Is the association of continuous metabolic syndrome risk score with body mass index independent of physical activity? The CASPIAN-III study

  • Heshmat, Ramin (Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences) ;
  • shafiee, Gita (Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences) ;
  • Kelishadi, Roya (Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences) ;
  • Babaki, Amir Eslami Shahr (Research Department, Tehran Heart Center, Tehran University of Medical Sciences) ;
  • Motlagh, Mohammad Esmaeil (Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences) ;
  • Arefirad, Tahereh (Department of Exercise Physiology, Science and Research Branch, Islamic Azad University) ;
  • Ardalan, Gelayol (Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences) ;
  • Ataie-Jafari, Asal (Department of Nutrition, Faculty of Medicine, Science and Research Branch, Islamic Azad University) ;
  • Asayesh, Hamid (Department of Medical Emergencies, Qom University of Medical Sciences) ;
  • Mohammadi, Rasool (Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences) ;
  • Qorbani, Mostafa (Department of Community Medicine, School of Public Health, Alborz University of Medical Sciences)
  • Received : 2013.11.02
  • Accepted : 2015.04.19
  • Published : 2015.08.01


BACKGROUND/OBJECTIVES: Although the association of body mass index (BMI) with metabolic syndrome (MetS) is well documented, there is little knowledge on the independent and joint associations of BMI and physical activity with MetS risk based on a continuous scoring system. This study was designed to explore the effect of physical activity on interactions between excess body weight and continuous metabolic syndrome (cMetS) in a nationwide survey of Iranian children and adolescents. SUBJECTS/METHODS: Data on 5,625 school students between 10 and 18 years of age were analyzed. BMI percentiles, screen time activity (STA), leisure time physical activity (LTPA) levels, and components of cMetS risk score were extracted. Standardized residuals (z-scores) were calculated for MetS components. Linear regression models were used to study the interactions between different combinations of cMetS, LTPA, and BMI percentiles. RESULTS: Overall, 984 (17.5%) subjects were underweight, whereas 501 (8.9%) and 451 (8%) participants were overweight and obese, respectively. All standardized values for cMetS components, except fasting blood glucose level, were directly correlated with BMI percentiles in all models (P-trend < 0.001); these associations were independent of STA and LTPA levels. Linear associations were also observed among LTPA and standardized residuals for blood pressure, high-density lipoprotein, and waist circumference (P-trend < 0.01). CONCLUSIONS: Our findings suggest that BMI percentiles are associated with cMetS risk score independent of LTPA and STA levels.


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