Variability of thinness and its relation to cardio-metabolic risk factors using four body mass index references in school-children from Delhi, India

Garg, P., Kaur, S., Osmond, Clive, Sinha, S., Kapil, U. and Sachdev, H.P.S. , Gupta, D. (ed.) (2013) 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, 50 (11), 1025-1032. (PMID:23798637)

Abstract

Objectives: to compare: (i) prevalences of thinness in school-children 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.

Participats: 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.

Conclusions: 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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Contributors

Author: Clive Osmond

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