Association of adiposity measures with blood lipids and blood pressure in children aged 8-11 years

AIM: To examine the association of body mass index (BMI), triceps skinfold thickness (TST) and percentage body fat (%BF) from bioelectrical impedance analysis (BIA) with blood lipids, systolic blood pressure (SBP) and diastolic blood pressure (DBP) in children. METHODS: Cross-sectional study was conducted on 1280 schoolchildren aged 8-11 years from the Cuenca province (Spain). Data collection was conducted under standardized conditions, taking several measurements of each variable to enhance accuracy. Analyses were performed using age-adjusted correlation coefficients, and multiple linear regression adjusted for age, BMI, TST and %BF. RESULTS: Correlations between %BF and apolipoprotein (apo) B, total cholesterol, low-density lipoprotein cholesterol (LDL-c), total cholesterol/HDL-c ratio and DBP were higher than those for BMI and TST. In contrast, the correlations between BMI, and apo A-I and SBP were higher than those for %BF and TST. The results were similar across the sexes. The correlations between each of the three measures of body fatness, and blood lipids and blood pressure were highest in children with greatest BMI and %BF. When analyses were adjusted for the three body fatness measures, %BF showed stronger associations than did BMI or TST with blood lipids and blood pressure, with the exception of apo A-I and SBP, which were more closely associated with BMI. CONCLUSION: %BF from BIA is more strongly associated than either BMI or TST with most of the blood lipid fractions in schoolchildren aged 8-11 years.     

Influence of parental obesity on the physical constitution of preschool children in Japan

The objective of this study was to assess the influence of parental obesity on the physical constitution of preschool children. A total of 3187 children aged between 1–6 years and their parents were studied. A child whose per cent obesity (%OB; per cent overweight for age, height and sex) was greater than 15%, and a parent whose body mass index (BMI; kg/m²) was greater than the 95th percentile were defined to be obese (27.40 and 25.97 for a father and a mother, respectively). We found that the incidence of obesity in children with obese fathers (11.5%) was significantly higher than in those with non-obese fathers (6.2%), and a similar difference was obtained between children with obese mothers (14.5%) and with non-obese mothers (6.2%), respectively. The incidence of obesity in children was 6.0% if both parents were non-obese; this incidence rose to 22.7% if one parent was obese, and to 30.8% if both were obese. The %OB of children was more markedly correlated with the mothers' BMI (r = 0.219) than the fathers' BMI (r = 0.165). The %OB of children correlated significantly with fathers' BMI, but only from the age of 3–6 years, whereas mothers' BMI correlated from the age of 1–6 years. We concluded that parental obesity was of significance in determining the development of juvenile obesity even in the preschool period.     

Estimation of body fat in children with intellectual disability: development and cross-validation of a simple anthropometric method

ObjectivePopulation-level monitoring of body composition requires accurate, biologically-relevant, yet feasible methods for estimating percent body fat (%BF). The aim of this study was to develop and cross-validate an equation for %BF from Body Mass Index (BMI), age, and sex among children with intellectual disability (ID). This study further aimed to examine the performance of an existing BMI-based equation (Deurenberg equation) for %BF in children with ID.MethodParticipants were 107 children (63 boys; aged 6-15 years) with ID randomly allocated to development (n = 81) and cross-validation (n = 26) samples. Dual-Energy X-Ray Absorptiometry provided the criterion %BF.ResultsThe model including BMI, age, and sex (0 = male; 1 = female) had a significant goodness-of-fit in determining %BF (p < 0.001; R² = 0.69; SEE =5.68%). The equation was: %BF = – 15.416 + (1.394 × BMI) + (4.538 × age) – (0.262 × age²) + (5.489 × sex). The equation was cross-validated in the separate sample based on (i) strong correlation (r = 0.82; p < 0.001) and non-significant differences between actual and predicted %BF (28.6 ± 9.6% and 30.1 ± 7.1%, respectively); (ii) mean absolute error (MAE) = 4.4%; and (iii) reasonable %BF estimations in Bland-Altman plot (mean: 1.48%; 95% CI: 12.5, -9.6). The Deurenberg equation had a large %BF underestimation (mean: -7.1%; 95% CI: 5.3, -19.5), significant difference between actual and estimated %BF (28.6 ± 9.7% and 21.5 ± 7.0%, respectively; p < 0.001), and MAE = 8.1%.ConclusionsThe developed equation with BMI, sex, and age provides valid %BF estimates for facilitating population-level body fat screening among children with ID.     

Estimation of body fatness by air displacement plethysmography in African American and white children

The purpose of this study was to determine the ability of air displacement plethysmography (ADP) to estimate body fatness in prepubertal and early pubertal African American and white children. One hundred nineteen nonoverweight and overweight boys (N = 56) and girls (N = 63), age (mean +/- SD) 9.8 +/- 1.7 y, body mass index 25.9 +/- 7.6 kg/m2 (range, 14.2-47.0 kg/m2), and mean percent body fat (%BF) by dual-energy x-ray absorptiometry (DXA) 39.2 +/- 11.7% (range, 12.2-57.5%), were studied. %BF by ADP was compared with DXA %BF estimates and with body fat by several field methods: skinfold thicknesses using the Slaughter et al. equations (Hum Biol 60: 709-723, 1988), bioelectrical impedance analysis (BIA) using the Houtkooper et al. equation (J Appl Physiol 72: 366-373, 1992), and a predictive equation using skinfold thicknesses, BIA, and weight (Goran et al.: Am J Clin Nutr 63: 299-305, 1996). All methods used to estimate %BF were significantly correlated with DXA (all p < 0.0001), with r2 ranging from 0.85 (skinfold measurements) to 0.95 (ADP). ADP using the Siri equation underestimated %BF by -1.9% (p < 0.001); the Bland-Altman limits of agreement (defined as +/-2 SD) were +/-7.4%. %BF by ADP-Siri underestimated %BF by DXA by 3.0% for girls (p < 0.001) and by 0.6% for boys (NS). Agreement between body fat estimation by ADP and DXA did not vary with age, race, or pubertal stage. Application of the age-adjusted Lohman model to ADP significantly increased the magnitude of the underestimation to -6.9% (p < 0.0001). Prediction of %BF by the Slaughter skinfold thickness equation showed no significant mean bias for the overall data, but significantly underestimated %BF in girls (-3.7%) while overestimating %BF in boys (+2.4%) with wide limits of agreement (+/-17.7%, p < 0.01 versus ADP). %BF by the Houtkooper BIA equation or Goran model underestimated %BF to a significantly greater degree than ADP (Houtkooper, -8.1%; Goran, -10.1%; both p < 0.0001 versus DXA or ADP). Determination of %BF from ADP using the Siri model slightly underestimates %BF as determined by DXA in girls, but appears to be superior to existing field methods both in accuracy and limits of agreement. Because of the ease with which it can be performed, ADP may prove useful for investigations of adiposity in children.     

Bioelectrical impedance analysis of body fatness in childhood congenital adrenal hyperplasia and its metabolic correlates

There is a tendency to adiposity in patients with congenital adrenal hyperplasia (CAH) despite physiological corticosteroid doses. This study investigated body fatness in children with CAH under corticosteroid replacement therapy. Seventeen children with CAH (female:male, 9:8; age range 1.6–10.5 years) and 18 controls (female:male, 9:9; age range 1.4–10.2 years) were studied. Serum lipids, leptin, insulin, anthropometry, body circumferences, skinfold thickness, and body fat ratio as measured with bioelectrical impedance analysis (BIA) were the study parameters. Weight standard deviation scores (SDS), body mass index (BMI), BMI–SDS, body circumferences, skinfold thickness, and body fat ratio were higher and leptin was positively correlated with all of the body circumference and skinfold thickness parameters as well as body fat ratio in the study group. Waist/hip ratio was lower in the study group. Body fatness is a serious problem starting in early childhood in CAH patients and further refinement of the glucocorticoid replacement regimens as well as lifestyle measures are needed.     

Relationship between fat distribution and lipid and apolipoprotein profiles in young teenagers

The influence of obesity and fat distribution on serum levels of lipoprotein and apolipoprotein was investigated in 294 Japanese junior high school children (12-13 years of age). Serum levels of low-density lipoprotein cholesterol (LDLC) (P= 0.013), triglycerides (TG) (P= 0.0006), and apolipoprotein B (apoB) (P= 0.003), and the apoB/A-I ratio (P= 0.005) were significantly higher and serum levels of high-density lipoprotein cholesterol (HDLC) (P= 0.00003) and apoA-1(P = 0.003) were significantly lower in obese boys than in non-obese boys. The serum levels of TG (P = 0.013) and the apoB/A-1 ratio (P= 0.011) were significantly higher and the serum levels of HDLC (P= 0.004) was significantly lower in obese girls than in non-obese girls. The LDLC/apoB ratio was lower in obese girls than in non-obese girls (P= 0.03). Obesity ( 20% of ideal weight) was strongly correlated with the serum levels of lipids and apolipoproteins in boys; this relationship was less clear in girls. The degree of obesity and the body mass index (BMI) were more strongly correlated with serum levels of lipids and apolipoproteins in boys than in girls. In boys, atherogenic-lipoproteins and apolipoproteins, such as LDLC and apoB, showed a stronger correlation with the thickness of the triceps skinfold, while in girls the anti-atherogenic lipoproteins and apolipoproteins, such as HDLC and apoA-1, showed a stronger correlation with both the triceps and the subscapular skinfold thicknesses. In girls the relationships between the BMI and the degree of obesity and the thickness of the subscapular skinfold (S) thickness were similar to the relationships between those parameters and the triceps skinfold (T) thickness. In boys, these parameters showed a stronger correlation with the subscapular skinfold thickness than with the triceps skinfold thickness. The correlation coefficients for the relationships between skinfold thickness and lipid and apolipoprotein levels were similar to the coefficients for the relationships between skinfold thicknesses and the severity of obesity and the BMI. The distribution of central-type fat accumulation, which is indicated by the thickness of the subscapular skinfold, the S/T ratio and S-T value, was inversely correlated with the HDLC level in both boys and girls. The degree of obesity was strongly correlated with the atherogenic lipoprotein profile in boys, in part because the subscapular skinfold thickness was strongly correlated with the degree of obesity and the BMI. In girls, the correlations between indices of central-type obesity and atherogenic lipid and apolipoprotein profiles were stronger than in boys. These data suggest that childhood obesity may be an early cardiovascular risk factor.     

肥胖儿童血浆脂联素与肿瘤坏死因子-α的变化及意义

目的儿童肥胖症与血浆脂联素（ADPN）和肿瘤坏死因子-α（TNF-α）水平的变化密切相关。该文通过分析肥胖儿童血浆ADPN和TNF-α的变化及其相互关系,探讨儿童肥胖症的发病原因,为儿童肥胖症的预防提供科学依据。方法265名儿童随机分为肥胖组（147人）和正常对照组（118人）,分别测定腰围（WC）,臀围,腰臀比（WHR）,体脂百分比（%BF）,收缩压（SBP）,舒张压（DBP）,甘油三酯（TG）,总胆固醇（TC）,高密度脂蛋白胆固醇（HDL-C）,低密度脂蛋白胆固醇（LDL-C）,空腹血糖（FBG）,空腹胰岛素（FINS）,ADPN,TNF-α,计算稳态模型胰岛素抵抗指数（HOMA-IR）,并分析ADPN,TNF-α与体质量指标、糖脂代谢指标及二者的相关关系。结果①肥胖组儿童ADPN水平低于正常组儿童（P<0.05）,且与TNF-α,BMI,WHR,HOMA-IR,%BF,FINS,SBP,TG呈显著负相关（均P<0.05）;②肥胖组儿童TNF-α水平高于正常组儿童(P<0.01),且与BMI,WHR,%BF,FINS,HOMA-IR,TG,SBP呈显著正相关（P<0.01）,与HDL（P<0.05）呈负相关;③多元逐步回归分析显示ADPN,BMI和TNF-α是影响BF%的主要因素（R2=0.926）,且ADPN和TNF-α的交互作用有统计学意义。结论 肥胖儿童ADPN水平显著下降、TNF-α水平显著升高,且均是影响儿童体脂的主要因素。ADPN与TNF-α的交互作用提示二者在机体内可相互影响,共同参与儿童肥胖的形成。［中国当代儿科杂志,2009,11（1）：47-50］     

Age- and sex-specific body composition of Chinese children

We examined age- and sex-specific body compositions of Chinese children by the bioelectrical impedance method. The subjects were a total of 587 children aged 6-14 y who had normal relative weight. In all ages, boys had larger fat-free mass and lower percent body fat (%BF) than girls did. Even in the subjects with BMI <20 kg/m2, more than one quarter of them had high %BF. CONCLUSION: Chinese children may have higher %BF than that predicted by BMI.     

Serum leptin levels during childhood and adolescence: relationship with age, sex, adiposity and puberty

We studied serum leptin levels in 189 healthy children to evaluate related factors during childhood and adolescence. Leptin correlated with body mass index (BMI), triceps skinfold thickness (p<0.001) and body weight (p<0.01). Obese children and girls had higher leptin levels than non-obese children and boys, respectively (p<0.001). In girls, leptin correlated positively with age, skinfold thickness and BMI (p<0.001). In boys, leptin correlated negatively with age (p<0.001) and positively with skinfold thickness (p<0.05). Prepubertal boys had higher leptin levels than prepubertal girls and pubertal boys (p<0.05). Pubertal girls had higher leptin levels than prepubertal girls and pubertal boys (p<0.001). Leptin levels in girls were higher at Tanner stages 4 and 5 than at stage 1 (p<0.001). In conclusion, serum leptin levels are related with adiposity, have obviously age-related gender differences during childhood and adolescence, and may be involved in the maturation of reproductive capacity.     

Body mass index centile charts to assess fatness of British children.

Body mass index (BMI) relates weight to height and reflects the shape of a child, but because of age dependency it has not been used conventionally for the estimation of fatness in children. From measurements of Tayside children (n = 34,533) centile charts were constructed for BMI (wt/ht2) from the raw data of height and weight, using Cole''s LMS method for normalised growth standards. These data were compared with the only available European BMI charts published from data of French children obtained over a period of 24 years from 1956-79. British children appear to be ''fatter''. Within a subgroup (n = 445) the BMI values were correlated with estimations of body fat, for boys and girls, from skinfold thickness (r = 0.8 and 0.81) and bioelectrical impedance (r = 0.65 and 0.7). The limits of acceptable BMI have yet to be defined.     

肥胖儿童瘦素水平的变化及其与骨密度的关系

目的：探讨长沙市肥胖儿童血清瘦素水平的变化及与骨密度（BMD）、身体成分的关系,为预防和治疗儿童肥胖及骨质疏松提供科学依据。方法：从长沙市5所小学随机抽取119例肥胖儿童和103例正常儿童,采用双能X线骨密度仪（DEXA）进行全身扫描,测定骨密度及身体成分;采用酶联免疫吸附试验（ELISA）测定血清瘦素水平。结果：①肥胖儿童的身高、体重、体重指数（BMI）、腰围和腰臀比均显著高于正常儿童（P<0.01）。②肥胖儿童的全身骨密度、骨矿物质含量、瘦组织含量、脂肪组织含量、体脂百分比(%BF)及血清瘦素水平均显著高于正常儿童（P<0.01）。③血清瘦素水平与儿童全身骨密度、骨矿物质含量、瘦组织含量、脂肪组织含量均呈显著正相关（r=0.528~0.903）,其中瘦素水平与脂肪组织含量呈高度正相关（男：r=0.883,女：r=0.903）。多元逐步回归分析显示,BMI及%BF是儿童血清瘦素水平的独立影响因素。结论：肥胖儿童血清瘦素水平升高,血清瘦素水平与骨密度及身体成分显著相关,BMI、%BF是儿童血清瘦素水平的独立影响因素。［中国当代儿科杂志,2009,11（9）：745-748］     

Body mass index centile charts to assess fatness of British children

Body mass index (BMI) relates weight to height and reflects the shape of a child, but because of age dependency it has not been used conventionally for the estimation of fatness in children. From measurements of Tayside children (n = 34,533) centile charts were constructed for BMI (wt/ht2) from the raw data of height and weight, using Cole's LMS method for normalised growth standards. These data were compared with the only available European BMI charts published from data of French children obtained over a period of 24 years from 1956-79. British children appear to be 'fatter'. Within a subgroup (n = 445) the BMI values were correlated with estimations of body fat, for boys and girls, from skinfold thickness (r = 0.8 and 0.81) and bioelectrical impedance (r = 0.65 and 0.7). The limits of acceptable BMI have yet to be defined.     

Relation of subepicardial adipose tissue thickness and clinical and metabolic parameters in obese prepubertal children

HızlıŞ, Özdemir O, Abacı A, Razi CH and Kabakuş N. Relation of subepicardial adipose tissue thickness and clinical and metabolic parameters in obese prepubertal children. Background: The measurement of subepicardial adipose tissue thickness (SATT) has been found to be related to insulin resistance (IR) in adults. Until now, the association between SATT and IR has not been evaluated in obese prepubertal children. We aimed to determine the relation of SATT with clinical anthropometric and metabolic parameters and to provide cutoff value of SATT associated with IR in obese prepubertal children. Methods: Fifty‐two obese (mean age: 9.5 ± 1.6 years, 29 female) and 31 lean prepubertal age‐ and gender‐matched subjects (mean age: 9.2 ± 1.4 years, 12 female) were evaluated by echocardiography. SATT was measured by transthoracic echocardiography. Results: SATT (6.54 ± 1.38 mm) and homeostatic model assessment‐insulin resistance (HOMA‐IR) (3.2 ± 2) values of obese prepubertal subjects were significantly higher than those of the lean subjects (3.72 ± 0.57 mm and 1.6 ± 1) in the control group (both p < 0.001). Bivariate correlation analysis showed significant correlation between SATT, age, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist‐to‐hip ratio (WHR), mid‐arm circumference (MAC), triceps skin fold (TSF) thickness, insulin, and HOMA‐IR (r = 0.547, r = 0.524, r = 0.543, r = 0.431, r = 0.289, r = 0.402, r = 0.400, r = 0.328, r = 0.289, p < 0.05, respectively). As an optimal cutoff point, an SATT of 4.33 mm determined IR with 93.3% sensitivity and 51% specificity. Conclusions: Our study on obese prepubertal children showed that SATT was significantly correlated with age, BMI, WC, HC, MAC, TSF, insulin, and HOMA‐IR.     

Can skinfold thickness equations be substituted for bioimpedance analysis in children?

ObjectiveThe aim of the present study was to evaluate the agreement between the most used skinfold thickness equations with multi-frequency bioimpedance analysis in the prediction of body fat levels in children.MethodA cross-sectional study of healthy Brazilian community-dwelling individuals. The anthropometric assessment included height, body mass, arm circumference, and waist circumference. The percentage of body fat was obtained by measuring skinfold thickness equations and using bioimpedance analysis, and skinfold thickness was measured using a scientific skinfold caliper. Bland–Altman plot analysis was used to verify the agreement between the methods.ResultsThere were 439 children and adolescents evaluated, with a mean age of 11.6 ± 3.7 years. The mean body fat by bioimpedance analysis was 22.8% ± 10.4%, compared to 22.4% ± 8.8% by Slaughter (1), 20.4% ± 9.2% by Slaughter (2), 19.6% ± 4.4% by Goran, and 24.7% ± 10.0% by Huang equations. Bland–Altman plot analysis revealed limits of agreement greater than 8% between the bioimpedance analysis approach and equations, exceeding the clinically acceptable limit predefined a priori. None of the equations had good agreement with bioimpedance analysis.ConclusionIt was concluded that skinfold thickness and bioimpedance analysis should not be used interchangeably in children and adolescents.     

肥胖儿童非酒精性脂肪肝病与心血管疾病的相关性

目的：探讨肥胖儿童非酒精性脂肪肝病（NAFLD）与心血管疾病(CVD)的关系。方法：231例肥胖儿童以及24例非肥胖儿童(对照组)进行临床、生化指标及颈动脉内膜-中层厚度（IMT）各项检查,根据诊断标准将231例肥胖儿童分为肥胖无肝脏损伤组（OCWLD）75例和NAFLD组156例。比较各组儿童临床、生化各项指标及IMT。结：果NAFLD组患儿IMT为0.066±0.021 cm,显著高于OCWLD组和对照组（分别为0.060±0.011 cm,0.037±0.007 cm,均P＜0.05）,OCWLD组亦显著高于对照组,P<0.05。NAFLD组患儿高血压、高脂血症患病率分别为39.7%和40.4%,明显高于OCWLD组（分别为22.7%,29.3%）和正常对照组（分别为4.2%,12.6%）（P<0.05）。经逐步线性回归分析显示IMT与BMI、NAFLD、ALT呈正相关（调整R2=0.316,P<0.01）。结论：肥胖儿童NAFLD的出现不仅是CVD发生的早期标志,而且是CVD发生的早期状态。NAFLD的早期诊断和治疗是预防心血管疾病发生发展的关键。［中国当代儿科杂志,2010,12（7）：547-550］     

Serum lipid profile in obese children in China

BACKGROUND: The aim of the present study was to examine the serum lipid profile in obese Chinese children, their serum lipid and apolipoprotein A-I (apoA-I) and B (apoB) levels were examined. METHODS: The subjects were 153 patients (109 male and 44 female) aged 4-16 years with obesity, who attended the outpatient clinic of Beijing Children's Hospital. Percentage bodyweight (%BW) ([(bodyweight - standard weight)/standard weight]x 100) were obtained. Skinfold thickness and hip and waist circumference were measured. Percentage body fat (%BF) was estimated by bioelectrical impedance analyzer. Serum total cholesterol (TC), high density lipoprotein cholesterol (HDLC), triglyceride (TG), apoA-I and apoB levels were also measured. RESULTS: TC showed an acceptable level in 86.8% of obese children. The prevalence of high TC levels (3.3%) or high LDLC levels (6.0%) was rather low. The HDLC level was reduced in 31.3% of obese children. Anthropometric variables had no linear relationship to TC, HDLC, TG, LDLC, apoA-I or apoB, but in the older age group (over 10 years old) %BW and %BF showed a weak correlation with HDLC (r = -0.202, r = -0.211, respectively). CONCLUSION: In obese Chinese children, HDLC as well as TC levels should be examined in order to assess coronary risk.     

新疆伊犁地区2438例哈萨克族儿童血压现况分析

目的：了解新疆伊犁地区哈萨克族儿童血压水平和高血压的发生状况及影响因素。方法：2009年5~6月采用随机整群抽样方法,抽取新疆伊犁地区哈萨克族学龄儿童2438例,进行身高、体重、腰围、臀围、皮褶厚度、血压测量,并计算体质指数（BMI）。结果：2438名儿童收缩压（SBP）平均水平为94±13 mm Hg,舒张压（DBP）平均水平为60±9 mm Hg,低于国内同年龄段汉族平均水平;检出高血压儿童138名,患病率5.66%（138/2438）,其中男童患病率4.38% （54/1232）,女童患病率6.97%（84/1206）,女童患病率高于男童（P<0.05）;血压及高血压患病率与BMI、腰围、臀围、皮褶厚度、性别、年龄均呈正相关。结论新疆伊犁地区哈萨克族儿童血压平均水平较国内儿童低;女童高血压患病率高于男童;肥胖与哈萨克族儿童高血压患病率密切相关。     

Body water measurement in growth disorders: a comparison of bioelectrical impedance and skinfold thickness techniques with isotope dilution.

Total body water was estimated as part of the assessment of body composition in children with growth disorders, using the newly commercially available method of bioelectrical impedance. This was undertaken to compare the precision and accuracy of the results with those derived from skinfold thickness against measurement of stable isotopically labelled water (H2(18)O) dilution as a standard. The comparisons were carried out to see to what extent the impedance method could be applied with confidence to assessment of children with growth disorders. Total body water was derived from impedance (I) using an association with height (Ht2/I). Impedance and skinfold thickness estimates of total body water were equally precise when compared with values obtained from H2(18)O dilution (limits of agreement -1.9 to +1.3 and -1.7 to +2.0 kg respectively). The mean intraobserver coefficient of variation for repeat measurements of impedance was 0.9% compared with 4.6% for skinfold thickness with an interobserver coefficient of variation for impedance of 2.8%. Bioelectrical impedance estimation of body composition is likely to be of value in the growth clinic when expertise in measurement of skinfold thickness is limited or repeated measurements are to be undertaken by different observers.     

Comparison of body mass index and triceps skinfold at 5 years and young adult body mass index, waist circumference and blood pressure

Aim: To examine which measure of obesity at 5 years, body mass index (BMI) or triceps skinfold thickness, is most strongly associated with 21‐year risk factors for cardiovascular disease (CVD), including BMI, waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Methods: Longitudinal birth cohort study with BMI and triceps skinfold measurements at age 5, and BMI, WC and blood pressure at 21 years. Overweight and obesity at 5 years were determined according to Cole‐International Obesity Task Force standards, at 21, by World Health Organization definitions. Triceps skinfold thickness measurements were converted to a z‐score, and cut‐offs for overweight and obesity were chosen to reflect similar proportions to the BMI subgroups. BMI, WC, SBP and DBP were also measured at 21 years. Results: Five‐year BMI and triceps skinfold thickness were both significantly associated with the CVD risk measures at 21 years. For overweight/obesity at 5 years, the adjusted odds ratio (95% confidence interval) for 21‐year overweight/obesity was 5.6 (4.2, 7.4), for 21‐year WC was 1.5 (1.2, 2.0). Mean difference (95% CI) in BMI was 4.4 (3.9, 5.0), in WC 8.3 cm (6.8, 9.8), in SBP 2.4 mm Hg (0.5, 4.3), in DBP 1.1 mm Hg (0.1, 2.2). For skinfold, the similar findings were odds ratio 2.6 (2.0, 3.4) and 1.2 (0.9, 1.6) for 21‐year BMI and WC, and mean differences of 2.6 (2.0, 3.2), WC 4.8 cm (3.3, 6.3), SBP 2.3 mm Hg (0.5, 4.2) and DBP 0.7 mm Hg (?0.4, 1.8). Conclusions: In children with overweight/obesity, BMI rather than triceps skinfold is the preferred epidemiological measure for identifying young adult CVD risk markers of BMI, WC and blood pressure.     

Changes of skinfold thickness during puberty induced by pulsatile gonadotrophin-releasing hormone therapy

We have analysed the changes in triceps and subscapular skinfold thickness ratios of 66 (46 male, 20 female) children with constitutional delay of growth and puberty who progressed through puberty spontaneously and 16 (7 male, 9 female) children with delayed puberty who were treated with pulsatile gonadotrophin-releasing hormone (GnRH). The pattern of change in skinfold thickness in both groups were identical and indistinguishable from standards of normal children when later chronological ages of the patients were allowed for. We observed a decrease in skinfold ratio just prior to the onset of puberty in boys, and such an assessment may be a useful early predictor of the onset of puberty. Our data provided further evidence that all aspects of human puberty are entirely GnRH-dependent.