**5. Conclusion**

*Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases...*

**Parameters OR(95% CI) P value OR (95% CI)** BMI 1.340 (1.005–1.788) 0.046 1.258(0.925–1.709) NC 1.208 (0.903–1.617) 0.203 1.080(0.763–1.530) WC 1.143 (1.017–1.285) 0.025 1.115(0.975–1.276) WHtR 1.510 (1.106–1.666) 0.579 1.413(0.752–1.777)

BMI 1.150 (0.909–1.456) 0.244 1.210(0.941–1.558) NC 1.076 (0.856–1.354) 0.529 1.189(0.901–1.571) WC 1.069 (0.973–1.174) 0.164 1.120(1.004–1.249) WHtR 1.042 (0.144–1.317) 0.092 0.172(0.093–3.181)

BMI 0.987 (0.827–1.177) 0.884 1.009(0.838–1.215) NC 0.831 (0.701–0.986) 0.034 0.813(0.663–0.998) WC 0.975 (0.910–1.045) 0.479 0.983(0.907–1.066) WHtR 0.137(0.124–1.432) 0.083 0.978(0.809–1.183) *P value < 0.05 = statistical significant; CI = confidence interval; OR = odds ratio; NC = Neck Circumference (cm);* 

**Unadjusted Adjusted for age and** 

**Systolic blood pressure**

*); WHtR = waist to height ration.*

**gender**

The main purpose of the study was to determine the relationship of blood pressure, blood glucose with anthropometric parameters among Ellisras children

*Binary logistic regression analysis of anthropometric parameters with systolic and diastolic blood pressure.*

which corroborates the previous findings that increased NC is an emerging risk factor for high blood glucose [12]. However, it is difficult to explain in the present study why only NC was associated with fasting blood glucose, although BMI, WC and WHtR are also anthropometric parameters. One possible explanation for these findings may be that different anthropometric parameters have varied impact on blood glucose. The mechanism linking anthropometric parameters with blood glucose levels is not clear but main schools of thought on the matter suggest different mechanisms. Firstly, in obesity (i.e WHR >0.90 or BMI >30 kg/m2), abundance of circulating fatty acids and liver-derived triglyceride (VLDL) provide an excellent fuel for muscle, decreasing their requirement for glucose [13]. People with obesity tend to be sedentary, and thus muscle consumes less glucose [14]. In obesity, increased delivery of fatty acids to the liver (as in visceral obesity) enhances gluconeogenesis and thus leading to production of glucose [15]. In obesity the increased fatty acid cause insulin resistance directly by activating enzymes that decrease the response to insulin, thereby aggravates the pre-existing insulin resistance which results in elevated blood glucose level and eventually type 2 diabetes mellitus [16]. The study also demonstrated that NC, WC and BMI are significantly associated

with blood pressure, which confirms the observations of the previous findings

The present study showed that NC is significantly associated with blood glucose,

aged 6 to 11 years old and several major findings emerged.

*WC = waist circumference (cm); BMI = body mass index (kg/m2*

**114**

**4. Discussion**

**Table 4.**

**Diastolic blood pressure**

**Fasting blood glucose**

The study shows that both blood glucose and blood pressure are associated with some anthropometric parameters. These findings suggest that it is crucial to manage and control traditional risk factors in rural South African communities in Ellisras in order to decelerate the increase in obesity, hypertension and type 2 diabetes mellitus and to reduce the burden of cardiovascular disease. The present study highlights the need of incorporating body mass index (BMI), waist circumference (WC), neck circumference (NC) and waist-height ratio (WHtR) while evaluating the association of easily accessed anthropometric parameters with CVD risk factors.
