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      Predictive Ability of Waist Circumference and Waist-to-Height Ratio for Cardiometabolic Risk Screening among Spanish Children

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          Abstract

          An excess of fat mass has been associated with adverse cardiometabolic risk factors. Different anthropometric measures have been proposed as alternative non-invasive measures for obesity-related cardiometabolic risk. To evaluate the magnitude of association between waist circumference (WC) and waist-to-height ratio (WtHR) with cardiometabolic risk factors and metabolic syndrome and to determine the WtHR cutoff associated with a more favorable cardiometabolic risk profile in Spanish children, data were taken from a cross-sectional survey conducted in 2010 among 848 schoolchildren aged 8–11 years from 20 public schools in the province of Cuenca (Spain). Anthropometric variables, glucose, insulin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), systolic (SBP) and diastolic blood pressure (DBP) and metabolic syndrome (MetS) were also analyzed. WtHR and WC had a good accuracy for TG, insulin, and MetS. The diagnostic odds ratio ranged from 2.95 to 9.07 for WtHR and from 5.30 to 27.40 for WC. The main result of the present study suggests that both WtHR and WC could be used as a screening tool to identify children with cardiometabolic abnormalities.

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          Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents.

          Overweight/obesity continues to increase in children and adolescents, and annual obesity-related hospital costs in 6-17 yr olds have reached 127 million dollars per year. Overweight children and adolescents are now being diagnosed with impaired glucose tolerance and type 2 diabetes, and they show early signs of the insulin resistance syndrome and cardiovascular risk. Several risk factors have been identified as contributors to the development of type 2 diabetes and cardiovascular risk in youth. These factors include increased body fat and abdominal fat, insulin resistance, ethnicity (with greater risk in African-American, Hispanic, and Native American children), and onset of puberty. There is no clear explanation of how these factors increase risk, but they appear to act in an additive fashion. We hypothesize that the constellation of these risk factors may be especially problematic during the critical period of adolescent development, especially in individuals who may have compromised beta-cell function and an inability to compensate for severe insulin resistance. Therefore, the purpose of this paper is to review the pathophysiology of type 2 diabetes and cardiovascular risk in obese children and adolescents.
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            Childhood obesity.

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              The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering.

              Metabolic syndrome (MetS) was developed by the National Cholesterol Education Program Adult Treatment Panel III, identifying adults with at least 3 of 5 cardiometabolic risk factors (hyperglycemia, increased central adiposity, elevated triglycerides, decreased high-density lipoprotein cholesterol, and elevated blood pressure) who are at increased risk of diabetes and cardiovascular disease. The constellation of MetS component risk factors has a shared pathophysiology and many common treatment approaches grounded in lifestyle modification. Several attempts have been made to define MetS in the pediatric population. However, in children, the construct is difficult to define and has unclear implications for clinical care. In this Clinical Report, we focus on the importance of screening for and treating the individual risk factor components of MetS. Focusing attention on children with cardiometabolic risk factor clustering is emphasized over the need to define a pediatric MetS.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                05 February 2020
                February 2020
                : 12
                : 2
                : 415
                Affiliations
                [1 ]Centro de estudios Socio-Sanitarios. Universidad de Castilla La Mancha, 16071 Cuenca, Spain jorge.canete@ 123456uclm.es (J.C.G.-P.); Mairena.Sanchez@ 123456uclm.es (M.S.-L.); Vicente.Martinez@ 123456uclm.es (V.M.V.); Montserrat.Solera@ 123456uclm.es (M.S.-M.)
                [2 ]Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, 31008 Navarra, Spain
                [3 ]Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago 71783-5, Chile
                [4 ]Facultad de Educación. Universidad de Castilla La Mancha, 13701 Cuidad Real, Spain
                [5 ]Facultad de Ciencias de la Salud. Universidad Autónoma de Chile, Talca 1670, Chile
                [6 ]Facultad de Enfermería, Universidad de Castilla La Mancha, 16071 Cuenca, Spain
                Author notes
                [* ]Correspondence: antonio.garciah@ 123456unavarra.es ; Tel.: +34-848-424-931
                Author information
                https://orcid.org/0000-0003-1135-2231
                https://orcid.org/0000-0002-1397-7182
                https://orcid.org/0000-0002-0217-0623
                https://orcid.org/0000-0001-6121-7893
                https://orcid.org/0000-0002-6661-078X
                Article
                nutrients-12-00415
                10.3390/nu12020415
                7071136
                32033484
                038ab291-f79c-4769-947c-51769c813af6
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 07 December 2019
                : 02 February 2020
                Categories
                Article

                Nutrition & Dietetics
                obesity,metabolic risk factors,anthropometric indicators
                Nutrition & Dietetics
                obesity, metabolic risk factors, anthropometric indicators

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