hospital, Athens, Greece; ¹³ Department of Sport, Health & Exercise Science, University of Hull, Hull, UK; ¹⁴ Division of Cardiology, Faculty of Medicine, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

INTRODUCTION: To compare the ability of Body Mass Index (BMI), waist circumference (WC) and waist to height ratio (WHtR) to estimate cardiovascular disease (CVD) risk levels in adolescents.
EVIDENCE ACQUISITION: A systematic review and meta-analysis was performed after a database search for relevant literature (Cochrane, Centre for Review and Dissemination, PubMed, British Nursing Index, CINAHL, BIOSIS citation index, ChildData, metaRegister).
EVIDENCE SYNTHESIS: The study included 117 records representing 96 studies with 994,595 participants were included in the systematic review, 14 of which (13 studies, N.=14,610) were eligible for the meta-analysis. The results of the meta-analysis showed that BMI was a strong indicator of systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and insulin; but not total cholesterol, low-density lipoprotein or glucose. Few studies were eligible for inclusion in the meta-analysis considering WC or WHtR (N.≤2). The narrative synthesis found measures of central adiposity to be consistently valid indicators of the same risk factors as BMI.
CONCLUSIONS: BMI was an indicator of CVD risk. WC and WHtR were efficacious for indicating the same risk factors BMI performed strongly for, though there was insufficient evidence to judge the relative strength of each measure possibly due to heterogeneity in the methods for measuring and classifying WC.

KEY WORDS: Adolescent - Body Mass Index - Waist circumference, Waist-height ratio