Predictive Ability of Waist Circumference and Waist-to-Height Ratio for Cardiometabolic Risk Screening among Spanish Children.

An excess of fat mass has been associated with adverse cardiometabolic risk factors. Different anthropometric measures have been proposed as alternative non-invasive measures for obesity-related cardiometabolic risk. To evaluate the magnitude of association between waist circumference (WC) and waist-to-height ratio (WtHR) with cardiometabolic risk factors and metabolic syndrome and to determine the WtHR cutoff associated with a more favorable cardiometabolic risk profile in Spanish children, data were taken from a cross-sectional survey conducted in 2010 among 848 schoolchildren aged 8-11 years from 20 public schools in the province of Cuenca (Spain). Anthropometric variables, glucose, insulin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), systolic (SBP) and diastolic blood pressure (DBP) and metabolic syndrome (MetS) were also analyzed. WtHR and WC had a good accuracy for TG, insulin, and MetS. The diagnostic odds ratio ranged from 2.95 to 9.07 for WtHR and from 5.30 to 27.40 for WC. The main result of the present study suggests that both WtHR and WC could be used as a screening tool to identify children with cardiometabolic abnormalities.

Homeostasis Model Assessment cut-off points related to metabolic syndrome in children and adolescents: a systematic review and meta-analysis.

The aim of this study was to perform a systematic review and meta-analysis of cut-off points of Homeostasis Model Assessment (HOMA-IR) to determine metabolic syndrome (MetS) in children and adolescents. A literature search was conducted in MEDLINE (via PubMed), EMBASE, Web of Science, Proquest, and Scopus databases from their inception to June 2018. Random effects models for the diagnostic odds ratio (dOR) value computed by Moses' constant for a linear model and 95% confidence intervals (CIs) were used to calculate the accuracy of the test. Hierarchical summary receiver operating characteristic curves (HSROC) were used to summarize the overall test performance. Six published studies were included in the meta-analysis that included 8732 children and adolescents. The region of HOMA-IR (i.e., dOR) associated with MetS range from 2.30 to 3.54. The pooled accuracy parameters from the studies that evaluated the diagnostic odds ratio of HOMA-IR ranged from 4.39 to 37.67.Conclusion: the HOMA-IR test may be useful for early evaluating children and adolescents with insulin resistance (IR). Furthermore, they present a good diagnostic accuracy independently of the definition of MetS used. According to the studies, the HOMA-IR cut point to avoid MetS risk ranged from 2.30 to 3.59.What is Known:• There is no consensus to define the optimal cut-off point of Homeostasis Model Assessment-Insulin Resistance in children and adolescents associated with Metabolic Syndrome.What is New:• The Homeostasis Model Assessment-Insulin Resistance test may be useful for early evaluations in children and adolescents with insulin resistance and presents a good diagnostic accuracy independently of the definition of Metabolic Syndrome used.• The Homeostasis Model Assessment-Insulin Resistance cut point to avoid Metabolic Syndrome risk ranged from 2.30 to 3.59.

Independent and combined effects of handgrip strength and adherence to a Mediterranean diet on blood pressure in Chilean children.

OBJECTIVE: The aim of the study was to examine the combined associations between handgrip strength (HGS) and adherence to a Mediterranean diet with blood pressure (BP) in Chilean children. METHODS: This cross-sectional study enrolled 1140 children (794 boys and 346 girls) 8 to 12 y of age. HGS was measured using a hand dynamometer with an adjustable grip. Adherence to a Mediterranean diet was assessed with the Kidmed score. Resting BP was measured by an automated monitor using an appropriately sized cuff. Elevated BP was defined as ≥90th percentile, and high HGS was defined as sex- and age-specific normative ≥80th percentile for the HGS. RESULTS: The prevalence of elevated systolic BP, diastolic BP, and overall BP were 16.6%, 12.9%, and 8.1%, respectively. HGS was negatively associated with BP parameters in an unadjusted and adjusted model after considering potential confounders (age, sex, body mass index z-score, and HGS). Regarding diet adherence, the unadjusted model reveals that children with high adherence to the Mediterranean diet showed lower BP levels (systolic, diastolic, and mean arterial pressure) compared with children with low-medium adherence; however, these differences disappear after considering potential confounders. The combination of high HGS and optimal adherence to a Mediterranean diet was negatively associated with BP. CONCLUSIONS: Children with a high HGS levels (i.e., ≥80th percentile) may somewhat overcome the deleterious effects of low adherence to a Mediterranean diet. Therefore, these findings suggest that the combination of these two components of a healthy lifestyle, especially HGS may be beneficial to children's BP.

Trends in cardiometabolic parameters among Spanish children from 2006 to 2010: The Cuenca study.

OBJECTIVE: The aim of this study was to examine the trends in cardiometabolic risk factors among schoolchildren in Cuenca, Spain, from 2006 to 2010. METHODS: Data were taken from two cross-sectional surveys conducted in 2006 and 2010 among schoolchildren aged 8-12 years from 20 public schools in the province of Cuenca. The final sample consisted of 2148 participants with measured anthropometric variables, biochemical assessment, and blood pressure. RESULTS: We observed an increase in mean serum total cholesterol (8.5 mg/dL and 10.7 mg/dL), LDL-cholesterol (13.7 mg/dL and 17.3 md/dL), triglycerides (3.6 mg/dL and 2.6 md/dL), fasting insulin (1.2 µU/mL and 0.3 µU/mL) and HOMA-IR (0.2 and 0.02) and a decrease in mean serum HDL-cholesterol (4.4 mg/dL and 5.7 mg/dL), systolic blood pressure (3.8 mmHg and 5.4 mmHg) and diastolic blood pressure (0.8 mmHg and 2.0 mmHg) in both sexes. In girls, mean arterial pressure (3.2 mmHg) also decreased in this period. In addition, we found an increase in the prevalence of adverse total cholesterol concentration (≥200 mg/dL) (7.8% and 8.9%), HDL-cholesterol concentration (<40 mg/dL) (1.9% in boys and 3.5% in girls) and LDL cholesterol concentration (≥130mg/dL) (4.8% and 5.8%) in boys and girls, respectively. CONCLUSIONS: There has been a worsening of the lipid profile in schoolchildren from Cuenca, independent of weight status and age.