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Pediatr Int. 2012 Apr;54(2):200-4. doi: 10.1111/j.1442-200X.2011.03499.x. Epub 2011 Dec 22.

Effect of body mass index-z score on adverse levels of cardiovascular disease risk factors.

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Department of Pediatrics, Faculty of Medicine, University of Ryukyus, Okinawa, Japan.



Cardiovascular disease (CVD) risk factors are associated with body mass index z-score (BMISD) and/or insulin resistance (IR). However, the correlation between adverse levels of these risk factors and BMISD, and the effect of IR on these associations are not fully understood in children. The aim of this study was to evaluate the association between adverse levels of CVD risk factors and BMISD, and the effect of IR on these associations in schoolchildren.


Conventional CVD risk factors, C-reactive protein (CRP), uric acid (UA) and adiponectin were determined in 757 boys and 494 girls aged between 7 and 12 years. IR was assessed by the homeostasis model approximation index.


BMISD were linearly associated with relative risks having adverse levels of all factors, except for glucose and low-density lipoprotein cholesterol (LDL-C) in boys, and except for glucose, LDL-C and adiponectin in girls (P < 0.01-0.001). These associations were weakened after adjustment for IR, but still significant in cases of UA and CRP in boys and UA, high-density lipoprotein cholesterol and CRP in girls (P < 0.01-0.001).


The relative risk of having adverse levels of most CVD risk factors in school children increased across the entire range of BMISD. IR contributed to most of these relative risks, but BMISD itself also contributed to these relative risks. To prevent future development of CVD, it might be important for schoolchildren to maintain BMISD within normal range. However, in cases of hyper LDL-cholesterolemia, we should consider causes other than BMISD.

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