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Association between general and central adiposity in childhood, and change in these, with cardiovascular risk factors in adolescence: prospective cohort study

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c6224 (Published 26 November 2010) Cite this as: BMJ 2010;341:c6224

Body mass index as cardiovascular risk factor in children and adolescents

Dear Sir:

Within the context of the ALSPAC study, Lawlor et al. have evaluated
the prospective association between body mass index (BMI), waist
circumference and body fat with cardiovascular risk factors in adolescents
(1). They found that waist circumference and body fat assessed by dual-
energy x-ray absorptiometry were not associated with cardiovascular risk
factors more strongly than BMI.

We have recently measured the carotid intima media thickness (CIMT)
of children with and without non-alcoholic fatty liver disease (NAFLD) and
found that it was associated with BMI (and age) but not with other
biochemical and liver-related instrumental measurements (2).

Thus, we wish to underline the prognostic value of BMI, whose
evaluation with proper charts, e.g. (3), should enter the daily practice
of all paediatricians. The prognostic value of BMI in children and
adolescents is also important to consider its inclusion among the outcomes
associated with "disease risk reduction" by regulatory bodies, as it is
for the nutritional claims addressed to the European Food Safety Agency
(http://www.efsa.europa.eu).

1. Lawlor DA, Benfield L, Logue J, Tilling K, Howe LD, Fraser A, et
al. Association between general and central adiposity in childhood, and
change in these, with cardiovascular risk factors in adolescence:
prospective cohort study. BMJ 2010;341:c6224.

2. Manco M, Bedogni G, Monti L, Morino G, Natali G, Nobili V. Intima-
media thickness and liver histology in obese children and adolescents with
non-alcoholic fatty liver disease. Atherosclerosis 2010;209:463-8.

3. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard
definition for child overweight and obesity worldwide: international
survey. BMJ 2000;320:1240-3.

Competing interests: No competing interests

29 November 2010
Valerio Nobili
Chief of Liver Unit
Giorgio Bedogni, Anna Alisi, Carlo Agostoni
Ospedale Pediatrico "Bambino Gesu'"-IRCCS