Percentiles for anthropometric measures in Iranian children and adolescents: the CASPIAN-IV study
-
Roya Kelishadi
,
Mostafa Hosseini
Abstract
Background:
The aim of the study was to provide the age- and sex-specific percentile values of anthropometric measures for Iranian children and adolescents.
Methods:
This cross-sectional nationwide survey was conducted on a representative sample of 14,880 school students, selected by multistage random cluster sampling from urban and rural areas of 30 provinces in Iran. Anthropometric measures including body mass index (BMI), waist circumference (WC), hip circumference (HC), and wrist circumference were measured under standard protocols by using calibrated instruments. Age- and gender-specific reference values were developed for anthropometric measures by the maximum penalized likelihood approach [Cole’s least mean square (LMS) method].
Results:
In the present study, 13,486 out of the 14,880 invited subjects completed all the required data of the study (participation rate: 90.6%). Participants consisted of 6640 girls (49.2%) and 75.6% urban residents; their mean and standard deviation (SD) age was 12.47±3.36 years. The BMI percentile curves of girls had a sharp increase from 14 to 18 years, and then began to plateau, but among boys, these curves had a consistent increase until the age of 18 years. In addition, the higher percentiles were higher in adolescent boys than girls. The HC percentile curves of both sexes had a persistent increase and the percentiles for HC were higher in adolescent girls than in boys. WC had a sharp increase from 7 to 18 years of age for boys, whereas for girls, these curves had a less sharp increase with age. In all ages, the percentiles for wrist circumference were higher in adolescent boys than girls.
Conclusions:
The findings of this study highlight the necessity of paying special attention to developing age- and gender-specific percentiles of anthropometric measures in children and adolescents.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: This nationwide survey was conducted in Iran with corporation of the Ministry of Health and Medical education, Ministry of Education and Training, Child Health Promotion Research Center, Isfahan University of Medical Sciences, and Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences., (Grant/Award Number: ‘F234565’).
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Nagy P, Kovacs E, Moreno LA, Veidebaum T, Tornaritis M, et al. Percentile reference values for anthropometric body composition indices in European children from the IDEFICS study. Int J Obes (Lond) 2014;38(Suppl 2):S15–25.10.1038/ijo.2014.131Suche in Google Scholar PubMed
2. Freedman DS, Serdula MK, Srinivasan SR, Berenson GS. Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 1999;69:308–17.10.1093/ajcn/69.2.308Suche in Google Scholar PubMed
3. Andaki AC, Tinôco AL, Mendes EL, Andaki Júnior R, Hills AP, et al. Anthropometry and physical activity level in the prediction of metabolic syndrome in children. Public Health Nutr 2014;17:2287–94.10.1017/S136898001300253XSuche in Google Scholar PubMed
4. Revenga-Frauca J, González-Gil E, Bueno-Lozano G, De Miguel-Etayo P, Velasco-Martínez P, et al. Abdominal fat and metabolic risk in obese children and adolescents. J Physiol Biochem 2009;65:415–20.10.1007/BF03185937Suche in Google Scholar PubMed
5. Sarria A, Moreno L, Garcí-LIop L, Fleta J, Morellon M, et al. Body mass index, triceps skinfold and waist circumference in screening for adiposity in male children and adolescents. Acta Paediatr 2001;90:387–92.10.1080/080352501750126195Suche in Google Scholar PubMed
6. Moreno L, Pineda I, Rodriguez G, Fleta J, Sarria A, et al. Waist circumference for the screening of the metabolic syndrome in children. Acta Paediatr 2002;91:1307–12.10.1111/j.1651-2227.2002.tb02825.xSuche in Google Scholar
7. Wells JC, Fewtrell MS, Williams JE, Haroun D, Lawson MS, et al. Body composition in normal weight, overweight and obese children: matched case-control analyses of total and regional tissue masses, and body composition trends in relation to relative weight. Int J Obes (Lond) 2006;30:1506–13.10.1038/sj.ijo.0803402Suche in Google Scholar PubMed
8. McCarthy HD, Jarrett KV, Crawley HF. The development of waist circumference percentiles in British children aged 5.0–16.9 y. Eur J Clin Nutr 2001;55:902–7.10.1038/sj.ejcn.1601240Suche in Google Scholar PubMed
9. Haas GM, Liepold E, Schwandt P. Percentile curves for fat patterning in German adolescents. World J Pediatr 2011;7:16–23.10.1007/s12519-011-0241-4Suche in Google Scholar PubMed
10. Galcheva SV, Iotova VM, Yotov YT, Grozdeva KP, Stratev VK, et al. Waist circumference percentile curves for Bulgarian children and adolescents aged 6–18 years. Int J Pediatr Obes 2009;4:381–8.10.3109/17477160902846195Suche in Google Scholar PubMed
11. Brambilla P, Bedogni G, Heo M, Pietrobelli A. Waist circumference-to-height ratio predicts adiposity better than body mass index in children and adolescents. Int J Obes (Lond) 2013;37:943–6.10.1038/ijo.2013.32Suche in Google Scholar PubMed
12. Markovic-Jovanovic SR, Stolic RV, Jovanovic AN. The reliability of body mass index in the diagnosis of obesity and metabolic risk in children. J Pediatr Endocrinol Metab 2015;28:515–23.10.1515/jpem-2014-0389Suche in Google Scholar PubMed
13. Capizzi M, Leto G, Petrone A, Zampetti S, Papa RE, et al. Wrist circumference is a clinical marker of insulin resistance in overweight and obese children and adolescents. Circulation 2011;123:1757–62.10.1161/CIRCULATIONAHA.110.012898Suche in Google Scholar PubMed
14. Jahangiri Noudeh Y, Hadaegh F, Vatankhah N, Momenan AA, Saadat N, et al. Wrist circumference as a novel predictor of diabetes and prediabetes: results of cross-sectional and 8.8-year follow-up studies. J Clin Endocrinol Metab 2013;98:777–84.10.1210/jc.2012-2416Suche in Google Scholar PubMed
15. Mohebi R, Mohebi A, Sheikholeslami F, Azizi F, Hadaegh F. Wrist circumference as a novel predictor of hypertension and cardiovascular disease: results of a decade follow up in a West Asian cohort. J Am Soc Hypertens 2014;8:800–7.10.1016/j.jash.2014.08.010Suche in Google Scholar PubMed
16. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, et al. CDC growth charts: United States. Adv Data 2000;314:1–27.Suche in Google Scholar
17. Shields M, Tremblay MS. Canadian childhood obesity estimates based on WHO, IOTF and CDC cut-points. Int J Pediatr Obes 2010;5:265–73.10.3109/17477160903268282Suche in Google Scholar PubMed
18. Ozturk A, Mazicioglu MM, Hatipoglu N, Budak N, Keskin G, et al. J Pediatr Endocrinol Metab 2008;21:827–36.10.1515/JPEM.2008.21.9.827Suche in Google Scholar
19. Taylor RW, Jones IE, Williams SM, Goulding A. Evaluation of waist circumference, waist-to-hip ratio, and the conicity index as screening tools for high trunk fat mass, as measured by dual-energy X-ray absorptiometry, in children aged 3–19 y. Am J Clin Nutr 2000;72:490–5.10.1093/ajcn/72.2.490Suche in Google Scholar PubMed
20. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114(2 Suppl 4th Report):555–76.10.1542/peds.114.S2.555Suche in Google Scholar
21. Kelishadi R. Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev 2007;29:62.10.1093/epirev/mxm003Suche in Google Scholar PubMed
22. Group WMGRS. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl 2006;450:76–85.Suche in Google Scholar
23. Baya Botti A, Perez-Cueto FJ, Vasquez Monllor PA, Kolsteren PW. Anthropometry of height, weight, arm, wrist, abdominal circumference and body mass index, for Bolivian adolescents 12 to 18 years: Bolivian adolescent percentile values from the MESA study. Nutr Hosp 2009;24:304–11.Suche in Google Scholar
24. Sardinha LB, Santos R, Vale S, e Silva MJ, Raimundo AM, et al. Waist circumference percentiles for Portuguese children and adolescents aged 10 to 18 years. Eur J Pediatr 2012;171:499–505.10.1007/s00431-011-1595-2Suche in Google Scholar PubMed
25. Mason C, Katzmarzyk PT. Variability in waist circumference measurements according to anatomic measurement site. Obesity 2009;17:1789–95.10.1038/oby.2009.87Suche in Google Scholar PubMed
26. Wills S, Bhopal R. The challenges of accurate waist and hip measurement over clothing: Pilot data. Obes Res Clin Pract 2010;4:e163–246.10.1016/j.orcp.2009.11.003Suche in Google Scholar PubMed
27. Kelishadi R, Heidari-Beni M, Azizi-Soleiman F, Ardalan G, Khoshhali M, et al. Reference curves of anthropometric indices in two national studies conducted among Iranian children in 2003–2004 and 2009–2010: the Caspian study. J Res Med Sci 2014;19:709–14.Suche in Google Scholar
28. Motlagh ME, Kelishadi R, Amirkhani MA, Ziaoddini H, Dashti M, et al. Double burden of nutritional disorders in young Iranian children: findings of a nationwide screening survey. Public Health Nutr 2011;14:605–10.10.1017/S1368980010002399Suche in Google Scholar PubMed
29. Zhang Y-X, Wang S-R. Prevalence and regional distribution of childhood overweight and obesity in Shandong Province, China. World J Pediatr 2013;9:135–9.10.1007/s12519-012-0392-ySuche in Google Scholar PubMed
30. Galal OM. The nutrition transition in Egypt: obesity, undernutrition and the food consumption context. Public Health Nutr 2002;5:141–8.10.1079/PHN2001286Suche in Google Scholar PubMed
31. Salazar-Martinez E, Allen B, Fernandez-Ortega C, Torres-Mejia G, Galal O, et al. Overweight and obesity status among adolescents from Mexico and Egypt. Arch Med Res 2006;37:535–42.10.1016/j.arcmed.2005.10.014Suche in Google Scholar PubMed
32. Song X, Jousilahti P, Stehouwer CD, Soderberg S, Onat A, et al. Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity in Europeans. Nutr Metab Cardiovasc Dis 2014;13:144.10.1016/j.numecd.2014.09.004Suche in Google Scholar PubMed
33. Guntsche Z, Guntsche EM, Saraví FD, Gonzalez LM, Lopez Avellaneda C, et al. Umbilical waist-to-height ratio and trunk fat mass index (DXA) as markers of central adiposity and insulin resistance in Argentinean children with a family history of metabolic syndrome. J Pediatr Endocrinol Metab 2010;23:245–56.10.1515/JPEM.2010.23.3.245Suche in Google Scholar
34. Fernández JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr 2004;145:439–44.10.1016/j.jpeds.2004.06.044Suche in Google Scholar PubMed
35. Eisenmann JC. Waist circumference percentiles for 7- to 15-year-old Australian children. Acta Paediatr 2005;94:1182–5.10.1111/j.1651-2227.2005.tb02071.xSuche in Google Scholar PubMed
36. Katzmarzyk P. Waist circumference percentiles for Canadian youth 11–18 y of age. European J Clin Nutr 2004;58:1011–5.10.1038/sj.ejcn.1601924Suche in Google Scholar PubMed
37. Zannolli R, Morgese G. Waist percentiles: a simple test for atherogenic disease? Acta Paediatr1996;85:1368–9.10.1111/j.1651-2227.1996.tb13928.xSuche in Google Scholar PubMed
38. Pirincci E, Cicek B, Acik Y, Ozturk A, Durmuş B. The second report from Turkey: waist percentiles for 6–11-year-old children in Elazig Province, Eastern Anatolia. J Pediatr Endocrinol Metab 2012;25:705–9.10.1515/jpem-2012-0142Suche in Google Scholar PubMed
39. Fredriks AM, van Buuren S, Fekkes M, Verloove-Vanhorick SP, Wit JM. Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice? European J Pediatr 2005;164:216–22.10.1007/s00431-004-1586-7Suche in Google Scholar PubMed
40. McCarthy H, Jarrett K, Crawley H. Original Communications-The development of waist circumference percentiles in British children aged 5.0–16.9 y. European J Clin Nutr 2001;55:902–7.10.1038/sj.ejcn.1601240Suche in Google Scholar PubMed
41. Poh BK, Jannah AN, Chong LK, Ruzita AT, Ismail MN, et al. Waist circumference percentile curves for Malaysian children and adolescents aged 6.0–16.9 years. Int J Pediatr Obes 2011;6:229–35.10.3109/17477166.2011.583658Suche in Google Scholar PubMed
©2016 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
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- Percentiles for anthropometric measures in Iranian children and adolescents: the CASPIAN-IV study
- Hormone disorder and vitamin deficiency in attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs)
- Case Reports
- Hyperinsulinism-hyperammonemia syndrome: a de novo mutation of the GLUD1 gene in twins and a review of the literature
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Artikel in diesem Heft
- Frontmatter
- Review
- A germline mutation of HRPT2/CDC73 (70 G>T) in an adolescent female with parathyroid carcinoma: first case report and a review of the literature
- Original Articles
- Seroprotection status of hepatitis B and measles vaccines in children with type 1 diabetes mellitus
- Prevalence and awareness of functional and structural foot abnormalities in children and adolescents with type 1 diabetes
- WHO European Childhood Obesity Surveillance Initiative in Serbia: a prevalence of overweight and obesity among 6–9-year-old school children
- Pilot study of newborn screening of inborn error of metabolism using tandem mass spectrometry in Malaysia: outcome and challenges
- In children with autoimmune thyroid diseases the association with Down syndrome can modify the clustering of extra-thyroidal autoimmune disorders
- Identification of monogenic gene mutations in Japanese subjects diagnosed with type 1B diabetes between >5 and 15.1 years of age
- Referral pattern of children with short stature to a pediatric endocrine clinic in Kuwait
- Factors associated with post-menarcheal growth: results of a longitudinal study in Chilean girls from different socioeconomic statuses
- Percentiles for anthropometric measures in Iranian children and adolescents: the CASPIAN-IV study
- Hormone disorder and vitamin deficiency in attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs)
- Case Reports
- Hyperinsulinism-hyperammonemia syndrome: a de novo mutation of the GLUD1 gene in twins and a review of the literature
- Novel homozygous likely-pathogenic intronic variant in INS causing permanent neonatal diabetes in siblings
- A girl with permanent neonatal diabetes due to KCNJ11 mutation presented with Mauriac syndrome after improper adjustment in sulfonylurea dosage over 6 years
- Treatment experience and long-term follow-up data in two severe neonatal hyperparathyroidism cases
- A novel splice site mutation of FGD1 gene in an Aarskog-Scott syndrome patient with a large anterior fontanel
