A population-based comparison of BMI percentiles and waist-to-height ratio for identifying cardiovascular risk in youth

Determine whether waist-to-height ratio (WHtR) or sex- and age-specific percentiles of body mass index (BMI) better identifies cardiovascular risk. The third National Health and Nutrition Examination Survey (NHANES III) provided measurements on 7657 participants statistically weighted to represent 5...

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Bibliographic Details
Published in:The Journal of pediatrics Vol. 146; no. 4; pp. 482 - 488
Main Authors: Kahn, Henry S., Imperatore, Giuseppina, Cheng, Yiling J.
Format: Journal Article
Language:English
Published: New York, NY Mosby, Inc 01.04.2005
Elsevier
Subjects:
Adolescent
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Body Height
Body Mass Index
Body Weights and Measures
Cardiology. Vascular system
Cardiovascular Diseases
Child
Child, Preschool
Coronary heart disease
Cross-Sectional Studies
Female
General aspects
Heart
Humans
Male
Medical sciences
Risk Assessment
HDL
CDC
HbA 1c
LDL
WHtR
BMI
NHANES III
Human
Pediatrics
Cardiovascular disease
Corporal biometry
Coronary heart disease
Vascular disease
Body mass index
Body size
Adolescent
Atherosclerosis
Risk factor
Cardiovascular risk
Height
Ratio
Comparative study
Public health
ISSN:0022-3476, 1097-6833
Online Access:Get full text
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Summary:Determine whether waist-to-height ratio (WHtR) or sex- and age-specific percentiles of body mass index (BMI) better identifies cardiovascular risk. The third National Health and Nutrition Examination Survey (NHANES III) provided measurements on 7657 participants statistically weighted to represent 50.05 million youth 4 to 17 years of age. We estimated the subpopulations corresponding to BMI strata that were normal (<85th percentile), at risk for overweight (85th to <95th percentile), and overweight (≥95th percentile). We chose WHtR cutoff points (0.490 and 0.539) so that subpopulation sizes in the three WHtR strata would equal those in the three BMI strata. For 13 cardiovascular risk factors we compared mean levels among youth discordant for their BMI and WHtR strata. 726 participants (representing 3.69 million youth) were identified as having WHtR stratum >BMI stratum. Compared with the 603 participants (representing 3.70 million youth) who were discordant in the opposite direction, weighted analyses showed they had higher mean levels of heart rate, low-density lipoprotein (LDL) cholesterol, fasting triglycerides, and total cholesterol ( P <.015, adjusted for sex, age, and race-ethnicity). Their mean systolic blood pressure was lower, but this difference was eliminated after adjustment for their shorter stature. WHtR, a simpler anthropometric index than sex- and age-specific BMI percentiles, better identifies youth with adverse cardiovascular risk factors.
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ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2004.12.028