Skip to main content
SpringerLink
Log in

Preliminary data on the association between waist circumference and insulin resistance in children without a previous diagnosis

  • Original Paper
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

The aim of the present work was to study the association between different anthropometric parameters and insulin resistance (IR) in Spanish schoolchildren without a previous diagnosis. A total of 443 Spanish schoolchildren (9–11 years of age) were studied in this cross-sectional study. The anthropometric measurements collected were weight, height, body circumferences and skinfolds. Body mass index (BMI), waist/hip ratio, percentage body fat and fat-free body mass were determined. Overnight-fasted blood lipids, insulin and glucose levels were analysed, and estimation of IR, taking into account the homeostasis model assessment (HOMA), was calculated. The children with IR had higher serum triglycerides and insulin levels, were heavier and taller, and had a higher BMI, a larger waist circumference, a larger hip circumference, a larger waist/hip ratio and thicker bicipital and tricipital skinfolds than those who did not have IR. Age, sex, BMI and waist circumference explained 32.0% of the variance in the HOMA values; only sex, triglycerides and waist circumference independently influenced this variable. A 1-cm increase in waist circumference was associated with approximately a 3.8% increase in the mean HOMA value. The children with a waist circumference of over the p90 for their age and sex were at greater risk of showing IR as measured by the HOMA: odds ratio = 6.94 (2.01–23.91; P < 0.001). In conclusion, according to these results, waist circumference is the best anthropometric parameter associated with IR in children, and those with a waist circumference of over the p90 for their age and sex would appear to be at particular risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Albareda M, Rodriguez-Espinosa J, Murugo M et al (2000) Assessment of insulin sensitivity and beta-cell function from measurements in the fasting state and during an oral glucose tolerance test. Diabetologia 43:1507–1511

    Article  CAS  PubMed  Google Scholar 

  2. Allain CC, Poon LS, Chan CS et al (1974) Enzymatic determination of total serum cholesterol. Clin Chem 20:470–475

    CAS  PubMed  Google Scholar 

  3. Allard P, Delvin EE, Paradis G et al (2003) Distribution of fasting plasma insulin, free fatty acids, and glucose concentrations and of homeostasis model assessment of insulin resistance in a representative sample of Quebec children and adolescents. Clin Chem 49:644–649

    Article  CAS  PubMed  Google Scholar 

  4. Artz E, Freemark M (2004) The pathogenesis of insulin resistance in children: metabolic complications and the roles of diet, exercise and pharmacotherapy in the prevention of type 2 diabetes. Pediatr Endocrinol Rev 1:296–309

    PubMed  Google Scholar 

  5. Bergman RN, Mittelman SD (1998) Central role of the adipocyte in insulin resistance. J Basic Clin Physiol Pharmacol 9:205–221

    CAS  PubMed  Google Scholar 

  6. Brambilla P, Bedogni G, Moreno LA et al (2006) Crossvalidation of anthropometry against magnetic resonance imaging for the assessment of visceral and subcutaneous adipose tissue in children. Int J Obes (Lond) 30:23–30

    Article  CAS  Google Scholar 

  7. Bucolo G, David H (1973) Quantitative determination of serum triglycerides by the use of enzymes. Clin Chem 19:476–482

    CAS  PubMed  Google Scholar 

  8. Burrows AR, Leiva BL, Burgueño AM et al (2006) Insulin sensitivity in children aged 6 to 16 years: association with nutritional status and pubertal development. Rev Med Chil 134:1417–1426

    Google Scholar 

  9. Burstein M, Morlin R (1970) Precipitation of serum lipoproteins by anionic detergents in the presence of bivalent cations. Rev Eur Étud Clin Biol 15:109–113

    CAS  PubMed  Google Scholar 

  10. Cao BY, Mi J, Gong CX et al (2008) Blood glucose profile in children and adolescents in Beijing area. Zhonghua Er Ke Za Zhi 46:297–300

    PubMed  Google Scholar 

  11. Chiarelli F, Marcovecchio ML (2008) Insulin resistance and obesity in childhood. Eur J Endocrinol 159(Suppl 1):S67–S74

    Article  CAS  PubMed  Google Scholar 

  12. Eisenmann JC, DuBose KD, Donnelly JE (2007) Fatness, fitness, and insulin sensitivity among 7- to 9-year-old children. Obesity (Silver Spring) 15:2135–2144

    Article  Google Scholar 

  13. Forsner M, Jansson L, Söderberg A (2009) Afraid of medical care school-aged children’s narratives about medical fear. J Pediatr Nurs 24:519–528

    Article  PubMed  Google Scholar 

  14. Fredriks AM, van Buuren S, Fekkes M et al (2005) Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice? Eur J Pediatr 164:216–222

    Article  PubMed  Google Scholar 

  15. Friedewald WT, Levy RJ, Fredrickson DS (1984) Estimation of the concentration of low-density lipoprotein cholesterol in plasma with polyanions. J Lipid Res 11:583–594

    Google Scholar 

  16. Goran MI, Gower BA (2001) Longitudinal study on pubertal insulin resistance. Diabetes 50:2444–2450

    Article  CAS  PubMed  Google Scholar 

  17. Goran MI, Bergman RN, Gower BA (2001) Influence of total vs. visceral fat on insulin action and secretion in African American and white children. Obes Res 9:423–431

    Article  CAS  PubMed  Google Scholar 

  18. Grundy SM, Brewer HB Jr, Cleeman JI, American Heart Association, National Heart, Lung, and Blood Institute et al (2004) Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 109:433–438

    Article  PubMed  Google Scholar 

  19. Gungor N, Hannon T, Libman I et al (2005) Type 2 diabetes mellitus in youth: the complete picture to date. Pediatr Clin North Am 52:1579–1609

    Article  PubMed  Google Scholar 

  20. Hatipoglu N, Ozturk A, Mazicioglu MM et al (2008) Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr 2008(167):383–389

    Article  Google Scholar 

  21. Hernández M, Castellet J, Narvaiza JL et al (1988) Curvas y tablas de crecimiento. Editorial Garsi, Madrid

    Google Scholar 

  22. Hirschler V, Delfino AM, Clemete G et al (2005) ¿Es la circunferencia de cintura un componente del síndrome metabólico en la infancia? Arch Argent Pediatr 103:7–13

    Google Scholar 

  23. Hirschler V, Maccallini G, Karam C et al (2009) Are girls more insulin-resistant than boys? Clin Biochem 42:1051–1056

    Article  CAS  PubMed  Google Scholar 

  24. Holst-Schumacher I, Nuñez-Rivas H, Monge-Rojas R et al (2008) Insulin resistance and impaired glucose tolerance in overweight and obese Costa Rican schoolchildren. Food Nutr Bull 29:123–131

    PubMed  Google Scholar 

  25. Hotamisligil GS (1999) The role of TNF-alpha and TNF receptors in obesity and insulin resistance. J Intern Med 245:621–625

    Article  CAS  PubMed  Google Scholar 

  26. Hotamisligil GS (1999) Mechanisms of TNF-alpha-induced insulin resistance. Exp Clin Endocrinol Diabetes 107:119–125

    Article  CAS  PubMed  Google Scholar 

  27. Huang TT, Johnson MS, Goran MI (2002) Development of a prediction equation for insulin sensitivity from anthropometry and fasting insulin in prepubertal and early pubertal children. Diab Care 25:1203–1210

    Article  Google Scholar 

  28. Inokuchi M, Matsuo N, Anzo M et al (2007) Age-dependent percentile for waist circumference for Japanese children based on the 1992–1994 cross-sectional national survey data. Eur J Pediatr 1666:55–61

    Google Scholar 

  29. Keskin M, Kurtoglu S, Kendirci M et al (2005) Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 115:500–503

    Article  Google Scholar 

  30. Kim JH, Bachmann RA, Chen J (2009) Interleukin-6 and insulin resistance. Vitam Horm 80:613–633

    Article  CAS  PubMed  Google Scholar 

  31. Krekoukia M, Nassis GP, Psarra G et al (2007) Elevated total and central adiposity and low physical activity are associated with insulin resistance in children. Metabolism 56:206–213

    Article  CAS  PubMed  Google Scholar 

  32. Lee JM (2006) Insulin resistance in children and adolescents. Rev Endocr Metab Disord 7:141–147

    Article  CAS  PubMed  Google Scholar 

  33. Lee JM, Okumura MJ, Davis MM et al (2006) Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study. Diab Care 29:2427–2432

    Article  Google Scholar 

  34. Lohman TG, Roche AF, Martorell R (1988) Anthropometric standardization reference manual. Human Kinetics, Champaign

    Google Scholar 

  35. Maffeis C, Manfredi R, Trombetta M et al (2008) Insulin sensitivity is correlated with subcutaneous but not visceral body fat in overweight and obese prepubertal children. J Clin Endocrinol Metab 93:2122–2128

    Article  CAS  PubMed  Google Scholar 

  36. Manios Y, Moschonis G, Kourlaba G et al (2008) Prevalence and independent predictors of insulin resistance in children from Crete, Greece: the Children Study. Diabet Med 25:65–72

    CAS  PubMed  Google Scholar 

  37. McCarthy HD (2006) Body fat measurements in children as predictors for the metabolic syndrome: focus on waist circumference. Proc Nutr Soc 65:385–392

    PubMed  Google Scholar 

  38. McCarthy HD, Jarrett KV, Crawley HF (2001) The development of waist circumference percentiles in British children aged 5.0‒16.9 y. Eur J Clin Nutr 55:902–907

    Article  CAS  PubMed  Google Scholar 

  39. Morales LM, Raleigh X, Fernández V et al (2007) Distribution of fasting glucose, insulin, homeostasis model assessment (HOMA) insulin resistance (IR) and HOMA beta cell in children and adolescents from Maracaibo, Venezuela. Rev Med Chil 135:205–211

    CAS  PubMed  Google Scholar 

  40. Moran A, Jacobs DR Jr, Steinberger J et al (1999) Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes 48:2039–2044

    Article  CAS  PubMed  Google Scholar 

  41. Moran A, Jacobs DR Jr, Steinberger J et al (2002) Association between the insulin resistance of puberty and the insulin-like growth factor-I/growth hormone axis. J Clin Endocrinol Metab 87:4817–4820

    Article  CAS  PubMed  Google Scholar 

  42. Moreira SR, Ferreira AP, Lima RM et al (2008) Predicting insulin resistance in children: anthropometric and metabolic indicators. J Pediatr (Rio J) 84:47–52

    Google Scholar 

  43. Moreno LA, Fleta J, Mur L, Rodríguez G et al (1999) Waist circumference values in Spanish children—gender related differences. Eur J Clin Nutr 53:429–433

    Article  CAS  PubMed  Google Scholar 

  44. Nelson DA, Barondess DA (2000) A noninvasive measure of physical maturity as a predictor of bone mass in children. J Am Coll Nutr 19:38–41

    CAS  PubMed  Google Scholar 

  45. Otto Buczkowska E (2005) Insulin resistance and hyperinsulinemia—risk factors of the metabolic syndrome in the pubertal population. Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw 11:109–114

    PubMed  Google Scholar 

  46. Parizková J, Roth Z (1972) The assessment of depot fat in children from skinfold thickness measurements by Holtain (Tanner–Whitehouse) caliper. Hum Biol 44:613–620

    PubMed  Google Scholar 

  47. Raman A, Fitch MD, Hudes ML et al (2008) Baseline correlates of insulin resistance in inner city high-BMI African-American children. Obesity (Silver Spring) 16:2039–2045

    Article  CAS  Google Scholar 

  48. Rodríguez-Rodríguez E, Perea JM, López-Sobaler AM et al (2009) Obesidad, resistencia a la insulina y aumento de los niveles de adipoquinas: importancia de la dieta y el ejercicio físico. Nutr Hosp 24:401–407

    Google Scholar 

  49. Rolland-Cachera MF, Deheger M, Bellisle F (2001) Définition actuelle et évolution de la fréquence de l’obésité chez l’enfant. Cah Nutr Die’t 36:108–112

    Google Scholar 

  50. Ruiz JR, Rizzo NS, Ortega FB et al (2007) Markers of insulin resistance are associated with fatness and fitness in school-aged children: the European Youth Heart Study. Diabetologia 50:1401–1408

    Article  CAS  PubMed  Google Scholar 

  51. Sabin MA, Shield JP (2008) Childhood obesity. Front Horm Res 36:85–96

    Article  CAS  PubMed  Google Scholar 

  52. Serra Ll, Ribas L, Aranceta J et al (2003) Obesidad infantil y juvenil en España. Resultados del estudio enkid (1998-2000). Med Clin (Brac) 121:725–732

    Google Scholar 

  53. Shalitin S, Abrahami M, Lilos P et al (2005) Insulin resistance and impaired glucose tolerance in obese children and adolescents referred to a tertiary-care center in Israel. Int J Obes (Lond) 29(6):571–578

    Article  CAS  Google Scholar 

  54. Sinaiko AR, Jacobs DR Jr, Steinberger J et al (2001) Insulin resistance syndrome in childhood: associations of the euglycemic insulin clamp and fasting insulin with fatness and other risk factors. J Pediatr 139:700–707

    Article  CAS  PubMed  Google Scholar 

  55. Stejskal D, Adamovská S, Bartek J et al (2003) Resistin-concentrations in persons with type 2 diabetes mellitus and in individuals with acute inflammatory disease. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 147:63–69

    CAS  PubMed  Google Scholar 

  56. Tanaka H, Thulesius O, Yamaguchi H et al (1994) Continuous non-invasive finger blood pressure monitoring in children. Acta Paediatr 83:646–652

    Article  CAS  PubMed  Google Scholar 

  57. Tanner JM (1962) Growth at adolescence, 2nd edn. Blackwell, Oxford

    Google Scholar 

  58. Taylor RW, Jones IE, Williams SM et al (2000) Evaluation of waist circumference, waist-to-hip ratio, and the conicity index as screening tools for high trunk fat mass, as measured by dual-energy X-ray absorptiometry, in children aged 3–19 y. Am J Clin Nutr 72:490–495

    CAS  PubMed  Google Scholar 

  59. Tripathy D, Carlsson M, Almgren P et al (2000) Insulin secretion and insulin sensitivity in relation to glucose tolerance: lessons from the Botnia Study. Diabetes 49:975–980

    Article  CAS  PubMed  Google Scholar 

  60. Vasudevan AR, Garber AJ (2005) Insulin resistance syndrome. A review. Minerva Endocrinol 30:101–119

    CAS  PubMed  Google Scholar 

  61. Vega GL, Grundy SM (1996) Hypoalphalipoproteinemia (low high density lipoprotein) as a risk factor for coronary heart disease. Curr Opin Lipidol 7:209–216

    Article  CAS  PubMed  Google Scholar 

  62. Wells JC (2007) Sexual dimorphism of body composition. Best Pract Res Clin Endocrinol Metab 21:415–430

    Article  PubMed  Google Scholar 

  63. White M, Davies P, Murphy A (2008) Validation of percent body fat indicators in pediatric oncology nutrition assessment. J Pediatr Hematol Oncol 30:124–129

    Article  PubMed  Google Scholar 

  64. Wilson PW, Abbot RD, Garrison RJ et al (1981) Estimation of very low density lipoprotein cholesterol from data on triglyceride concentration in serum. Clin Chem 19:476–482

    Google Scholar 

  65. World Health Organization (1995) Physical status: the use and interpretation of anthropometry. Report of the WHO expert committee. WHO technical report series no. 854. WHO, Geneva

    Google Scholar 

Download references

Acknowledgements

This study was performed with financial help from the FISS (project number PI060318) and the “Creation and Consolidation Program Research Group at the Complutense University of Madrid, Madrid” (Ref: GR58/O8; Code: 4120787).

Conflicts of interest

Authors do not have a financial relationship with the organization that sponsored the research.

Author information

Authors and Affiliations

  1. Departamento de Nutrición, Facultad de Farmacia, Universidad Complutense de Madrid (UCM), 28040, Madrid, Spain

    Elena Rodríguez-Rodríguez, Carolina Palmeros-Exsome, Ana M. López-Sobaler & Rosa M. Ortega

Authors
  1. Elena Rodríguez-Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carolina Palmeros-Exsome
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ana M. López-Sobaler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rosa M. Ortega
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

Research Group: 920030

Corresponding author

Correspondence to Elena Rodríguez-Rodríguez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rodríguez-Rodríguez, E., Palmeros-Exsome, C., López-Sobaler, A.M. et al. Preliminary data on the association between waist circumference and insulin resistance in children without a previous diagnosis. Eur J Pediatr 170, 35–43 (2011). https://doi.org/10.1007/s00431-010-1260-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-010-1260-1

Keywords

Search

Navigation