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Elizabeth Denney-Wilson, PhD, MPH, BN; Louise L. Hardy, PhD, MPH (Hons); Timothy Dobbins, PhD; Anthony D. Okely, EdD; Louise A. Baur, MBBS (Hons), BSc (Med), PhD

Arch Pediatr Adolesc Med. 2008;162(6):566-573.

Objective  To determine the association between measures of adiposity (body mass index and waist circumference) and risk factors for heart disease, type 2 diabetes, fatty liver disease, and the clustering of risk factors in middle adolescence.

Design  Cross-sectional study.

Setting  Secondary schools in Sydney.

Participants  Grade 10 students (N = 496; 58.4% boys; mean [SD] age, 15.4 [0.4] years).

Main Exposures  Height, weight, waist circumference, blood pressure, and fasting blood samples.

Outcome Measures  Participants were categorized as overweight or obese using the International Obesity Task Force cut points and the UK waist circumference cut points. Blood was analyzed for high- and low-density lipoprotein cholesterol, triglycerides, insulin, glucose, alanine aminotransferase, -glutamyltransferase, and high-sensitivity C-reactive protein levels, and the results were categorized as normal or abnormal according to published guidelines where possible. Associations between overweight and obesity and risk factors were explored using logistic regression. Clustering of risk factors within individuals was also explored.

Results  Insulin (P < .001), alanine aminotransferase (P < .001), -glutamyltransferase (P = .005), high-density lipoprotein cholesterol (P < .001), high-sensitivity C-reactive protein (P < .001), and blood pressure (P < .001) were significantly associated with overweight and obesity in adolescent boys. In adolescent girls, insulin, high-density lipoprotein cholesterol (P < .001), and high-sensitivity C-reactive protein (P < .001) were significantly associated with overweight and obesity. Obese adolescent boys and girls were significantly more likely to have 2 or more risk factors (boys: 73.5% vs 7.6%; girls: 44.4% vs 5.4%; P < .001 for both) than nonoverweight adolescents.

Conclusions  Overweight and obese adolescents, especially boys, are at substantial risk for chronic conditions. Waist circumference is not a better predictor of metabolic risk factors than is body mass index.

Author Affiliations: NSW Centre for Overweight and Obesity (Drs Denney-Wilson, Hardy, and Baur), School of Public Health (Dr Dobbins), and Discipline of Paediatrics and Child Health (Drs Denney-Wilson and Baur), University of Sydney, Sydney; and Child Obesity Research Centre, University of Wollongong, Wollongong (Dr Okely), Australia.