Abstract
ObjectiveTo examine the associations between body mass index (BMI) and waist-to-height ratio (WHtR) measured in childhood and adolescence and cardiometabolic risk factors in adolescence.MethodsSecondary data analysis of the Avon Longitudinal Study of Parents and Children, a population based cohort. Data from 2858 adolescents aged 15.5 (standard deviation 0.4) years and 2710 of these participants as children aged 7–9 years were used in this analysis. Outcome measures were cardiometabolic risk factors, including triglycerides, low density lipoprotein cholesterol, high density lipoprotein cholesterol, insulin, glucose and blood pressure at 15 years of age.ResultsBoth BMI and WHtR measured at ages 7–9 years and at age 15 years were associated with cardiometabolic risk factors in adolescents. A WHtR ≥0.5 at 7–9 years increased the odds by 4.6 [95% confidence interval 2.6 to 8.1] for males and 1.6 [0.7 to 3.9] for females of having three or more cardiometabolic risk factors in adolescence. Cross-sectional analysis indicated that adolescents who had a WHtR ≥0.5, the odds ratio of having three or more cardiometabolic risk factors was 6.8 [4.4 to 10.6] for males and 3.8 [2.3 to 6.3] for females. The WHtR cut-point was highly specific in identifying cardiometabolic risk co-occurrence in male children and adolescents as well as female children (90 to 95%), but had poor sensitivity (17 to 53%). Similar associations were observed when BMI was used to define excess adiposity.ConclusionsWHtR is a simple alternative to age and sex adjusted BMI for assessing cardiometabolic risk in adolescents.
Highlights
Graves et al Conclusions: waist-to-height ratio (WHtR) is a simple alternative to age and sex adjusted body mass index (BMI) for assessing cardiometabolic risk in adolescents
Obesity in childhood is associated with adverse levels of cardiometabolic risk factors, including higher blood pressure (BP), triglycerides, total and low density lipoprotein cholesterol (LDLc) and insulin, and lower high density lipoprotein cholesterol (HDLc) [1,2,3]
We have previously reported, using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), that childhood body mass index (BMI), waist circumference and total fat mass are positively associated with cardiovascular risk factors in adolescence and the magnitudes of these associations are similar for all measures of adiposity [2]
Summary
Obesity in childhood is associated with adverse levels of cardiometabolic risk factors, including higher blood pressure (BP), triglycerides, total and low density lipoprotein cholesterol (LDLc) and insulin, and lower high density lipoprotein cholesterol (HDLc) [1,2,3]. It is important to identify children who are at increased risk of developing comorbidities associated with obesity, to potentially intervene and prevent the development of chronic disease including type 2 diabetes. We have previously reported, using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), that childhood body mass index (BMI), waist circumference and total fat mass are positively associated with cardiovascular risk factors in adolescence and the magnitudes of these associations are similar for all measures of adiposity [2]. WHtR may be a more straightforward anthropometric index to apply in the clinical setting where BMI centile charts may not be readily available
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