Pankaj Garg1, Supreet Kaur, Dileep Gupta, Clive Osmond, Ramakrishnan Lakshmy, Shikha Sinha, Umesh Kapil, H P S Sachdev. 1. Department of Pediatrics and Clinical Epidemiology, Sitaram Bhrtia Institute of Science and Research, B 16, Qutab Institutional Area, New Delhi 110016, India; Departments of Human Nutrition and Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi 110029, India; Medical Research Council Lifecourse Epideiology Unit, University of Southampton, Southampton General Hospital, Southampton S016 6YD, UK; Current affiliation: Conjoint Associate Lecturer, School of Womens and Children Health, University of New South Wales and Department of Community Pediatrics, Liverpool Hospital, NSW, Australia; Current affiliation: Senior Programme Associate, Public Health Foundation of India (PHFI), Vasant Kunj, New Delhi 110070 and Current affiliation: Statistical Officer, Planning Department, Government of NCT of Delhi, New Delhi 110002. Correspondence to: Prof HPS Sachdev, Senior Consultant Pediatrics and Clinical Epidemiology, E 6/12, Vasant Vihar, New Delhi 110 057, India. hpssachdev@gmail.com.
Abstract
OBJECTIVES: To compare: (i) prevalences of thinness in school-children by four body mass index references in common use viz., Centre for Disease Control (CDC); Cole; Indian Academy of Pediatrics (IAP); World Health Organization (WHO); and (ii) relationship of thinness with absence of cardio-metabolic risk factors in these BMI references. DESIGN: Cross-sectional. SETTING: Schools in Delhi. PARTICIPANTS: Anthropometry and blood pressure were measured in 16,245 school children aged 5 to 18 years. Fasting lipids and blood sugar were estimated in 2796 subjects. OUTCOME MEASURES: Age and sex-specific prevalences of thinness and predictive ability of reference cut-off for detecting any cardio-metabolic risk factor were compared. RESULTS: Prevalence of thinness varied with the reference employed; more so for boys. Overall prevalence of thinness was least with IAP reference and highest with CDC cut-offs (6.6% to 16.9% in boys, 6.5% to 10.3% in girls). Children identified as thin by any reference had comparable, significantly lower risks (OR 0.59 to 0.73) of associated cardio-metabolic aberrations. In subjects with any cardio-metabolic or blood pressure aberration, the prevalence of thinness was highest with CDC and least with IAP definition. CONCLUSION: Prevalence of thinness varies considerably with the reference employed. Thin children, identified by any reference, have a lower risk of associated cardio-metabolic aberrations; however, thinness is a poor diagnostic test for this purpose. In populations undergoing nutrition transition, there is a need to link cardio-metabolic risk factors with recommended anthropometric criteria to define undernutrition.
OBJECTIVES: To compare: (i) prevalences of thinness in school-children by four body mass index references in common use viz., Centre for Disease Control (CDC); Cole; Indian Academy of Pediatrics (IAP); World Health Organization (WHO); and (ii) relationship of thinness with absence of cardio-metabolic risk factors in these BMI references. DESIGN: Cross-sectional. SETTING: Schools in Delhi. PARTICIPANTS: Anthropometry and blood pressure were measured in 16,245 school children aged 5 to 18 years. Fasting lipids and blood sugar were estimated in 2796 subjects. OUTCOME MEASURES: Age and sex-specific prevalences of thinness and predictive ability of reference cut-off for detecting any cardio-metabolic risk factor were compared. RESULTS: Prevalence of thinness varied with the reference employed; more so for boys. Overall prevalence of thinness was least with IAP reference and highest with CDC cut-offs (6.6% to 16.9% in boys, 6.5% to 10.3% in girls). Children identified as thin by any reference had comparable, significantly lower risks (OR 0.59 to 0.73) of associated cardio-metabolic aberrations. In subjects with any cardio-metabolic or blood pressure aberration, the prevalence of thinness was highest with CDC and least with IAP definition. CONCLUSION: Prevalence of thinness varies considerably with the reference employed. Thin children, identified by any reference, have a lower risk of associated cardio-metabolic aberrations; however, thinness is a poor diagnostic test for this purpose. In populations undergoing nutrition transition, there is a need to link cardio-metabolic risk factors with recommended anthropometric criteria to define undernutrition.
Authors: Jiao Wang; Yanna Zhu; Jin Jing; Yajun Chen; Jincheng Mai; Stephen H S Wong; John O'Reilly; Lu Ma Journal: BMC Public Health Date: 2015-08-14 Impact factor: 3.295
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