Waist circumference provides an indication of numerous cardiometabolic risk factors in adults with cerebral palsy

Arch Phys Med Rehabil. 2014 Aug;95(8):1540-6. doi: 10.1016/j.apmr.2014.03.029. Epub 2014 Apr 15.


Objective: To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors.

Design: Cross-sectional study.

Setting: Testing took place in a laboratory setting.

Participants: Adults with CP (N=55; mean age, 37.5±13.3 y; Gross Motor Function Classification System levels, I-V) participated in this study.

Interventions: Not applicable.

Main outcome measures: Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, and C-reactive protein levels were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA-IR) index. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio, and waist-height ratio were also measured. The metabolic syndrome (MetS) was defined according to the 2009 Joint Interim Statement.

Results: The prevalence of the MetS was 20.5% in ambulatory adults and 28.6% in nonambulatory adults. BMI was associated with HOMA-IR only (β=.451; P<.01). WC was associated with HOMA-IR (β=.480; P<.01), triglycerides (β=.450; P<.01), and systolic blood pressure (β=.352; P<.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidemia, HOMA-IR, and the presence of multiple risk factors (area under the curve, .713-.763).

Conclusions: A high prevalence of the MetS was observed in this relatively young sample of adults with CP. WC was a better indicator of a number of risk factors than was BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP.

Keywords: Body mass index; Cardiovascular diseases; Cerebral palsy; Metabolic syndrome X; Rehabilitation; Risk factors; Waist circumference.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Height
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Cerebral Palsy / blood
  • Cerebral Palsy / physiopathology*
  • Cholesterol / blood*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / physiopathology
  • Insulin / blood
  • Insulin Resistance
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / physiopathology*
  • Middle Aged
  • ROC Curve
  • Risk Assessment / methods
  • Risk Factors
  • Triglycerides / blood
  • Waist Circumference*
  • Waist-Hip Ratio
  • Young Adult


  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Insulin
  • Triglycerides
  • C-Reactive Protein
  • Cholesterol