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 inexpensive but accurate diagnostic tools are required for general use in clinical practice, we examined body mass index (BMI), waist circumference (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 > 85th, WC > 90th, WHtR > 90th and SFT > 90th percentile was examined by multivariate logistic regression models. SPSS17 was used for statistical analyses; P < 0.05 was considered statistically significant. Results: In studied children the prevalence of increased general adiposity (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. Ageand 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 > 90th 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 increased skin-fold thickness and BMI.