Utility of Waist Circumference Percentiles vs. Adult Waist Circumference Cutoffs for Assessing Metabolic Risk in Overweight/Obese Adolescents

Abstract

Background Waist circumference [WC] is difficult to use in pediatric clinical practice because there are no easy methods to convert measurements to percentiles [%tile]; use of adult cutoffs for adolescents could improve implementation. We assessed the utility of WC %tile 蠅90 and adult WC cutoffs (88 cm for women, 102 cm for men) in predicting high triglycerides [TG] (蠅150 mg/dl) and fasting blood glucose [FBG] (蠅100 mg/dl) and low HDL cholesterol [HDL] (<40 mg/dl men, <50 mg/dl women) in overweight/obese [OW/OB] adolescents. Methods: Cross-sectional data on WC (done in duplicate or triplicate if the first two measurements differed by >0.5 cm), TG, FBG and HDL were collected for 75 OW/OB participants (BMI %tile 蠅85) in 9th and 10th grade attending 4 urban high schools in the Southwest. Results: Participants were 52% female, 84% Hispanic and 55% obese (BMI %tile 蠅95), with an average age of 15.5 yrs. Based on 蠅90 WC %tile cutoff and adult cutoffs, respectively, 55% and 56% had high WC. Overall prevalence of high TG, high FBG and low HDL was 19%, 23% and 60%, respectively. The percentage of students with high TG, high FBG and low HDL, respectively, identified by the WC %tile 蠅90 vs. adult WC cutoffs was 79% vs. 54%, 62% vs. 64%, and 59% vs. 53%. At the 90th %tile WC cutoff, the sensitivity and specificity for high TG, high FBG and low HDL were 79% and 51%, 53% and 45% and 64% and 60%, respectively. Conclusions In this sample, the %tile-based cutoff was most useful for identifying teens with high TG; the adult cutoff performed very similarly for identifying teens with high FBG and low HDL. Funded by: NIH Grant R01 HL118734