Body mass index as a surrogate measure of cardiovascular risk factor clustering in fifth-grade children: results from the coronary artery risk detection in the Appalachian Communities Project.

BACKGROUND

Obesity, an increasing problem in children in the United States and abroad, has been associated with risk factors for cardiovascular disease (CVD). Consequently, there is a need to determine body mass index (BMI) cut-off values for recommending comprehensive assessment and intervention for high-risk children. The objective of this study was to use results from a large-scale cross-sectional screening project, the Coronary Artery Risk Detection in Appalachian Communities (CARDIAC), to derive BMI cut-off values that predict clustering of CVD risk factors. Design. 29 436 fifth grade West Virginia students in the United States participated in a comprehensive risk factor screening between 1997 and 2006.

METHODS

Screening included the calculation of BMI, resting blood pressure, presence or absence of acanthosis nigricans, and a fasting lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides). Factor analysis and receiver operating characteristic curves were used to examine BMI as a predictor for CVD risk factor clustering.

RESULTS

BMI at the 95th percentile or higher were shown to be specific and sensitive predictors when three or more CVD risk factor clusters were present.

CONCLUSION

These findings suggest that BMI, a cost-effective assessment tool, can be used to identify CVD risk-factor clustering at the 95th percentile.