Increased waist circumference is associated with subclinical atherosclerosis in schoolchildren.

Background: Waist circumference (WC) is an indicator of adiposity; particularly visceral fat, cardiometabolic risk factors and related morbidity. The aim of this study was to determine the attribution of WC to increased carotid intima-media thickness (cIMT) and circulating levels of inflammation and endothelial dysfunction in schoolchildren.

Methods: A total of 122 children (61 boys and 61 girls) aged 10-15 years were distributed into three groups: (i) the lower smoothed sex- and age-specific WC (LWC) group (ii) the middle smoothed sex- and age-specific WC (MWC) group, and (iii) the higher smoothed sex- and age-specific WC (HWC) group. Measurements of cIMT using high-resolution B-mode ultrasound, lipemic profile, blood pressure, serum proinflammatory cytokines and soluble adhesion molecules were performed.

Results: Mean measured values in the HWC and/or MWC groups showed significantly higher values (p ≤ 0.05) of cIMT (mm), total cholesterol, triglycerides, low-density lipoprotein (LDL), blood pressure, interlukien-6 (IL-6), and interlukien-1 beta (IL-1β), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1(ICAM-1) and E-selectin, and significantly lower values of high-density lipoprotein (HDL) as compared to the LWC group. Using multiple linear regression analysis of WC-SDS adjusted for BMI-SDS with the studied subclinical atherosclerosis risk, WC-SDS was significantly (p ≤ 0.05) associated with the variation in HDL (R = -0.12), LDL (R = 0.36), IL-6 (R = 0.26), and VCAM-1 (R = 0.26).

Conclusions: Higher WC is positively associated with atherosclerosis risk factors including increased cIMT, a state of dyslipidemia, higher blood pressure and circulating levels of inflammation and adhesion molecules among schoolchildren. Waist circumference seems to be useful for the prediction of subclinical atherosclerosis in schoolchildren.