Association of anthropometric indices with continuous metabolic syndrome in children and adolescents: the CASPIAN-V study

  • Hanieh-Sadat Ejtahed
  • Mostafa Qorbani
  • Mohammad Esmaeil Motlagh
  • Pooneh Angoorani
  • Shirin Hasani-Ranjbar
  • Hasan Ziaodini
  • Majzoubeh Taheri
  • Zeinab Ahadi
  • Shaghayegh Beshtar
  • Tahereh Aminaee
  • Ramin HeshmatEmail author
  • Roya KelishadiEmail author
Original Article



This study aims to examine the association of anthropometric indices with continuous metabolic syndrome (cMetS) among Iranian children and adolescents.


This multicentric study was conducted on 14138 students aged 7–18 years, who participated in a national surveillance program. Fasting blood sample was obtained from a subsample of 3843 randomly selected students. Physical examination including the measurement of anthropometric indices and blood pressure was conducted; fasting blood glucose and lipid profile were measured; and cMetS score was computed. Standardized residuals (z-scores) were calculated for MetS components. A higher cMetS score indicates a less favorable metabolic profile. Linear regression models were applied to determine the association between cMetS and anthropometric indices.


The study participants consisted of 3843 children and adolescents (52.3% boys) with mean (SD) age of 12.45 ± 3.04 years. All anthropometric indices had positive correlation with standardized scores of mean arterial pressure, waist circumference and cMetS (P < 0.05). Standardized scores of triglycerides were positively correlated with weight and body mass index (P < 0.05). In multivariate model, general and abdominal obesity, as well as high circumferences of neck, wrist, and hip circumferences increased the standardized cMetS risk score to 1.8, 1.9, 1.6, 1.5 and 1.5, respectively (P < 0.05 for all variables).


The results demonstrated that higher anthropometric indices are associated with higher cMetS risk score in children and adolescents. This information could be valuable for screening and prevention of MetS at population level.

Level of evidence

V, cross-sectional descriptive study (National surveillance study).


Continuous metabolic syndrome Anthropometric indices General obesity Abdominal obesity Children Adolescents 



This study was supported by the Ministry of Health and Medical education, Ministry of Education and Training, Isfahan University of Medical Sciences, and Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences. We are indebted to the participating schools, families and students in the study for their cooperation.

Compliance with ethical standards


This study was funded by the Ministry of Health and Medical education, Ministry of Education and Training, Isfahan University of Medical Sciences, and Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences (Grant no. 194049).

Conflict of interest

The corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent and oral assent were obtained from parents and participants, respectively.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Hanieh-Sadat Ejtahed
    • 1
  • Mostafa Qorbani
    • 2
  • Mohammad Esmaeil Motlagh
    • 3
  • Pooneh Angoorani
    • 4
  • Shirin Hasani-Ranjbar
    • 1
  • Hasan Ziaodini
    • 5
  • Majzoubeh Taheri
    • 6
  • Zeinab Ahadi
    • 7
  • Shaghayegh Beshtar
    • 8
  • Tahereh Aminaee
    • 6
  • Ramin Heshmat
    • 7
    Email author
  • Roya Kelishadi
    • 9
    Email author
  1. 1.Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences InstituteTehran University of Medical SciencesTehranIran
  2. 2.Non-Communicable Diseases Research CenterAlborz University of Medical SciencesKarajIran
  3. 3.Department of PediatricsAhvaz Jundishapur University of Medical SciencesAhvazIran
  4. 4.Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
  5. 5.Health Psychology Research CenterEducation MinistryTehranIran
  6. 6.Office of Adolescents and School HealthMinistry of Health and Medical EducationTehranIran
  7. 7.Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
  8. 8.Student Research Committee, School of Paramedical SciencesIran University of Medical SciencesTehranIran
  9. 9.Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable DiseaseIsfahan University of Medical SciencesIsfahanIran

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