Abstract
Background The present study was conducted to assess some specific factors related to anthropometric indices in a representative sample of Iranian mid-adolescents. It also aimed to investigate the relationship between three anthropometric indices using a multivariate multilevel approach.Methods This study was conducted among 2538 students (1286 boys) aged 14 - 20 years old, who were randomly selected among 16 high schools by multi-stage random sampling procedure from 4 education districts of Shiraz, Iran. Data on demographic characteristics and anthropometric measures were collected. Anthropometric indices were estimated by the calibrated tools. A multivariate multilevel model was used to assess the predictor variables associated with obesity measures of the triceps (TST), abdominal (AST), and subscapular (SST) skinfold thickness.Results In this study, the prevalence of overweight and obesity was estimated to be 10.2 and 5.1%, respectively. Hierarchical models showed that, the outcome variables were correlated at the child and district levels. Positive associations were observed between the sex, family history of obesity, and moderate and high Socio-Economic Status (SES) with three anthropometric indices. Moreover, there were positive associations between moderate to vigorous physical activities with AST and SST, but they were not statistically significant at a significance level of 0.05.Conclusions Our findings revealed that, TST, AST, and SST could be useful indices for measuring the adiposity in mid-adolescents. In addition, the effect of the district level on the predictor variables highlights the important role of the environmental factors on the childhood obesity.