Reference centile curves for triceps skinfold thickness for Indian children aged 5–17 years and cut-offs for predicting risk of childhood hypertension: A multi-centric study

Objectives To create age- and gender-specific Triceps Skinfold Thickness percentile curves for Indian children; and to determine cut-offs for predicting the risk of childhood hypertension. Design Cross-sectional. Setting Multicentric, school-based, 5 major Indian cities Participants 13375 children (7590 boys) aged 5-17 years Procedure Data on height, weight, blood pressure, triceps skinfold thickness (using Harpenden Skinfold caliper) were collected. Reference triceps skinfold thickness percentile curves were derived for boys and girls by LMS (lambda-mu-sigma) method. Receiver operating curve analyses were performed to determine the optimal cut-off of triceps skinfold thickness centile for predicting the risk of hypertension. Results Percentile curves for boys plateau around 13 years whereas for girls the curves increase steadily till the age of 17 years. Median triceps skinfold thickness increased by 7% to 9% till the age of 9 years in boys and girls. After 12 years, median triceps skinfold thickness decreased by 1% to 2% in boys but increased by 3% to 4% in girls. The optimal cut-off percentile yielding maximal sensitivity (68%) and specificity (74-78%) for predicting high blood pressure was the 70th triceps skinfold thickness percentile in both genders. Conclusions Percentile curves for triceps skinfold thickness developed in the present study would be useful in the assessment of adiposity and the risk of hypertension in Indian children.