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Public Health Nutr. 2014 Oct;17(10):2378-85. doi: 10.1017/S1368980013003285. Epub 2014 Jan 2.

Waist-to-height ratio, inflammation and CVD risk in obese children.

Author information

  • 11Department of Biochemistry and Molecular Biology II,Institute of Nutrition and Food Technology,Centre for Biomedical Research (CIB),Lab 123,University of Granada,Avda. del Conocimiento s/n,18016 Armilla,Granada,Spain.
  • 22Paediatric Research and Metabolism Unit,Reina Sofía University Hospital,Maimonides Institute for Biomedical Research (IMIBIC) and Unit of Paediatric Endocrinology,Cordoba,Spain.
  • 33Unit of Investigation in Nutrition,Growth and Human Development of Galicia,Paediatric Department,Clinic University Hospital of Santiago,University of Santiago de Compostela,Santiago de Compostela,Spain.
  • 44Paediatric Department,Lozano Blesa University Hospital,University of Zaragoza,Zaragoza,Spain.
  • 55Unit of Clinical Analyses,Valle de los Pedroches Hospital,Cordoba,Spain.
  • 66GENUD (Growth, Exercise,Nutrition and Development) Research Group, Faculty of Health Sciences,University of Zaragoza,Zaragoza,Spain.



To evaluate the association between waist-to-height ratio (WHtR) and specific biomarkers of inflammation, CVD risk and endothelial dysfunction in prepubertal obese children.


Prospective, multicentre case-control study matched by age and sex.


Children were recruited between May 2007 and May 2010 from primary-care centres and schools in three cities in Spain (Cordoba, Santiago de Compostela and Zaragoza).


Four hundred and forty-six (223 normal weight and 223 obese) Caucasian prepubertal children aged 6-12 years.


WHtR was higher in the obese than in the normal-weight children. Blood pressure, waist circumference, weight, height, insulin, plasma lipids, leptin, resistin, abnormal neutrophil and monocyte counts, C-reactive protein, IL-6, IL-8, TNF-α, myeloperoxidase, soluble intercellular adhesion molecule-1, selectin and plasminogen activator inhibitor-1 levels were higher in the obese than in the normal-weight group. Adiponectin and HDL-cholesterol were lower and glucose and metalloproteinase-9 showed no differences. Resistin, TNF-α and active plasminogen activator inhibitor-1 were associated with WHtR, a sensitive indicator of central obesity.


Our results lead to the hypothesis that changes in biomarker levels of insulin resistance, inflammation and CVD risk before puberty might induce metabolic consequences of obesity in obese children before reaching adulthood.

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