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      Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children☆

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          Abstract

          Objective:

          To identify the association between both, body mass index and aerobic fitness, with cardiovascular disease risk factors in children.

          Methods:

          Cross-sectional study, carried out in Itaúna-MG, in 2010, with 290 school children ranging from 6 to 10 years-old of both sexes, randomly selected. Children from schools located in the countryside and those with medical restrctions for physical activity were not included. Blood sample was collected after a 12-hour fasting period. Blood pressure, stature and weight were evaluated in accordance with international standards. The following were considered as cardiovascular risk factors: high blood pressure, high total cholesterol, LDL, triglycerides and insulin levels, and low HDL. The statistical analysis included the Spearman's coefficient and the logistic regression, with cardiovascular risk factors as dependent variables.

          Results:

          Significant correlations were found, in both sexes, among body mass index and aerobic fitness with most of the cardiovascular risk factors. Children of both sexes with body mass index in the fourth quartile demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Moreover, girls with aerobic fitness in the first quartile also demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors.

          Conclusion:

          The significant associations and the increased chances of having cardiovascular risk factors in children with less aerobic fitness and higher levels of body mass index justify the use of these variables for health monitoring in Pediatrics.

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          Most cited references50

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          Body mass index, waist circumference, and clustering of cardiovascular disease risk factors in a biracial sample of children and adolescents.

          To derive optimal body mass index (BMI) and waist circumference thresholds for children and adolescents, to predict risk factor clustering. Cross-sectional receiver operating characteristic curve analysis. The Bogalusa Heart Study, a community-based study of cardiovascular disease risk factors in early life. A total of 2597 black and white children and adolescents, 5 to 18 years of age, who were examined between 1992 and 1994. The presence or absence of > or =3 age-adjusted risk factors (low high-density lipoprotein cholesterol level, high low-density lipoprotein cholesterol level, high triglyceride level, high glucose level, high insulin level, and high blood pressure) was predicted from age-adjusted BMI and waist circumference values. The areas under the receiver operating characteristic curves were significantly different from 0.5 for both BMI and waist circumference for all gender/race groups, ranging from 0.73 to 0.82. The optimal BMI thresholds were at the 53rd and 50th percentiles for white and black male subjects, respectively, and at the 57th and 51st percentiles for white and black female subjects, respectively. Similarly, the optimal waist circumference thresholds were at the 56th and 50th percentiles for white and black male subjects, respectively, and at the 57th and 52nd percentiles for white and black female subjects, respectively. The sensitivity and specificity at the thresholds were similar for all gender/race groups, ranging from 67% to 75%. The use of BMI and waist circumference for the prediction of risk factor clustering among children and adolescents has significant clinical utility. In this sample, race and gender differences in the optimal thresholds were minimal.
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            Low cardiorespiratory fitness is a strong predictor for clustering of cardiovascular disease risk factors in children independent of country, age and sex.

            Few studies have investigated the association between maximal cardiorespiratory capacity (fitness) and the clustered cardiovascular disease (CVD) risk in children and youth from culturally diverse countries. This cross-sectional study examined the association between fitness and clustered CVD risk in children and adolescents from three European countries. Participants were 2845 randomly selected school children aged 9 or 15 years from Portugal (n=944), Denmark (n=849) and Estonia (n=1052). Cardiorespiratory fitness was determined during a maximal test on a cycle ergometer. CVD risk factors selected to assess the degree of clustering were the total cholesterol/high-density lipoprotein cholesterol ratio, plasma triglycerides, insulin resistance (homeostasis model assessment), sum of four skinfolds, and systolic blood pressure. There was a strong association between cardiorespiratory fitness and the clustering of CVD risk factors. The odds ratios for clustering in each quartile of fitness, using the quartile with the highest fitness as reference, were 13.0 [95% confidence interval (CI) 8.8-19.1]; 4.8 (95% CI 3.2-7.1) and 2.5 (95% CI 1.6-3.8), respectively, after adjusting for country, age, sex, socio-economic status, pubertal stage, family history of CVD and diabetes. In stratified analyses by age group, sex and country, similar strong patterns were observed. Low cardiorespiratory fitness is strongly associated with the clustering of CVD risk factors in children independent of country, age and sex.
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              Adiposity and cardiovascular risk factors in a large contemporary population of pre-pubertal children.

              to examine the associations of several markers of adiposity and a wide range of cardiovascular risk factors and biomarkers in pre-pubertal children. four measures of adiposity,body mass index (BMI), waist circumference, dual-energy X-ray absorptiometry (DXA)-determined fat mass, and leptin concentration, were available in up to 7589 children aged 8.8-11.7 (9.9 mean) years from the Avon Longitudinal Study of Parents and Children (ALSPAC). Thirteen per cent of boys and 18.8% of girls were overweight, and 5.3% of boys and 5% of girls were obese. Body mass index was highly correlated with waist circumference (r = 0.91), DXA fat mass (r = 0.87), and leptin concentration (r = 0.75), and all had similar associations with cardiovascular risk factors. A 1 kg/m(2) greater BMI was associated with 1.4 mmHg (95% CI 1.25-1.44) higher systolic blood pressure (BP). In 5002 children, a 1 kg/m(2) greater BMI was associated with a 0.05 mmol/L (95% CI 0.036-0.055) higher non-high-density lipoprotein (HDL) cholesterol and 0.03 mmol/L (95% CI -0.034 to -0.025) lower HDL cholesterol. There were also graded associations with apolipoproteins A1 and B, interleukin-6, and C-reactive protein. Comparing children who were obese with those who were normal weight, the odds ratio for hypertension was 10.7 (95% CI 7.2-15.9) for boys and 13.5 (95% CI 9.4-19.5) for girls. in pre-pubertal UK children, overweight/obesity is common and has broadly similar associations with BP, HDL cholesterol, and non-HDL cholesterol to those observed in adults. Future research should evaluate whether effective interventions to maintain healthy weight in childhood could have important benefits for adult cardiovascular risk.
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                Author and article information

                Journal
                Rev Paul Pediatr
                Rev Paul Pediatr
                0103-0582
                Revista Paulista de Pediatria
                Sociedade de Pediatria de São Paulo
                0103-0582
                1984-0462
                September 2014
                September 2014
                : 32
                : 3
                : 208-214
                Affiliations
                [a ] Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
                [b ] Universidade Federal de Pernambuco (UFPE), Recife, PE, Brasil
                [c ] Universidade Federal de Lavras (UFLA), Lavras, MG, Brasil
                [d ] Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, MG, Brasil
                [a ] Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
                [b ] Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
                [c ] Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil
                [d ] Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, MG, Brazil
                Author notes
                [* ] Corresponding author. E-mail: reginaldog@ufmg.br (R. Gonçalves).

                Conflicts of interest

                The authors declare no conflicts of interest.

                [* ]Autor para correspondência. E-mail: reginaldog@ufmg.br (R. Gonçalves).

                Conflitos de interesse

                Os autores declaram não haver conflitos de interesse.

                Article
                10.1590/0103-0582201432310
                4227342
                25479851
                c51ded63-0736-49c6-98bf-08ec0a9fa0b6
                © 2014 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. Todos os direitos reservados.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 November 2013
                : 19 March 2014
                Page count
                Figures: 0, Tables: 6, Equations: 0, References: 29, Pages: 7
                Funding
                Funded by: FAPEMIG
                Award ID: APQ 02341-10
                FAPEMIG - process APQ 02341-10. Universidade de Itaúna - MG: project 016/2010.
                Categories
                Original Articles

                children,cardiovascular system,risk factors,fitness,crianças,sistema cardiovascular,atores de risco,aptidão física

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