WAIST CIRCUMFERENCE AND WAIST-TO-HIP RATIO PERCENTILES TO IDENTIFY ABDOMINAL OBESITY IN CHILDREN AGED 9 FROM THE REPUBLIC OF NORTH MACEDONIA
Abdominal obesity (AO) has been associated with children's risk of metabolic and cardiovascular disease. For this reason, the aim of this study was to provide gender-specific percentiles of anthropometric indices WC and WHR to identify AO in children aged 9. In this study, a total of 320 children aged 9 (160 boys and 160 girls) were investigated. We selected four parameters to measure (weight and height) and two circumferences (waist and hip) using a standard protocol. The following indices are taken into consideration Body-Mass Index (BMI), Waist Circumference (WC) and Waist-to-Hip Ratio (WHR). The percentile distribution of the tested parameters was done by gender. General obesity based on the BMI cut-off occurs at 5.63% in boys and 6.88 % in girls. Abdominal obesity across cut-off points WHR and WC-for age>=90th percentile occur at 11.88% and 6.26% in boys and 12.5 and 11.25% in girls respectively. Both the WHR and WC identify more children with abdominal obesity, but we note that more girls were classified as obese than boys. However, the anthropometric indices of WC and WHR, complement nutritional evaluation and are of great importance for the early detection of AO in our 9-year-old children. These findings support the need to use the measurement of WC as a strong predictor for AO in routine clinical practice.
Keywords: children, BMI, WC, obesity.
2. Vatan Kavak, Mara Pilmane and Dzintra Kazoka.Body Mass Index, Waist Circumference and Waist-to-Hip-Ratio in the Prediction of Obesity in Turkish Teenagers. Coll. Antropol. 38 (2014) 2: 445–451.
3. Paoli M, Uzcátegui L, Zerpa Y, Gómez-Pérez R, Camacho N, Molina Z, Cichetti R, Vallarroel V, Fargier A, Arata-Bellabarba G. Obesidad en escolares de Mérida, Venezuela: asociación con factores de riesgo cardiovascular [Obesity in schoolchildren from Merida, Venezuela: association with cardiovascular risk factors]. Endocrinol Nutr. 2009 May;56(5):218-26.
4. Schro¨der H, Ribas L, Koebnick C, Funtikova A, Gomez SF, et al. (2014) Prevalence of Abdominal Obesity in Spanish Children and Adolescents. Do We Need Waist Circumference Measurements in Pediatric Practice? PLoS ONE 20149(1): e87549. doi:10.1371/journal.pone.008754PLoS ONE 9(1): e87549. doi:10.1371/journal.pone.008754.
5. Asif M, Aslam M, Altaf S, Mustafa S. Developing waist circumference, waist-to-height ratio percentile curves for Pakistani children and adolescents aged 2-18 years using Lambda-Mu-Sigma (LMS) method. J Pediatr Endocrinol Metab. 2020 Jul 6:/j/jpem.ahead-of-print/jpem-2019-0527/jpem-2019-0527.xml.
6. Zafirova Biljana et al.,Underweight, overweight, general and central obesity in 5-year-old children from North Macedonia. JMS 2022;5(1):119-126.
7. Avalos C, Díaz C, Martínez A, Bancalari R, Zamorano J, Harbin F, Cerda V, Fernández M, Cavada G, Arteaga J, Valenzuela M, Toro M, García H. Waist circumference percentiles in children and adolescents between 6 and 14 years from Santiago, Chile. Endocrinol Nutr. 2012; 59(5):296-303.
8. Kristen Cashin and Lesley Oot. Guide to anthropometry.
A Practical Tool for Program Planners, Managers and Implementers. 2018. https://www.fantaproject.org/sites/default/files/resources/FANTA-Anthropometry-Guide-May2018.pdf
9. California Department of Health Care Services, Systems of Care Division Child Health and Disability Prevention Program, Health Assessment Anthropometric measurements Guidelines Mar2016 https://www.dhcs.ca.gov/services/chdp/Documents/HAG/4AnthropometricMeasure.pdf
10. Using the BMI-for-Age Growth Charts CDC https://www.cdc.gov/nccdphp/ dnpa/growthcharts/ training/modules/module1/text/module1print.pdf.
11. Olcay Neyzi Ruvede Bundak Gublin Gokcay et all.Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children. J Clin Res Endocrinol 2015D; 7(4):280-293.
12. Vaman Khadilkar, Sangeeta Yadav et all. IAP Growth Charts for Height, Weight and Body Mass Index for 5- to 18-year-old Indian Children.Indian Pediatr 2015; 20 (52): 47-55
13. Wijnhoven TM, van Raaij JM, Spinelli A, Rito AI, Hovengen R, Kunesova M, Starc G, Rutter H, Sjöberg A, Petrauskiene A, O'Dwyer U, Petrova S, Farrugia Sant'angelo V, Wauters M, Yngve A, Rubana IM, Breda J. WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6-9-year-old children. Pediatr Obes. 2013 Apr;8(2):79-97. doi: 10.1111/j.2047-6310.2012.00090.x. Epub 2012 Sep 21. PMID: 23001989.
14. Cole TJ, Bellizzi CM, Flegal MK, Dietz HW. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240-6.
15. CDC table for calculated BMI values for selected heights and weights for ages 2–20 years. National Health and Nutrition Examination Survey. 2000; Available from: http://www.cdc.gov/
16. Body Composition in Children and Adolescents Residing in Southern Europe: Prevalence of Overweight and Obesity According to Different International References. Available from: https://www.researchgate.net/publication/330811755_Body_Composition_in_Children_and_Adolescents_Residing_in_Southern_Europe_Prevalence_of_Overweight_and_Obesity_According_to_Different_International_References
17. Mladenova S et al. Prevalence of underweight, overweight, general and central obesity among 8-15-years old Bulgarian children and adolescents (Smolyan region, 2012-204). Nutr.Hosp.2015;31(6):2419-2427.
18. Muhammad Asif et al. Evaluation of anthropometric parameters of central obesity in Pakistani children aged 5-12 years, using receiver operating characteristic (ROC )analysis. JPEM 2108; 31 (19).
19. Magalhea EI et al. Waist circumference, waist/height ratio and neck circumference as parameters of central obesity assessment in children. RevPaul de Pediatr 2014;32:273-82.
20. Xi B, Zong X, Kelishadi R, Litwin M, Hong YM, Poh BK, Steffen LM, Galcheva SV, Herter-Aeberli I, Nawarycz T, Krzywińska-Wiewiorowska M, Khadilkar A, Schmidt MD, Neuhauser H, Schienkiewitz A, Kułaga Z, Kim HS, Stawińska-Witoszyńska B, Motlagh ME, Ruzita AT, Iotova VM, Grajda A, Ismail MN, Krzyżaniak A, Heshmat R, Stratev V, Różdżyńska-Świątkowska A, Ardalan G, Qorbani M, Świąder-Leśniak A, Ostrowska-Nawarycz L, Yotov Y, Ekbote V, Khadilkar V, Venn AJ, Dwyer T, Zhao M, Magnussen CG, Bovet P. International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years. J Clin Endocrinol Metab. 2020 Apr 1;105(4):e1569–83
21. Zimmet P, Alberti G, Kaufman F, et al.; International Diabetes Federation Task Force on Epidemiology and Prevention of Diabetes. The metabolic syndrome in children and adolescents. Lancet. 2007;369(9579):2059–2061.