Variability of Thinness and its Relation to Cardio-metabolic Risk Factors using Four Body Mass Index References in School-children from Delhi, India.
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Date
2013-11
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Abstract
Objectives: To compare: (i) prevalences of thinness in schoolchildren
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.
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Keywords
Body mass index, Cholesterol, Glucose, Thinness, Hypertension, Triglyceride
Citation
Garg Pankaj, Kaur Supreet, Gupta Dileep, Osmond Clive, Lakshmy Ramakrishnan, Sinha Shikha, Kapil Umesh, Sachdev H P S. Variability of Thinness and its Relation to Cardio-metabolic Risk Factors using Four Body Mass Index References in School-children from Delhi, India. Indian Pediatrics. 2013 November; 50(11): 1025-1032.