ESPE Abstracts (2014) 82 P-D-2-3-402

Usefulness of Hypertriglyceridemic Waist Phenotype in Obese Indian Children

Janani Ravi, Hemchand Krishna Prasad, Lakshmi Venugopalan, Gowrishankar Chokanathan, Nedunchelian Krishnamoorthy & Kannan Narayanaswamy


Mehta Children’s Hospital, Chennai, India


Background: BMI to screen children for cardiometabolic risk has numerous drawbacks. Hypertriglyceridemic-waist (HW) phenotype is recognized as an effective screening tool to identify adults but role in children is not known.

Objective and hypotheses: To evaluate HW-phenotype as an alternative for BMI in recognizing children (5–18 years) at risk for cardiometabolic risk factors.

Method: Retrospective review of case records of children evaluated for cardiometabolic risks in the Paediatric Endocrine Clinic of a developing country. Children with waist circumference ≥90th percentile and serum triglyceride levels >100 mg/dl considered to have abnormal HW-phenotype.

Results: Records of 40 children (mean age 10.0±3.3 years; 27 males; mean BMI–SDS 2.8±0.6) reviewed. 87.5, 50, and 40% subjects had abnormal waist, elevated triglycerides, and abnormal HW-phenotype respectively. Children with abnormal HW-phenotype had higher total cholesterol (166.7±38.1 vs 161.2±33.4 mg/dl; P<0.05), higher LDL levels (105.7±38.1 vs 102.9±30.4 mg/dl; P<0.05), and lower HDL levels (41.3±17.1 vs 45.0±14.1 mg/dl; P>0.05). Low HDL was more frequently observed in children with abnormal HW-phenotype (46.7 vs 30.8%; P<0.05). Comparison of BMI, waist circumference alone, and HW-phenotype revealed that BMI has highest sensitivity and HW phenotype has highest specificity to recognize cardiometabolic risk factors (Table 1).

Table 1.
BMI–SDS >+2HW phenotypeWC >90th percentile
Sen (%)Sp (%)Sen (%)Sp (%)Sen (%)Sp (%)
TCa >170 mg/dl92.313.437.558.3754.1
LDLb >110 mg/dl91.613.04062.573.34.1
HDLc <35 mg/dl80858.370.383.311.1
Insulin >15 mIU/ml1005506488.825
Blood sugar >110 mg/dl83.39.542.868.17912.3

Conclusion: Though HW phenotype is more specific, BMI remains the gold standard to screen children for metabolic risk factors.

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