Skip to main content
SpringerLink
Log in

Association of anthropometric indices with continuous metabolic syndrome in children and adolescents: the CASPIAN-V study

  • Original Article
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

This study aims to examine the association of anthropometric indices with continuous metabolic syndrome (cMetS) among Iranian children and adolescents.

Methods

This multicentric study was conducted on 14138 students aged 7–18 years, who participated in a national surveillance program. Fasting blood sample was obtained from a subsample of 3843 randomly selected students. Physical examination including the measurement of anthropometric indices and blood pressure was conducted; fasting blood glucose and lipid profile were measured; and cMetS score was computed. Standardized residuals (z-scores) were calculated for MetS components. A higher cMetS score indicates a less favorable metabolic profile. Linear regression models were applied to determine the association between cMetS and anthropometric indices.

Results

The study participants consisted of 3843 children and adolescents (52.3% boys) with mean (SD) age of 12.45 ± 3.04 years. All anthropometric indices had positive correlation with standardized scores of mean arterial pressure, waist circumference and cMetS (P < 0.05). Standardized scores of triglycerides were positively correlated with weight and body mass index (P < 0.05). In multivariate model, general and abdominal obesity, as well as high circumferences of neck, wrist, and hip circumferences increased the standardized cMetS risk score to 1.8, 1.9, 1.6, 1.5 and 1.5, respectively (P < 0.05 for all variables).

Conclusion

The results demonstrated that higher anthropometric indices are associated with higher cMetS risk score in children and adolescents. This information could be valuable for screening and prevention of MetS at population level.

Level of evidence

V, cross-sectional descriptive study (National surveillance study).

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

Similar content being viewed by others

References

  1. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). (2001) JAMA 285:2486–2497

    Article  Google Scholar 

  2. Eisenmann JC (2008) On the use of a continuous metabolic syndrome score in pediatric research. Cardiovasc Diabetol 7:17

    Article  Google Scholar 

  3. Barbaro G, Piedimonte A, Podagrosi M, Mercurio R, Mosca A, D’Avanzo M et al (2016) Epicardial adipose tissue and signs of metabolic syndrome in children. Eat Weight Disord Stud Anorex Bulim Obes 21:269–276

    Article  Google Scholar 

  4. Paz Filho GJ (2017) Metabolic syndrome in children and teenagers: worth assessing it, but how? Arch Endocrinol Metab 61:1–4

    Article  Google Scholar 

  5. Peña-Espinoza B, Granados-Silvestre M, Sánchez-Pozos K, Ortiz-López M, Menjivar M (2017) Metabolic syndrome in Mexican children: low effectiveness of diagnostic definitions. Endocrinol Diabetes Nutr 64:369

    Article  Google Scholar 

  6. DuBose KD, Stewart EE, Charbonneau SR, Mayo MS, Donnelly JE (2006) Prevalence of the metabolic syndrome in elementary school children. Acta paediatrica 95:1005–1011

    Article  Google Scholar 

  7. Statistics MS (2004) The Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III, NHLBI) defines the metabolic syndrome as three or more of the following abnormalities. American Heart Association

  8. Kahn R, Buse J, Ferrannini E, Stern M (2005) The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 28:2289–2304

    Article  Google Scholar 

  9. Andersen LB, Harro M, Sardinha LB, Froberg K, Ekelund U, Brage S et al (2006) Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study). Lancet 368:299–304

    Article  Google Scholar 

  10. Katzmarzyk PT, Pérusse L, Malina RM, Bergeron J, Després JP, Bouchard C (2001) Stability of indicators of the metabolic syndrome from childhood and adolescence to young adulthood: the Québec Family Study. J Clin Epidemiol 54:190–195

    Article  CAS  Google Scholar 

  11. Raitakari OT, Porkka KV, Räsänen L, Rönnemaa T, Viikari JS (1994) Clustering and six year cluster-tracking of serum total cholesterol, HDL-cholesterol and diastolic blood pressure in children and young adults. The Cardiovascular Risk in Young Finns Study. J Clin Epidemiol 47:1085–1093

    Article  CAS  Google Scholar 

  12. Kelishadi R, Gouya MM, Adeli K, Ardalan G, Gheiratmand R, Majdzadeh R et al (2008) Factors associated with the metabolic syndrome in a national sample of youths: CASPIAN Study. Nutr Metab Cardiovasc Dis 18:461–470

    Article  Google Scholar 

  13. Shafiee G, Kelishadi R, Heshmat R, Qorbani M, Motlagh ME, Aminaee T et al (2013) First report on the validity of a continuous metabolic syndrome score as an indicator for metabolic syndrome in a national sample of paediatric population—the CASPIAN-III study. Endokrynol Pol 64:278–284

    Article  CAS  Google Scholar 

  14. Motlagh ME, Ziaodini H, Qorbani M, Taheri M, Aminaei T, Goodarzi A et al (2017) Methodology and early findings of the fifth survey of childhood and adolescence surveillance and prevention of adult noncommunicable disease: the CASPIAN-V study. Int J Prev Med 8:4

    Article  Google Scholar 

  15. Organization WH (1995) Expert committee on physical status. Physical status: the use and interpretation of anthropometry. WHO, Geneva

    Google Scholar 

  16. Knowles KM, Paiva LL, Sanchez SE, Revilla L, Lopez T, Yasuda MB et al (2011) Waist circumference, body mass index, and other measures of adiposity in predicting cardiovascular disease risk factors among Peruvian adults. Int J Hypertens 24:931402

  17. Aswathappa J, Garg S, Kutty K, Shankar V (2013) Neck circumference as an anthropometric measure of obesity in diabetics. N Am J Med Sci 5:28–31

    Article  Google Scholar 

  18. Nyland J, Fried A, Maitra R, Johnson DL, Caborn DN (2006) Wrist circumference is related to patellar tendon thickness in healthy men and women. Clin Imaging 30:335–338

    Article  Google Scholar 

  19. Meaney E, Alva F, Moguel R, Meaney A, Alva J, Webel R (2000) Formula and nomogram for the sphygmomanometric calculation of the mean arterial pressure. Heart 84:64

    Article  CAS  Google Scholar 

  20. McNamara JR, Schaefer EJ (1987) Automated enzymatic standardized lipid analyses for plasma and lipoprotein fractions. Clin Chim Acta 166:1–8

    Article  CAS  Google Scholar 

  21. Kelishadi R, Ardalan G, Gheiratmand R, Majdzadeh R, Hosseini M, Gouya MM et al (2008) Thinness, overweight and obesity in a national sample of Iranian children and adolescents: CASPIAN Study. Child Care Health Dev 34:44–54

    CAS  PubMed  Google Scholar 

  22. Maffeis C, Banzato C, Talamini G (2008) Obesity study group of the italian society of pediatric endocrinology and diabetology. Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children. J Pediatr 152:207–213. doi:10.1016/j.jpeds.2007.09.021 (Epub 2007 Nov 19)

    Article  PubMed  Google Scholar 

  23. The Australian College of Paediatrics (1994) Policy statement. Children’s television. J Paediatr Child Health 30:6–8

    Article  Google Scholar 

  24. Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B et al (2005) Evidence based physical activity for school-age youth. J Pediatr 146:732–737

    Article  Google Scholar 

  25. Kelishadi R, Majdzadeh R, Motlagh ME, Heshmat R, Aminaee T, Ardalan G et al (2012) Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents: the Caspian-IV Study. Int J Prev Med 3:699–705

    PubMed  PubMed Central  Google Scholar 

  26. Okosun IS, Boltri JM, Lyn R, Davis-Smith M (2010) Continuous metabolic syndrome risk score, body mass index percentile, and leisure time physical activity in American children. J Clin Hypertens 12:636–644

    Article  Google Scholar 

  27. Alberti KG, Zimmet P, Shaw J (2005) The metabolic syndrome—a new worldwide definition. Lancet 366:1059–1062

    Article  Google Scholar 

  28. Caro DH, Cortés D (2012) Measuring family socioeconomic status: an illustration using data from PIRLS 2006. IERI Monogr Ser Issues Methodol Large Scale Assess 5:9–33

    Google Scholar 

  29. Jafari-Adli S, Jouyandeh Z, Qorbani M, Soroush A, Larijani B, Hasani-Ranjbar S et al (2014) Prevalence of obesity and overweight in adults and children in Iran; a systematic review. J Diabetes Metab Disord 13:121

    Article  Google Scholar 

  30. Alberti KGMM, Zimmet P, Shaw J (2006) Metabolic syndrome—a new world-wide definition. A consensus statement from the international diabetes federation. Diabet Med 23:469–480

    Article  CAS  Google Scholar 

  31. Burke V, Beilin L, Simmer K, Oddy W, Blake K, Doherty D et al (2005) Predictors of body mass index and associations with cardiovascular risk factors in Australian children: a prospective cohort study. Int J Obes 29:15

    Article  CAS  Google Scholar 

  32. Katzmarzyk PT, Pérusse L, Malina RM, Bergeron J, Després J-P, Bouchard C (2001) Stability of indicators of the metabolic syndrome from childhood and adolescence to young adulthood: the Quebec Family Study. J Clin Epidemiol 54:190–195

    Article  CAS  Google Scholar 

  33. Katzmarzyk PT, Janssen I, Ross R, Church TS, Blair SN (2006) The importance of waist circumference in the definition of metabolic syndrome. Diabetes Care 29:404–409

    Article  Google Scholar 

  34. Alvarez MM, Vieira AC, Sichieri R, Veiga GV (2008) Association between central body anthropometric measures and metabolic syndrome components in a probabilistic sample of adolescents from public schools. Arq Bras Endocrinol Metabol 52:649–657

    Article  Google Scholar 

  35. Qorbani M, Kelishadi R, Farrokhi-Khajeh-Pasha Y, Motlagh M, Aminaee T, Ardalan G et al (2013) Association of anthropometric measures with cardiovascular risk factors and metabolic syndrome in normal-weight children and adolescents: the CASPIAN III study. Obes Facts 6:483–492

    Article  Google Scholar 

  36. Wijndaele K, Beunen G, Duvigneaud N, Matton L, Duquet W, Thomis M et al (2006) A continuous metabolic syndrome risk score: utility for epidemiological analyses. Diabetes Care 29:2329

    Article  Google Scholar 

  37. Heshmat R, Shafiee G, Kelishadi R, Babaki AE, Motlagh ME, Arefirad T et al (2015) Is the association of continuous metabolic syndrome risk score with body mass index independent of physical activity? The CASPIAN-III study. Nutr Res Pract 9:404–410

    Article  Google Scholar 

  38. DuBose KD, Eisenmann JC, Donnelly JE (2007) Aerobic fitness attenuates the metabolic syndrome score in normal-weight, at-risk-for-overweight, and overweight children. Pediatr 120:1262–1268

    Article  Google Scholar 

  39. Simmons RK, Alberti KG, Gale EA, Colagiuri S, Tuomilehto J, Qiao Q et al (2010) The metabolic syndrome: useful concept or clinical tool? Report of a WHO expert consultation. Diabetologia 53:600–605

    Article  CAS  Google Scholar 

  40. Wang JJ, Li HB, Kinnunen L, Hu G, Jarvinen TM, Miettinen ME et al (2007) How well does the metabolic syndrome defined by five definitions predict incident diabetes and incident coronary heart disease in a Chinese population? Atherosclerosis 192:161–168

    Article  CAS  Google Scholar 

  41. Kryfti M, Dimakou K, Toumbis M, Daniil Z, Hatzoglou C, Gourgoulianis KI (2015) Effects of smoking cessation on serum leptin and adiponectin levels. Tob Induc Dis 13:30

    Article  Google Scholar 

  42. Cena H, Fonte ML, Turconi G (2011) Relationship between smoking and metabolic syndrome. Nutr Rev 69:745–53

    Article  Google Scholar 

Download references

Acknowledgements

This study was supported by the Ministry of Health and Medical education, Ministry of Education and Training, Isfahan University of Medical Sciences, and Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences. We are indebted to the participating schools, families and students in the study for their cooperation.

Author information

Author notes

  1. Ramin Heshmat and Roya Kelishadi have equally contributed.

Authors and Affiliations

  1. Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Hanieh-Sadat Ejtahed & Shirin Hasani-Ranjbar

  2. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Mostafa Qorbani

  3. Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Mohammad Esmaeil Motlagh

  4. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Pooneh Angoorani

  5. Health Psychology Research Center, Education Ministry, Tehran, Iran

    Hasan Ziaodini

  6. Office of Adolescents and School Health, Ministry of Health and Medical Education, Tehran, Iran

    Majzoubeh Taheri & Tahereh Aminaee

  7. Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Zeinab Ahadi & Ramin Heshmat

  8. Student Research Committee, School of Paramedical Sciences, Iran University of Medical Sciences, Tehran, Iran

    Shaghayegh Beshtar

  9. Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran

    Roya Kelishadi

Authors
  1. Hanieh-Sadat Ejtahed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mostafa Qorbani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohammad Esmaeil Motlagh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pooneh Angoorani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shirin Hasani-Ranjbar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hasan Ziaodini
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Majzoubeh Taheri
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zeinab Ahadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Shaghayegh Beshtar
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tahereh Aminaee
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Ramin Heshmat
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Roya Kelishadi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Ramin Heshmat or Roya Kelishadi.

Ethics declarations

Funding

This study was funded by the Ministry of Health and Medical education, Ministry of Education and Training, Isfahan University of Medical Sciences, and Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences (Grant no. 194049).

Conflict of interest

The corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent and oral assent were obtained from parents and participants, respectively.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ejtahed, HS., Qorbani, M., Motlagh, M.E. et al. Association of anthropometric indices with continuous metabolic syndrome in children and adolescents: the CASPIAN-V study. Eat Weight Disord 23, 597–604 (2018). https://doi.org/10.1007/s40519-017-0455-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-017-0455-0

Keywords

Search

Navigation