Effect of BMI on cardiovascular and metabolic syndrome risk factors in an Appalachian pediatric population

Figures & data

Figure 1 Proportion of individuals from C8 Health Project and NHANES data by BMI percentile. The proportion of individuals within each BMI percentile from the NHANES and C8 populations were plotted in an overlaid histogram. The bottom area of each bar shaded darkest gray is where the two populations overlap. The top portion of each bar that is a lighter gray is the proportion that is greater among the C8 population, and the lightest gray is the proportion that is greater among the NHANES population.

Abbreviations: BMI, body mass index; NHANES, National Health and Nutrition Examination Survey.

Table 1 Characteristics of population by BMI category, mean (SEM) or n (%), adjusted for age

	<85% 8,093 (62.2%)	85%–<95% 2,163 (16.6%)	>95% 2,762 (21.2%)	Linear P-value trend
Age (years)	13.3 (0.05)	13.0 (0.10)	11.8 (0.09)	<0.0001
Race (% white)	7,748 (96.4%)	2,063 (96.0%)	2610 (95.5%)	0.01
Serum C8 (ng/mL)	67.3 (1.25)	64.1 (2.42)	61.6 (2.23)	0.03
Total cholesterol (mg/dL)	158.8 (0.36)	164.9 (0.69)	169.3 (0.64)	<0.0001
LDL cholesterol (mg/dL)	86.0 (0.30)	91.2 (0.59)	93.9 (0.55)	<0.0001
VLDL cholesterol (mg/dL)	21.3 (0.15)	25.7 (0.29)	30.0 (0.27)	<0.0001
HDL cholesterol (mg/dL)	51.2 (0.13)	47.7 (0.25)	44.0 (0.23)	<0.0001
Triglycerides (mg/dL)	108.2 (0.87)	132.2 (1.69)	160.8 (1.56)	<0.0001
Fasting glucose (mg/dL)	90.3 (0.25)	91.3 (0.46)	91.8 (0.43)	0.002
Non-fasting glucose (mg/dL)	90.9 (0.25)	92.4 (0.49)	94.4 (0.45)	<0.0001
Fasting insulin (μIU/mL)	8.85 (0.29)	12.7 (0.53)	17.9 (0.49)	<0.0001
White blood cell count (×10^3/μL)	7.05 (0.02)	7.50 (0.04)	7.92 (0.04)	<0.0001
C-reactive protein (mg/L)	1.21 (0.06)	2.02 (0.11)	2.81 (0.10)	<0.0001
Serum albumin (g/dL)	4.65 (0.003)	4.60 (0.01)	4.55 (0.01)	<0.0001
Serum creatinine (mg/dL)	0.73 (0.002)	0.73 (0.003)	0.73 (0.003)	0.86
Female
Free testosterone (pg/mL)	0.49 (0.01)	0.75 (0.02)	0.94 (0.02)	<0.0001
Total testosterone (ng/dL)	31.7 (0.27)	35.3 (0.53)	37.2 (0.55)	<0.0001
Male
Free testosterone (pg/mL)	6.11 (0.07)	6.21 (0.13)	6.01 (0.11)	0.42
Total testosterone (ng/dL)	231.9 (2.20)	201.6 (4.20)	178.6 (3.57)	<0.0001

Abbreviations: BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; SEM, standard error of the mean; VLDL, very low-density lipoprotein.

Table 2 Correlations with C8 (Spearman rank correlation coefficient)

	<85%	85%–<95%	≥95%
BMI percentile	−0.02456*	−0.03361	0.00412
Total cholesterol (mg/dL)	0.04479*	0.03377	0.07740*
LDL cholesterol (mg/dL)	0.02979*	0.02518	0.04411*
VLDL cholesterol (mg/dL)	0.04645*	0.04134	0.06047*
HDL cholesterol (mg/dL)	−0.00029	−0.00409	−0.01213
Triglycerides (mg/dL)	0.04823*	0.03234	0.06777*
Fasting glucose (mg/dL)	−0.00188	0.10700*	0.02028
Non-fasting glucose (mg/dL)	0.02604	−0.03547	−0.01459
Fasting insulin (μIU/mL)	−0.04550*	0.01198	0.00494
White blood cell count (×10^3/μL)	0.04880*	−0.01410	0.00571
C-reactive protein (mg/L)	−0.10378*	−0.10024*	−0.08683*
Serum albumin (g/dL)	0.10413*	0.17531*	0.16837*
Serum creatinine (mg/dL)	−0.01688	0.2199	−0.03466
Female
Free testosterone (pg/mL)	−0.09151*	−0.03225	−0.04083
Serum testosterone (ng/dL)	−0.12990*	−0.07554*	−0.11314*
Male
Free testosterone (pg/mL)	−0.05028*	−0.04214	−0.01605
Serum testosterone (ng/dL)	−0.07826*	−0.05937	−0.04114

Note:

* P<0.05.

Abbreviations: BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; VLDL, very low-density lipoprotein.

Table 3 Characteristics of population by metabolic syndrome, mean (SEM), adjusted for age

	Non-cases 11,071 (95.4%)	Cases 539 (4.64%)	P-value
Age (years)	13.6 (0.04)	14.3 (0.18)	<0.0001
Race (% white)*	10,569 (96.2%)	511 (95.3%)	0.34
BMI percentile	63.6 (0.28)	97.8 (1.27)	<0.0001
Serum C8 (ng/mL)	65.0 (1.02)	67.6 (4.61)	0.59
Total cholesterol (mg/dL)	161.5 (0.29)	170.2 (1.32)	<0.0001
LDL cholesterol (mg/dL)	88.3 (0.25)	91.5 (1.17)	0.007
VLDL cholesterol (mg/dL)	22.9 (0.12)	42.0 (0.57)	<0.0001
HDL cholesterol (mg/dL)	49.9 (0.11)	34.0 (0.48)	<0.0001
Triglycerides (mg/dL)	117.4 (0.70)	233.5 (3.18)	<0.0001
Fasting glucose (mg/dL)	90.4 (0.20)	97.8 (0.88)	<0.0001
Fasting insulin (μIU/mL)	10.6 (0.23)	28.6 (1.02)	<0.0001
White blood cell count (×10^3/μL)	7.25 (0.02)	8.19 (0.09)	<0.0001
C-reactive protein (mg/L)	1.61 (0.05)	2.71 (0.21)	<0.0001
Serum albumin (g/dL)	4.63 (0.003)	4.53 (0.01)	<0.0001
Serum creatinine (mg/dL)	0.73 (0.001)	0.74 (0.006)	0.003
Female
Free testosterone (pg/mL)	0.60 (0.01)	1.03 (0.05)	<0.0001
Total testosterone (ng/dL)	33.1 (0.23)	37.8 (1.36)	0.0006
Male
Free testosterone (pg/mL)	6.14 (0.05)	5.61 (0.20)	0.01
Total testosterone (ng/dL)	219.0 (1.78)	150.9 (6.73)	<0.0001

Note:

* Variable reported as frequency and percent relative to the column attribute.

Abbreviations: BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; VLDL, very low-density lipoprotein; SEM, standard error of the mean.

Table 4 C8 and NHANES population comparisons, mean (95% CLM) or percent (95% confidence interval)

	C8	NHANES*
Age	12.9 (12.9, 13.0)	10.6 (10.3, 11.0)
Mean BMI percentile	65.4 (64.9, 66.0)	61.4 (59.1, 63.7)
Metabolic syndrome	4.64 (4.26, 5.03)	3.40 (0.83, 5.97)

Note:

* Survey procedures accounted for NHANES weights.

Abbreviations: BMI, body mass index; CLM, confidence limit for the mean; NHANES, National Health and Nutrition Examination Survey.