Distribution of waist-to-height ratio and cardiometabolic risk in children and adolescents: a population-based study

Hye Jin Lee,Jong Seo Yoon,Min Jae Kang,Young Suk Shim,Il Tae Hwang,Hwal Rim Jeong

doi:10.1038/s41598-021-88951-9

Abstract

This study was performed to evaluate the waist-to-height ratio (WHtR) distribution and assess its relationship with cardiometabolic risk in children and adolescents. A total of 8091 subjects aged 10–18 years were included from a nationally representative survey. Participants were classified into three groups: (1) < 85th, (2) ≥ 85th and < 95th, and (3) ≥ 95th percentile of WHtR. The WHtR distribution varied with sex and age. Whereas WHtR decreased from age 10–15 years in boys and from age 10–12 years in girls, it slightly increased thereafter. Compared to the < 85th percentile group, the WHtR ≥ 85th and < 95th percentile group had an odds ratio (OR) of 1.2 for elevated blood pressure (BP), 1.89 for elevated triglycerides (TGs), 1.47 for reduced high-density lipoprotein cholesterol (HDL-C) and 4.82 for metabolic syndrome (MetS). The ≥ 95th percentile group had an OR of 1.4 for elevated BP, 2.54 for elevated glucose, 2.22 for elevated TGs, 1.74 for reduced HDL-C, and 9.45 for MetS compared to the < 85th percentile group. Our results suggest that sex- and age-specific WHtR percentiles can be used as a simple clinical measurement to estimate cardiometabolic risk.

Highlights

This study was performed to evaluate the waist-to-height ratio (WHtR) distribution and assess its relationship with cardiometabolic risk in children and adolescents
The systolic blood pressure (SBP) ≥ 90th percentile group accounted for 3.5% of the total population (n = 288), and the diastolic blood pressure (DBP) ≥ 90th percentile group accounted for 23.2% (n = 2361)
Though WHtR is a simple anthropometric measure of central obesity used in clinical settings, unlike in adults, the distribution of WHtR may vary in children and adolescents since they grow and their body proportions change during puberty[15]

Summary

Introduction

This study was performed to evaluate the waist-to-height ratio (WHtR) distribution and assess its relationship with cardiometabolic risk in children and adolescents. As the prevalence of childhood obesity increases, metabolic syndrome (MetS), which is a clustering of abdominal obesity-associated factors including elevated waist circumference (WC), elevated blood pressure (BP), elevated glucose, elevated triglycerides (TGs) or reduced high-density lipoprotein cholesterol (HDL-C), has increased[2]. Obesity in children and adolescents commonly progresses to adult obesity and increases the likelihood of comorbidities associated with cardiometabolic risk, such as type 2 diabetes mellitus (T2DM), dyslipidemia, and h ypertension[3,4]. Since height and WC vary according to sex and age in children and adolescents, percentiles or standard deviation scores (SDSs) rather than a single cut-off have been proposed to evaluate cardiometabolic risk. Sex- and age-specific BMI percentiles are used to define obesity in children and adolescents, while a single cut-off value. While a previous study reported on the centile charts and secular trend of WHtR in Korean children and a dolescents[13], there have been no publications on sex- and age-specific LMS values to calculate SDSs or exact centiles of WHtR in Korean children despite such data already having been accumulated in other c ountries[12,14]

Objectives

Methods

Results

Conclusion