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J Pediatr. 2008 Aug;153(2):222-7. doi: 10.1016/j.jpeds.2008.02.006. Epub 2008 Apr 3.

Large waist but low body mass index: the metabolic syndrome in Australian Aboriginal children.

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  • 1Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.



To describe the prevalence and clinical characteristics of the metabolic syndrome (MetS) in a cohort of Australian Aboriginal children.


Body mass index (BMI), waist circumference, skin fold thickness, body fat percentage, insulin resistance, and the prevalence of MetS were evaluated in 486 children age 9 to 14 years from the Darwin Health Region, Northern Territory, Australia.


Using an age- and sex- specific definition, 14% of the children in the cohort had MetS, 6.4% were overweight, 4.9% were obese, and 26.2% had an elevated waist circumference. The mean percentage of body fat was 30.2%. The children with MetS had higher BMI and waist z-scores, percent body fat, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) score, and skin fold thickness compared with those without MetS (P < .001); however, >50% of those with MetS were neither overweight nor obese. Waist circumference was significantly associated with insulin resistance as measured by the HOMA-IR (P < .001).


MetS is common in our cohort despite low rates of overweight and obesity. A tendency for central adiposity is already evident in these young children. Measurement of waist circumference may help identify Aboriginal children at high risk for MetS.

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