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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Development of waist circumference percentiles for Japanese children and an examination of their screening utility for childhood metabolic syndrome: a population-based cross-sectional study

Authors: Rie Matsushita, Tsuyoshi Isojima, Ryuzo Takaya, Eiichiro Satake, Rie Yamaguchi, Kazuteru Kitsuda, Eiko Nagata, Shinichiro Sano, Toshiki Nakanishi, Yuichi Nakagawa, Takehiko Ohzeki, Tsutomu Ogata, Yasuko Fujisawa

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

In Japan, waist circumference (WC) percentiles to screen for childhood metabolic syndrome (MetS) are unavailable. The objectives of this study were to develop WC and WC-to-height ratio (WC/Ht) percentile curves by age and sex for Japanese children, and to test their utility in screening for MetS in children with obesity who are otherwise healthy.

Methods

The WC and WC/Ht percentiles were developed using the LMS method of summarizing growth standards, which monitors changing skewness (L), medians (M), and coefficients of variation (S) in childhood distributions. A representative dataset was used, which consisted of 3,634 boys and 3,536 girls aged 4.5–12.75 years in Shizuoka prefecture, Japan, between 2010 and 2012. Children who were obese (355 boys and 230 girls) aged 6–12 years from Osaka prefecture, Japan, were screened for childhood MetS using the new percentiles and the International Diabetes Federation’s (IDF’s) definition of MetS.

Results

The number of participants with certain metabolic abnormalities (high systolic and diastolic blood pressure, and a high level of triglycerides) was significantly higher in boys aged 10–12 years, with a WC ≥ 90th percentile, than among those with a WC < 90th percentile. None of the participants with a WC < 90th percentile exhibited two or more metabolic abnormalities, regardless of their age or sex. Among the participants aged 10–12 years, 11.4 % of boys and 4.4 % of girls with a WC ≥ 90th percentile were diagnosed with MetS.

Conclusions

The new percentiles may have a certain level of potential to screen Japanese children for childhood MetS in accordance with the IDF definition.
Appendix
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Literature
1.
Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101(3 Pt 2):518–25.PubMed
2.
Must A, Strauss RS. Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord. 1999;23 Suppl 2:S2–11.CrossRefPubMed
3.
4.
Sinha R, Fisch G, Teague B, Tamborlane WV, Banyas B, Allen K, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med. 2002;346(11):802–10.CrossRefPubMed
5.
Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004;113(3 Pt 1):475–82.CrossRefPubMed
6.
Defining the problem. Obesity: preventing and managing the global epidemic. Geneva: World Health Organization; 2000. p. 6–15.
7.
de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation. 2004;110(16):2494–7.CrossRefPubMed
8.
Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350(23):2362–74.CrossRefPubMed
9.
Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents. Lancet. 2007;369(9579):2059–61.CrossRefPubMed
10.
Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes. 2007;8(5):299–306.CrossRefPubMed
11.
Kurtoglu S, Akin L, Kendirci M, Hatipoglu N, Elmali F, Mazicioglu M. The absence of insulin resistance in metabolic syndrome definition leads to underdiagnosing of metabolic risk in obese patients. Eur J Pediatr. 2012;171(9):1331–7.CrossRefPubMed
12.
Sangun Ö, Dündar B, Kösker M, Pirgon Ö, Dündar N. Prevalence of metabolic syndrome in obese children and adolescents using three different criteria and evaluation of risk factors. J Clin Res Pediatr Endocrinol. 2011;3(2):70–6.CrossRefPubMedPubMedCentral
13.
Ford ES, Li C, Zhao G, Pearson WS, Mokdad AH. Prevalence of the metabolic syndrome among U.S. adolescents using the definition from the International Diabetes Federation. Diabetes Care. 2008;31(3):587–9.CrossRefPubMed
14.
15.
Anzo M, Inokuchi M, Matsuo N, Takayama JI, Hasegawa T. Waist circumference centiles by age and sex for Japanese children based on the 1978–1981 cross-sectional national survey data. Ann Hum Biol. 2014;42(1):52–61.
16.
Inokuchi M, Matsuo N, Anzo M, Takayama JI, Hasegawa T. Age-dependent percentile for waist circumference for Japanese children based on the 1992–1994 cross-sectional national survey data. Eur J Pediatr. 2007;166(7):655–61.CrossRefPubMed
17.
Matsuzawa Y. Metabolic syndrome-definition and diagnostic criteria in Japan. J Atheroscler Thromb. 2005;12(6):301.CrossRefPubMed
18.
Nagaretani H, Nakamura T, Funahashi T, Kotani K, Miyanaga M, Tokunaga K, et al. Visceral fat is a major contributor for multiple risk factor clustering in Japanese men with impaired glucose tolerance. Diabetes Care. 2001;24(12):2127–33.CrossRefPubMed
19.
Matsushita Y, Tomita K, Yokoyama T, Mizoue T. Relations between waist circumference at four sites and metabolic risk factors. Obesity (Silver Spring). 2010;18(12):2374–8.CrossRef
20.
Okazawa T, Iwata M, Matsushita Y, Kamura Y, Kato H, Okazawa S, et al. Aging attenuates the association of central obesity with the accumulation of metabolic risk factors when assessed using the waist circumference measured at the umbilical level (the Japanese standard method). Nutr Diabetes. 2013;3, e96.CrossRefPubMedPubMedCentral
21.
Yokoyama H, Hirose H, Kanda T, Kawabe H, Saito I. Relationship between waist circumferences measured at the umbilical level and midway between the ribs and iliac crest - a solution to the debate on optimal waist circumference standards in the diagnostic criteria of metabolic syndrome in Japan. J Atheroscler Thromb. 2011;18(9):735–43.CrossRefPubMed
22.
Eguchi Y, Eguchi T, Mizuta T, Ide Y, Yasutake T, Iwakiri R, et al. Visceral fat accumulation and insulin resistance are important factors in nonalcoholic fatty liver disease. J Gastroenterol. 2006;41(5):462–9.CrossRefPubMed
23.
Ninomiya T, Kubo M, Doi Y, Yonemoto K, Tanizaki Y, Rahman M, et al. Impact of metabolic syndrome on the development of cardiovascular disease in a general Japanese population: the Hisayama study. Stroke. 2007;38(7):2063–9.CrossRefPubMed
24.
Hara M, Saitou E, Iwata F, Okada T, Harada K. Waist-to-height ratio is the best predictor of cardiovascular disease risk factors in Japanese schoolchildren. J Atheroscler Thromb. 2002;9(3):127–32.CrossRefPubMed
25.
Hsieh SD, Yoshinaga H, Muto T. Waist-to-height ratio, a simple and practical index for assessing central fat distribution and metabolic risk in Japanese men and women. Int J Obes Relat Metab Disord. 2003;27(5):610–6.CrossRefPubMed
26.
Hsieh SD, Yoshinaga H. Waist/height ratio as a simple and useful predictor of coronary heart disease risk factors in women. Intern Med. 1995;34(12):1147–52.CrossRefPubMed
27.
Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012;13(3):275–86.CrossRefPubMed
28.
Cole TJ. The LMS, method for constructing normalized growth standards. Eur J Clin Nutr. 1990;44(1):45–60.PubMed
29.
Asayama K, Ozeki T, Sugihara S, Ito K, Okada T, Tamai H, et al. Criteria for medical intervention in obese children: a new definition of ‘obesity disease’ in Japanese children. Peadiatr Int. 2003;45(5):642–6.CrossRef
30.
31.
Johnson ST, Kuk JL, Mackenzie KA, Huang TT, Rosychuk RJ, Ball GD. Metabolic risk varies according to waist circumference measurement site in overweight boys and girls. J Pediatr. 2010;156(2):247–52.CrossRefPubMed
32.
Harrington DM, Staiano AE, Broyles ST, Gupta AK, Katzmarzyk PT. Waist circumference measurement site does not affect relationships with visceral adiposity and cardiometabolic risk factors in children. Pediatr Obes. 2013;8(3):199–206.CrossRefPubMed
33.
Goran MI. Visceral fat in prepubertal children: influence of obesity, anthropometry, ethnicity, gender, diet, and growth. Am J Hum Biol. 1999;11(2):201–7.CrossRefPubMed
34.
Goran MI, Gower BA. Relation between visceral fat and disease risk in children and adolescents. Am J Clin Nutr. 1999;70(1):149S–56.
35.
Satake E, Nakagawa Y, Kubota A, Saegusa H, Sano S, Ohzeki T. Age and sex differences in fat distribution in non-obese Japanese children. J Pediatr Endocrinol Metab. 2010;23(9):873–8.CrossRefPubMed
36.
Staiano AE, Katzmarzyk PT. Ethnic and sex differences in body fat and visceral and subcutaneous adiposity in children and adolescents. Int J Obes (Lond). 2012;36(10):1261–9.CrossRef
37.
Moreno LA, Fleta J, Mur L, Rodríquez G, Sarría A, Bueno M. Waist circumference values in Spanish children--gender related differences. Eur J Clin Nutr. 1999;53(6):429–33.CrossRefPubMed
38.
Roemmich JN, Rogol AD. Hormonal changes during puberty and their relationship to fat distribution. Am J Hum Biol. 1999;11(2):209–24.CrossRefPubMed
39.
Hatipoglu N, Mazicioglu MM, Poyrazoglu S, Borlu A, Horoz D, Kurtoglu S. Waist circumference percentiles among Turkish children under the age of 6 years. Eur J Pediatr. 2013;172(1):59–69.CrossRefPubMed
40.
Taylor RW, Gold E, Manning P, Goulding A. Gender differences in body fat content are present well before puberty. Int J Obes Relat Metab Disord. 1997;21(11):1082–4.CrossRefPubMed
41.
Reinehr T, Toschke AM. Onset of puberty and cardiovascular risk factors in untreated obese children and adolescents: a 1-year follow-up study. Arch Pediatr Adolesc Med. 2009;163(8):709–15.CrossRefPubMed
42.
Reinehr T, Wolters B, Knop C, Lass N, Holl RW. Strong effect of pubertal status on metabolic health in obese children: a longitudinal study. J Clin Endocrinol Metab. 2015;100(1):301–8.CrossRefPubMed
43.
Bassali R, Waller JL, Gower B, Allison J, Davis CL. Utility of waist circumference percentile for risk evaluation in obese children. Int J Pediatr Obes. 2010;5(1):97–101.CrossRefPubMedPubMedCentral
44.
Burns SF, Arslanian SA. Waist circumference, atherogenic lipoproteins, and vascular smooth muscle biomarkers in children. J Clin Endocrinol Metab. 2009;94(12):4914–22.CrossRefPubMedPubMedCentral
45.
Zhang YX, Wang SR. Comparison of blood pressure levels among children and adolescents with different body mass index and waist circumference: study in a large sample in Shandong. China Eur J Nutr. 2014;53(2):627–34.CrossRefPubMed
46.
Ma GS, Ji CY, Ma J, Mi J, Yt Sung R, Xiong F, et al. Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents. Biomed Environ Sci. 2010;23(1):21–31.CrossRefPubMed
47.
Liu A, Hills AP, Hu X, Li Y, Du L, Xu Y, et al. Waist circumference cut-off values for the prediction of cardiovascular risk factors clustering in Chinese school-aged children: a cross-sectional study. BMC Public Health. 2010;10:82.CrossRefPubMedPubMedCentral
48.
McCarthy HD, Ashwell M. A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message—‘keep your waist circumference to less than half your height.’. Int J Obes (Lond). 2006;30(6):988–92.CrossRef
49.
Li C, Ford ES, Mokdad AH, Cook S. Recent trends in waist circumference and waist-height ratio among US children and adolescents. Pediatrics. 2006;118(5):e1390–8.CrossRefPubMed
50.
Kouda K, Nakamura H, Nishio N, Fujita Y, Takeuchi H, Iki M. Trends in body mass index, blood pressure, and serum lipids in Japanese children: Iwata population-based annual screening (1993–2008). J Epidemiol. 2010;20(3):212–8.CrossRefPubMedPubMedCentral
51.
Kouda K, Nakamura H, Fujita Y, Iki M. Relationship between body mass index at age 3 years and body composition at age 11 years among Japanese children: the Shizuoka population-based study. J Epidemiol. 2012;22(5):411–6.CrossRefPubMed
52.
Yoshinaga M, Ichiki T, Tanaka Y, Hazeki D, Horigome H, Takahashi H, et al. Prevalence of childhood obesity from 1978 to 2007 in Japan. Pediatr Int. 2010;52(2):213–7.CrossRefPubMed
Metadata
Title
Development of waist circumference percentiles for Japanese children and an examination of their screening utility for childhood metabolic syndrome: a population-based cross-sectional study
Authors
Rie Matsushita
Tsuyoshi Isojima
Ryuzo Takaya
Eiichiro Satake
Rie Yamaguchi
Kazuteru Kitsuda
Eiko Nagata
Shinichiro Sano
Toshiki Nakanishi
Yuichi Nakagawa
Takehiko Ohzeki
Tsutomu Ogata
Yasuko Fujisawa
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2447-1

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