The waist-height ratio stratified and its association with haematological abnormalities in obese paediatric patients
Aranza Lilian Perea Caballero1, Ariada Guadalupe Lara Campos1, Arturo Perea Martínez1, Paul Tadeo Ríos Gallardo1, Lilia Mayrel Santiago Lagunes1, María De los Ángeles Hernández López1, Miriam Mercedes Padrón Martínez1, Ana Lídia González Valadez1, Verónica García Osorio1
1National Institute of Pediatrics, Clinical Obesity and Non Communicable disease, México, Mexico
Objectives and Study:
To determine the association between the waist-height ratio and haemoglobin
and hematocrit levels in obese patients. Descriptive, transversal, observational and retrospective study.
698 individuals between 5 and 18 years old who attended for the Obesity and Adolescents Clinic of the National Institute of Paediatrics (COAINP) with a diagnosis of overweight (Z score of Body Mass Index [BMI] above +1 Standard Deviation [SD] and up to +1.99 DE for age/sex) and obesity (BMI Z score above +2 SD for age/sex) according to international standards without presenting any intercurrent pathology. The waist-height ratio (W/H ratio) was established at different parameters. The values of low haemoglobin (anaemia) and high hematocrit were according to the criteria of the World Health Organization (WHO). Low haemoglobin was defined as < 114 g/l for < 11 years old and < 120g/l for >12 years old. High hematocrit was defined as >41% for girls and >43% for boys. All patients included in the study live in locations above 7300 feet above sea level. Software IBM SPSS Statistics V.24.
Elevation of Hemoglobin (Hb) and hematocrit (hto) were the most frequent findings. In the W/H ratio stratum the elevation of ALT is more frequent with a percentage of 65%, increasing the resulting proportion directly with the W/H ratio value reaching up to 79 % in stratum 0.65 – 0.69. The GGT was found to be elevated in more than 40% of the cases from the W/H ratio stratum of 0.55 – 0.59, maintaining an ascending value as the W/H ratio increased. Hyperuricemia was found in more than 50% of the cases in strata 0.60 – 0.64 and 0.65 – 0.69; however, the increase was not directly related to the value of W/H ratio of strata with higher value. The results reflect the high relationship between stratified W/H ratio with an elevated hematocrit and haemoglobin.
Recent studies demonstrate an association between blood lipid levels, haematologic profile and body fat in obese adolescents, positive correlations were found for red blood cells and haemoglobin with waist circumference (WC). Various cross-sectional studies have demonstrated a stronger association of W/H ratio with cardiovascular risk factors compared to BMI and WC.
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with high hematocrit and haemoglobin levels either within the normal range or outside of this. However, there are not enough studies have been conducted to describe any possible associations between body fat and haematological variables, and so this topic is poorly discussed in the current literature. In the present study, the value of W/H ratio above 0.50 as a concept of central obesity, relates in a general way to a greater possibility of presenting high values of Hb and hto, an aspect that presumably could constitute an early index of hypoventilation and OSAHS, allowing an earlier detection of this last disease. It indicates the clinicians who treat obesity, the importance of investigating these parameters of the blood count, as sensors of this highly incapacitating clinical condition that is added to the cardiovascular risk.
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