Visceral obesity may be an important risk factor for insulin resistance syndrome in children

Waist circumference is associated with insulin resistance in children and may offer a simple way to identify children with risk factors for cardiovascular disease and type 2 diabetes, according to a study in the August issue of Archives of Pediatrics & Adolescent Medicine.

The prevalence of childhood obesity has doubled in the past two decades, accompanied by an epidemic of type 2 diabetes mellitus (T2DM) and potentially devastating cardiovascular disease (CVD) consequences, according to background information in the article. Some studies suggest that in adults, measurement of waist circumference (WC), an indicator of intra-abdominal fat, is a better indication of CVD risk than body mass index (BMI), a measure of overall obesity. Waist circumference is one component of the metabolic syndrome, a combination of health conditions, including type 2 diabetes, high blood pressure and high levels of lipids (fat) in the blood, that place a person at high risk for heart disease.

Valeria Hirschler, M.D., of the Durand Hospital of Buenos Aires, Argentina, and colleagues measured the waist circumference of children aged six to 13 years and compared waist circumference to measurements of components of the metabolic syndrome, including obesity (BMI), insulin resistance, lipid profile (fats in the blood, including cholesterol and triglyceride levels) and blood pressure.

Of the 84 children evaluated (44 girls), 28 were overweight, 40 were obese and 16 were normal weight. Statistical analysis showed that waist circumference was an independent predictor for elevated blood pressure, insulin resistance and elevated high-density lipoprotein cholesterol level. "In our study, there was a significant correlation between WC and all the components of the metabolic syndrome," the authors report.

"Visceral obesity may be an important risk factor for insulin resistance syndrome in children," the authors conclude. "Waist circumference serves as a readily available means to estimate abdominal obesity in the office setting. Normative data specific for ethnic group need to be collected. The present study showed that children with abdominal obesity, as determined by WC, have increased metabolic risk factors for CVD and T2DM."