Utility of Waist-To-Height Ratio in Detecting Central Obesity and Related Adverse Cardiovascular Risk Profile Among Normal Weight Younger Adults (from the Bogalusa Heart Study)

Angiotensin converting enzyme (ACE) plays a dominant role in renal and cardiovascular diseases, obesity and diabetes. The somatic ACE (130-190 kDa) is composed of two homologous N- and C- domains. Two soluble N-domain isoforms have been described in human urine with 65 and 90KDa. Studies have supported that N-domain ACE with 90KDa is a biomarker for hypertension, pre-eclampsia and inflammation. We analyzed the expression of somatic and soluble N-domain ACE isoforms in urine of children and adolescents with different nutritional status and cardiovascular risk profile. The volunteers aged from 6 to 19 years were classified into four groups according to their BMI percentile; underweight (n=51), normal weight (n = 53), overweight (n=53) and obese (n=49). Waist-height-ratio (WHtR) was used to assess cardiovascular risk profile dividing the participants into normal risk (n=105) and high risk (n=101). The urines were concentrated 10-fold and dialyzed with Tris-HCl pH 8 and pure water. Then, we performed western blot analysis using 50μg of lyophilized urinary protein, using the ACE polyclonal antibody Y1. Protein detection was performed by chemiluminescent and analysis in Image Lab software utilizing total protein stain for normalization. ACE expression is augmented in obese children when compared with normal weight children ( 0.09 vs 0.53 arbitrary units, p=0,04 ). The higher cardiovascular risk group also presented increased expression of ACE ( 0.27 vs 0.09 arbitrary units, p=0.046 ). The 90KDa N-domain isoform is frequently found in the high cardiovascular risk children ( p= 0.02 ). According to Spearman correlation test, the expression of 90 kDa N-domain ACE correlates positively with waist circumference, WHtR, BMI percentile and Z-score of BMI. Increased ACE expression in obese children contributes to higher cardiovascular risk once this enzyme biosynthesizes Angiotensin II which promotes blood pressure increase, sympathetic nervous system activation and release of glucocorticoids from adrenal gland. ACE expression is also augmented in children with high cardiovascular risk. Presence of 90 KDa N-domain ACE in urine of children and adolescents is a biomarker of poor prognostic for cardiovascular disease in childhood obesity.

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Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: the Bogalusa Heart Study

American Journal of Clinical Nutrition ◽

10.1093/ajcn/86.1.33 ◽

2007 ◽

Vol 86 (1) ◽

pp. 33-40 ◽

Cited By ~ 196

Author(s):

David S Freedman ◽

Henry S Kahn ◽

Zuguo Mei ◽

Laurence M Grummer-Strawn ◽

William H Dietz ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Children And Adolescents ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Height Ratio ◽

Bogalusa Heart Study ◽

Heart Study ◽

Waist To Height Ratio

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MALE-FEMALE DIVERGENCE IN THE RELATION OF SERUM PHOSPHORUS TO CARDIOVASCULAR RISK AMONG YOUNGER ADULTS: THE BOGALUSA HEART STUDY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(11)61217-5 ◽

2011 ◽

Vol 57 (14) ◽

pp. E1217

Author(s):

Azad A. Kabir ◽

Maen Nusair ◽

Sathanur R. Srinivasan ◽

Gerald S. Berenson

Keyword(s):

Cardiovascular Risk ◽

Serum Phosphorus ◽

Younger Adults ◽

Bogalusa Heart Study ◽

Heart Study

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Overweight/Obese Schoolchildren with Low Muscle Strength Have a Lower Cardiorespiratory Capacity and Greater Cardiovascular Risk: Results of the School Health Survey of the Extreme South of Chile 2019

Children ◽

10.3390/children8090734 ◽

2021 ◽

Vol 8 (9) ◽

pp. 734

Author(s):

Javier Albornoz-Guerrero ◽

Rafael Zapata-Lamana ◽

Daniel Reyes-Molina ◽

Igor Cigarroa ◽

Guillermo García Pérez de Sevilla ◽

...

Keyword(s):

Cardiovascular Risk ◽

Muscle Strength ◽

Muscular Strength ◽

High Strength ◽

Normal Weight ◽

Overweight And Obesity ◽

Obese Group ◽

Height Ratio ◽

Waist To Height Ratio ◽

Low Strength

Objective: To compare cardiovascular risk and cardiorespiratory capacity in schoolchildren from a region in the extreme south of Chile according to nutritional status and muscular strength. Methods: An analytical cross-sectional study was performed on a sample of 594 schoolchildren from 5th to 8th grade in the extreme south of Chile. Based on body mass index and lower limb muscle strength, participants were divided into four groups: high strength-normal weight, high strength-overweight/obese, low strength-normal weight, and low strength-overweight/obese. Then, waist-to-height ratio and cardiorespiratory capacity, measured with the 20 m shuttle run test, were assessed to determine their cardiovascular risk, comparing the four groups. Results: The overweight/obese group with high muscular strength presented better indicators in anthropometric variables (waist circumference and waist-to-height ratio) than their peers with low muscular strength. Additionally, the overweight/obese group with low muscular strength presented a lower cardiorespiratory capacity than their peers with high muscular strength. Both results were observed in boys and girls. Conclusion: The results of this study suggest that overweight/obese schoolchildren with high muscle strength present healthier anthropometric indicators and greater cardiorespiratory capacity than their peers with low muscle strength. These results confirm the relevance of measuring muscle strength in schoolchildren and its usefulness to assess functionality. These results encourage the scientific community to continue studying the role that muscle strength plays in modulating the effects of overweight and obesity on respiratory and cardiovascular conditions in childhood.

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Screening of central obesity among normal-weight children and adolescents in Shandong, China

British Journal Of Nutrition ◽

10.1017/s0007114520004882 ◽

2020 ◽

pp. 1-25

Author(s):

Ying-xiu Zhang ◽

Jian Chen ◽

Xiao-hui Liu

Keyword(s):

Children And Adolescents ◽

Health Risks ◽

Central Obesity ◽

Total Population ◽

Final Analysis ◽

Normal Weight ◽

Overweight And Obesity ◽

Height Ratio ◽

Waist To Height Ratio ◽

Age And Sex

Abstract The prevalence of central obesity in total population has been reported in numerous studies. However, information on the prevalence of central obesity within normal category of body mass index (BMI) is scant. In the present study, we examined the profiles of central obesity among normal-weight children and adolescents. A total of 29 516 (14 226 boys and 15 290 girls) normal-weight children and adolescents (excluding underweight, overweight and obesity) aged 7–18 years were included in the final analysis. Central obesity was defined by the international age- and sex-specific cut-offs of waist circumference (WC) and threshold of waist-to-height ratio (WHtR≥0.5). All subjects were classified into four groups (Q1–Q4) according to the age- and sex-specific quartiles of BMI, those in the upper fourth (Q4) were defined as ‘high-normal BMI’, and those in the lower fourth (Q1) were defined as ‘low-normal BMI’. The prevalence of central obesity as measured by WC was 9.90% (95% CI 9.41–10.39%) for boys and 8.11% (95% CI 7.68–8.54%) for girls; by WHtR was 2.97% (95% CI 2.69–3.25%) for boys and 2.44% (95% CI 2.20–2.68%) for girls. Subjects in the ‘high-normal BMI’ group had a much higher prevalence of central obesity than their counterparts in the ‘low-normal BMI’ group (P<0.01). Central obesity was also evident among normal-weight children and adolescents. Our findings suggest that the health risks of children with normal-weight central obesity may be missed when BMI is used alone as a measure, it is meaningful to include WC in the clinical practice and to include the simple message “Keep your waist to less than half your height”.

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Insulin Resistance of Normal Weight Central Obese Adolescents in Korea Stratified by Waist to Height Ratio: Results from the Korea National Health and Nutrition Examination Surveys 2008–2010

International Journal of Endocrinology ◽

10.1155/2015/158758 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Won Kyoung Cho ◽

Hyojin Kim ◽

Hyun Young Lee ◽

Kyung Do Han ◽

Yeon Jin Jeon ◽

...

Keyword(s):

Insulin Resistance ◽

National Health ◽

Central Obesity ◽

Normal Weight ◽

Female Adolescents ◽

Height Ratio ◽

Health And Nutrition ◽

High Insulin ◽

Waist To Height Ratio ◽

Wbc Count

Background. To evaluate insulin resistance of normal weight central obese 13–18-year-old male and female adolescents stratified by waist to height ratio (WHR).Methods. Data were obtained from the Korea National Health and Nutrition Examination Survey (K-NHANES) conducted during 2008–2010. Central obesity was defined as that in the upper quartile of age and sex specific WHR. Subjects were classified into no central obesity normal weight (NW), central obesity normal weight (CONW), no central obesity overweight (OW), and central obesity overweight (COOW).Results. The prevalence of CONW was 9.6% (83/832) in female and 7.0% (61/909) in male. CONW showed higher levels of insulin (P<0.006), HOMA-IR (P<0.006), and ALT (P<0.001) than NW in female. CONW had higher levels of insulin (P<0.0001), HOMA-IR (P<0.0001), and WBC count (P<0.021) and lower level of HDL (P<0.0001) than NW in male. WHR and BMI had similar significant correlations with MS components. CONW showed 2.5 times (95% confidence interval, 1.21–5.00) more likelihood to have high insulin resistance than NW in male.Conclusions. Screening for central obesity using WHR in clinical setting is recommended.

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