Cardiovascular disease risk factor (CVDRF) associated waist circumference patterns in obese-prone children

Objectives. The present study tested whether children born at high risk (HR) compared with low risk (LR) for obesity are more likely to have a waist circumference (WC) associated with cardiovascular disease risk factors (CVDRF-WC) and tested whether CVDRF-WC status tracks over time. Methods. This prospective cohort study involved 71 children, three to eight years, who were divided into two groups, LR (n = 37) and HR (n = 34), based upon maternal prepregnancy body mass index (BMI). HR subjects were subdivided into HR normal-weight (HRNW) and HR overweight (HROW) groups, based on BMI ≥85%. Children were classified as having or not having a CVDRF-WC at each year, using age- and gender-specific WC cut-offs. Anthropometry was assessed annually. Results. Although HR children had a significantly greater mean WC than LR children at years 5-8 (p < 0.03), these differences became non-significant after adjusting for BMI. HROW were more likely to have a CVDRF-WC status (p ≤0.0001) at age 4 years (10%, 5%, vs. 58%), 5 years (3%, 10%, vs. 60%), 6 years (0%, 0%, vs. 70%), 7 years (0%, 0%, vs. 50%) to 8 years (0%, 0%, vs. 55%) than LR and HRNW. Although 60-100% of the children tracked CVDRF-WC status, higher proportions of HROW children (0-40%) transitioned into having a CVDRF-WC, compared with LR (0-6%) and HRNW (0-9%). Conclusions. HROW were more likely to have or develop a CVDRF-WC. Although the effects of obesity risk on WC may be secondary to BMI, clinically assessing WC in obese-prone children may help identify youth at risk for obesity-related complications.