Key result
Body mass index was a strong indicator of cardiovascular disease risk in adolescents, with systolic blood pressure being 6.81 mmHg lower in underweight/normal weight compared to overweight/obese participants.
Why the study?
Do anthropometric measures of adiposity (BMI, WC, WHtR) identify cardiovascular disease risk factors in adolescents?
Meta-Analysis (n=994,595)
Do anthropometric measures of adiposity (BMI, WC, WHtR) identify cardiovascular disease risk factors in adolescents?
BMI is a valid indicator of several cardiovascular risk factors (SBP, DBP, TG, HDL-c, insulin) in adolescents, while evidence for waist circumference and waist-to-height ratio remains limited due to methodological heterogeneity.
BMI screening identifies adolescents with elevated cardiovascular risk factors; confirms its validity while leaving evidence for waist measures limited.
INTRODUCTION: To compare the ability of Body Mass Index (BMI), waist circumference (WC) and waist to height ratio (WHtR) to estimate cardiovascular disease (CVD) risk levels in adolescents. EVIDENCE ACQUISITION: A systematic review and meta-analysis was performed after a database search for relevant literature (Cochrane, Centre for Review and Dissemination, PubMed, British Nursing Index, CINAHL, BIOSIS citation index, ChildData, metaRegister). EVIDENCE SYNTHESIS: The study included 117 records representing 96 studies with 994,595 participants were included in the systematic review, 14 of which (13 studies, N.=14,610) were eligible for the meta-analysis. The results of the meta-analysis showed that BMI was a strong indicator of systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and insulin; but not total cholesterol, low-density lipoprotein or glucose. Few studies were eligible for inclusion in the meta-analysis considering WC or WHtR (N.≤2). The narrative synthesis found measures of central adiposity to be consistently valid indicators of the same risk factors as BMI. CONCLUSIONS: BMI was an indicator of CVD risk. WC and WHtR were efficacious for indicating the same risk factors BMI performed strongly for, though there was insufficient evidence to judge the relative strength of each measure possibly due to heterogeneity in the methods for measuring and classifying WC.
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Lichtenauer et al. (2018) conducted a meta-analysis in Cardiovascular disease risk (n=994,595). Overweight/Obese adiposity status (BMI) vs. Underweight/Normal weight adiposity status was evaluated on Systolic blood pressure difference (MD -6.81 mmHg, 95% CI -8.71 to -4.90). Body mass index was a strong indicator of cardiovascular disease risk in adolescents, with systolic blood pressure being 6.81 mmHg lower in underweight/normal weight compared to overweight/obese participants.
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