Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Cardiol. Aug 26, 2013; 5(8): 295-304
Published online Aug 26, 2013. doi: 10.4330/wjc.v5.i8.295
Central obesity in Yemeni children: A population based cross-sectional study
Mohamed Bamoshmoosh, Luciano Massetti, Hameed Aklan, Mahdi Al-Karewany, Husni Al Goshae, Pietro Amedeo Modesti
Mohamed Bamoshmoosh, Hameed Aklan, Mahdi Al-Karewany, Husni Al-Goshae, University of Science and Technology, Sana’a 15201, Yemen
Luciano Massetti, Institute of Biometeorology, National Research Council, 50134 Florence, Italy
Pietro Amedeo Modesti, Department of Clinical and Experimental Medicine, University of Florence, Azienda Ospedaliero Universitaria Careggi, 50134 Florence, Italy
Author contributions: Bamoshmoosh M and Modesti PA drafted the manuscript; Bamoshmoosh M, Massetti L, Aklan H, Al-Karewany M, Al-Goshae H and Modesti PA were involved in the conception and design of the study; Aklan H, Al-Karewany M and Al-Goshae H coordinated data collection for the study; Modesti PA wrote the statistical analysis plan and provided statistical advice; Massetti L conducted the main analyses; Modesti PA is the guarantor.
Supported by HYpertension and Diabetes in Yemen Project is part of the Executive Programme of Scientific and Technological Cooperation between Italy and Yemen for the years 2006-2009; MIUR (Direzione Generale per le strategie e lo sviluppo dell’internazionalizzazione della ricerca scientifica e tecnologica), Rome, Italy; and Menarini International Operations Luxembourg SA
Correspondence to: Pietro Amedeo Modesti, MD, PhD, Department of Clinical and Experimental Medicine, University of Florence, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy. pamodesti@unifi.it
Telephone: +39-55-4979376 Fax: +39-55-4378638
Received: March 6, 2013
Revised: June 20, 2013
Accepted: July 25, 2013
Published online: August 26, 2013
Processing time: 182 Days and 20.8 Hours
Abstract

AIM: To establish percentile curves and to explore prevalence and correlates of central obesity among Yemeni children in a population based cross-sectional study.

METHODS: A representative sample of 3114 Yemeni children (1564 boys, 1550 girls) aged 6-19 years participating in the HYpertension and Diabetes in Yemen study was studied. Data collection was conducted at home by survey teams composed of two investigators of both genders. Study questionnaire included questions about demographics, lifestyle, and medical history. Anthropometric measurements included body weight, height, waist circumference (WC) and hip circumferences. Waist to hip ratio (WHR) and waist-to-height ratio (WHtR) were then calculated. Age and gender specific smoothed percentiles of WC, WHR, and WHtR were obtained using lambda-mu-sigma parameters (LMS method). The independent predictors of central obesity defined as (1) WC percentile ≥ 90th; (2) WHtR ≥ 0.5; or (3) WC percentile ≥ 90th and WHtR ≥ 0.5, were identified at multivariate logistic regression analysis adjusted for age, gender, urban/rural location, years of school education, sedentary/active life-style.

RESULTS: Percentile curves for WC, WHR and WHtR are presented. Average WC increased with age for both genders. Boys had a higher WC than girls until early adolescence and thereafter girls had higher values than boys. WHR decreased both in boys and girls until early adolescence. Thereafter while in boys it plateaued in girls it continued to decrease. Mean WHtR decreased until early adolescence with no gender related differences and thereafter increased more in girls than in boys towards adult age. Prevalence of central obesity largely varied according to the definition used which was 10.9% for WC ≥ 90th percentile, 18.3% for WHtR ≥ 0.5, and 8.6% when fulfilling both criteria. At adjusted logistic regression WC ≥ 90th percentiles and WHtR ≥ 0.5 were less prevalent in rural than in urban areas (OR = 0.52, 95%CI: 0.41-0.67 and 0.66, 0.54-0.79 respectively), being more prevalent in children with sedentary lifestyle rather than an active one (1.52, 95%CI: 1.17-1.98 and 1.42, 95%CI: 1.14-1.75, respectively).

CONCLUSION: Yemeni children central obesity indices percentile curves are presented. Central obesity prevalence varied according to the definition used and was more prevalent in urban sedentary subjects.

Keywords: Central obesity; Waist circumference; Waist-to-height ratio; Waist to hip ratio; Developing countries

Core tip: This study presents the first central obesity percentile curves of waist circumference (WC), waist-to-height ratio (WHtR) and waist to hip ratio (WHR) for Yemeni children aged six to nineteen years. WC, WHtR and WHR changed similarly in girls and boys until early adolescence. Thereafter, differently from what observed in Western countries, obesity increased more in girls than in boys. Prevalence of central obesity in Yemeni children is low, being associated with urbanization and sedentary lifestyle, and varied according to the definition used: (1) WC percentile ≥ 90th (10.9%); (2) WHtR ≥ 0.5 (18.3%); (3) WC percentile ≥ 90th and WHtR ≥ 0.5 (8.6%).