Gender and urban-rural difference in anthropometric indices predicting dyslipidemia in Chinese primary school children: a cross-sectional study

Background: Childhood dyslipidemia is a critical factor of lifelong health. Therefore, screening and controlling dyslipidemia from childhood is a practical healthy strategy. However, few studies have examined the performance of anthropometric predictors of dyslipidemia in Chinese children, let alone the potential gender and urban-rural disparity. Thus, we evaluated anthropometric indices predicting dyslipidemia by genders and living areas in Chinese children.

Methods: Data were from a health and nutrition survey conducted in seven urban areas and two rural areas in China between 2011 and 2012. The serum lipid levels of the participants were compared between genders and living areas. The body mass index z-score (BMI z-score), waist-hip ratio (WHR), waist-height ratio (WHtR), and mid-upper arm height ratio (MaHtR) were used as predictors. The receiver operating characteristic (ROC) analysis was performed to investigate the ability of anthropometric indices predicting dyslipidemia.

Results: A total of 773 participants (average age = 9.3 ± 1.7 y) were included. The prevalence of dyslipidemia was 10.9%. Anthropometric indices were all significantly related to blood lipid profiles in boys after adjustment for age. The areas under the ROC curves (ACUs) were significantly larger than 0.5 in boys (ranged between 0.66-0.73), and were larger in rural boys (ranged between 0.68 and 0.94). MaHtR and WHR were associated with the highest specificity (93.8%) and highest sensitivity (100%), respectively.

Conclusion: Using anthropometric indices, screening for dyslipidemia may be more appropriate in boys than in girls in China, especially in rural boys. The BMI z-score, WHR, WHtR, and MaHtR were all significantly associated with dyslipidemia in boys; using WHR and MaHtR as indicators achieved the highest sensitivity and specificity, respectively.