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Role of the waist/height ratio in the cardiometabolic risk assessment of children classified by body mass index.
J Am Coll Cardiol. 2013 Aug 20; 62(8):742-51.JACC

Abstract

OBJECTIVES

The aim of this study was to determine the utility of waist/height ratio (WHtR) in the specification of cardiometabolic risk in children already stratified by body mass index (BMI).

BACKGROUND

Reflective of its association with cardiometabolic risk, BMI is a commonly used indirect indicator of adiposity in children. The WHtR, a marker of central adiposity, has been advocated as a possibly superior indicator of cardiometabolic risk.

METHODS

Cross-sectional analysis of 5 National Health and Nutrition Examination Surveys from 1999 to 2008 (ages 5 to 18 years of age). The BMI percentile categories (normal, overweight, and obese) were further stratified on the basis of WHtR (<0.5, 0.5 to <0.6, ≥ 0.6). Outcome measures were lipid and glycemic profiles, C-reactive protein, liver transaminases, prevalence of hypertension, and metabolic syndrome.

RESULTS

Data were available for 14,493 subjects. Overweight and obese subjects with a WHtR <0.5 had a cardiometabolic risk approaching that of subjects with a normal BMI percentile category. Increasing WHtR was significantly associated with increased cardiometabolic risk in overweight and obese subjects, with the greatest associations observed in the obese population. Of obese subjects with WHtR ≥ 0.6, 26% had elevated non-high-density lipoprotein levels, 18% had elevated C-reactive protein levels, 69% had an elevated homeostatic model assessment-insulin resistance, and 32% had metabolic syndrome.

CONCLUSIONS

The WHtR further specifies cardiometabolic risk within classifications stratification on the basis of BMI percentile. A significant proportion of obese children with increased WHtRs have abnormal cardiometabolic risk factor levels. The WHtR should be included in the routine screening and assessment of overweight and obese children, and those with an elevated WHtR should undergo a further cardiometabolic risk assessment.

Authors+Show Affiliations

Department of Pediatrics, University of Toronto, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23500256

Citation

Khoury, Michael, et al. "Role of the Waist/height Ratio in the Cardiometabolic Risk Assessment of Children Classified By Body Mass Index." Journal of the American College of Cardiology, vol. 62, no. 8, 2013, pp. 742-51.
Khoury M, Manlhiot C, McCrindle BW. Role of the waist/height ratio in the cardiometabolic risk assessment of children classified by body mass index. J Am Coll Cardiol. 2013;62(8):742-51.
Khoury, M., Manlhiot, C., & McCrindle, B. W. (2013). Role of the waist/height ratio in the cardiometabolic risk assessment of children classified by body mass index. Journal of the American College of Cardiology, 62(8), 742-51. https://doi.org/10.1016/j.jacc.2013.01.026
Khoury M, Manlhiot C, McCrindle BW. Role of the Waist/height Ratio in the Cardiometabolic Risk Assessment of Children Classified By Body Mass Index. J Am Coll Cardiol. 2013 Aug 20;62(8):742-51. PubMed PMID: 23500256.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of the waist/height ratio in the cardiometabolic risk assessment of children classified by body mass index. AU - Khoury,Michael, AU - Manlhiot,Cedric, AU - McCrindle,Brian W, Y1 - 2013/04/02/ PY - 2012/09/24/received PY - 2012/12/24/revised PY - 2013/01/08/accepted PY - 2013/3/19/entrez PY - 2013/3/19/pubmed PY - 2014/2/5/medline KW - BMI KW - C-reactive protein KW - CRP KW - HDL KW - HOMA-IR KW - LDL KW - NHANES KW - National Health and Nutrition Examination Survey KW - TC KW - TG KW - WHtR KW - adiposopathy KW - body mass index KW - body weights and measures KW - epidemiology KW - high-density lipoprotein KW - homeostatic model assessment of insulin resistance KW - low-density lipoprotein KW - obesity KW - overweight KW - risk factors KW - total cholesterol KW - triglyceride KW - waist/height ratio SP - 742 EP - 51 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 62 IS - 8 N2 - OBJECTIVES: The aim of this study was to determine the utility of waist/height ratio (WHtR) in the specification of cardiometabolic risk in children already stratified by body mass index (BMI). BACKGROUND: Reflective of its association with cardiometabolic risk, BMI is a commonly used indirect indicator of adiposity in children. The WHtR, a marker of central adiposity, has been advocated as a possibly superior indicator of cardiometabolic risk. METHODS: Cross-sectional analysis of 5 National Health and Nutrition Examination Surveys from 1999 to 2008 (ages 5 to 18 years of age). The BMI percentile categories (normal, overweight, and obese) were further stratified on the basis of WHtR (<0.5, 0.5 to <0.6, ≥ 0.6). Outcome measures were lipid and glycemic profiles, C-reactive protein, liver transaminases, prevalence of hypertension, and metabolic syndrome. RESULTS: Data were available for 14,493 subjects. Overweight and obese subjects with a WHtR <0.5 had a cardiometabolic risk approaching that of subjects with a normal BMI percentile category. Increasing WHtR was significantly associated with increased cardiometabolic risk in overweight and obese subjects, with the greatest associations observed in the obese population. Of obese subjects with WHtR ≥ 0.6, 26% had elevated non-high-density lipoprotein levels, 18% had elevated C-reactive protein levels, 69% had an elevated homeostatic model assessment-insulin resistance, and 32% had metabolic syndrome. CONCLUSIONS: The WHtR further specifies cardiometabolic risk within classifications stratification on the basis of BMI percentile. A significant proportion of obese children with increased WHtRs have abnormal cardiometabolic risk factor levels. The WHtR should be included in the routine screening and assessment of overweight and obese children, and those with an elevated WHtR should undergo a further cardiometabolic risk assessment. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/23500256/Role_of_the_waist/height_ratio_in_the_cardiometabolic_risk_assessment_of_children_classified_by_body_mass_index_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(13)00390-2 DB - PRIME DP - Unbound Medicine ER -