Predicting Cardiovascular Risk Factors by dIfferent Body Fat Patterns in 3850 German Children: the PEP Family Heart Study

OBJECTIVES: Increased central adiposity is associated with increased risk of cardiovascular disease (CVD) in youths. Since simple and inex-pensive but accurate diagnostic tools are required for general use in clinical practice, we examined body mass index (BMI), waist circumfe-rence (WC), waist-to-height ratio (WHtR) and skin-fold thickness (SFT) for their utility in predicting CVD risk factors in children. METHODS: A representative sample of 3850 children (1981 males) aged, 3-11years, participated in this cross-sectional study. The association of CVD risk factors with BMI > 85(th), WC > 90(th), WHtR > 90(th) and SFT > 90(th) percentile was examined by multivariate logistic regression models. SPSS(17)was used for statistical analyses; P < 0.05 was considered statistically significant. RESULTS: In studied children the prevalence of increased general adi-posity (BMI 4.1%) was considerably lower than the prevalence of high central adiposity (WC 11.8%, WHtR 9.5% and SFT sum 9.8%). Girls had more adverse lipid profiles and CVD risk factors than boys. Age-and gender- adjusted hypertension was significantly associated with adiposity (OR: 2.8) and increased skin-fold thickness (OR: 1.7). Among the four fat patterning variables WHtR > 90(th) percentile had the strongest association with increased LDL-C (OR: 2.0), Non HDL-C (OR: 2.1), LDL-C/HDL-C ratio (OR: 3.3), TG/HDL-C ratio (OR: 2.0) and risk factor clustering (OR: 1.7). CONCLUSIONS: Among the children studied, increased (WtHR) was the strongest predictor of traditional CDV risk factors, followed by in-creased skin-fold thickness and BMI.