Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: The Bogalusa Heart Study

被引:244
作者
Mokha, Jasmeet S. [1 ]
Srinivasan, Sathanur R. [1 ]
DasMahapatra, Pronabesh [1 ]
Fernandez, Camilo [1 ]
Chen, Wei [1 ]
Xu, Jihua [1 ]
Berenson, Gerald S. [1 ]
机构
[1] Tulane Univ, Hlth Sci Ctr, Dept Epidemiol, Ctr Cardiovasc Hlth, New Orleans, LA 70118 USA
关键词
TYPE-2; DIABETES-MELLITUS; BODY-MASS INDEX; METABOLIC SYNDROME; CARDIOVASCULAR-DISEASE; INSULIN-RESISTANCE; BIRACIAL COMMUNITY; YOUNG-ADULTS; ADOLESCENTS; POPULATION; BMI;
D O I
10.1186/1471-2431-10-73
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: Body Mass Index (BMI) is widely used to assess the impact of obesity on cardiometabolic risk in children but it does not always relate to central obesity and varies with growth and maturation. Waist-to-Height Ratio (WHtR) is a relatively constant anthropometric index of abdominal obesity across different age, sex or racial groups. However, information is scant on the utility of WHtR in assessing the status of abdominal obesity and related cardiometabolic risk profile among normal weight and overweight/obese children, categorized according to the accepted BMI threshold values. Methods: Cross-sectional cardiometabolic risk factor variables on 3091 black and white children (56% white, 50% male), 4-18 years of age were used. Based on the age-, race- and sex-specific percentiles of BMI, the children were classified as normal weight (5th - 85th percentiles) and overweight/obese (>= 85th percentile). The risk profiles of each group based on the WHtR (<0.5, no central obesity versus >= 0.5, central obesity) were compared. Results: 9.2% of the children in the normal weight group were centrally obese (WHtR >= 0.5) and 19.8% among the overweight/obese were not (WHtR < 0.5). On multivariate analysis the normal weight centrally obese children were 1.66, 2.01, 1.47 and 2.05 times more likely to have significant adverse levels of LDL cholesterol, HDL cholesterol, triglycerides and insulin, respectively. In addition to having a higher prevalence of parental history of type 2 diabetes mellitus, the normal weight central obesity group showed a significantly higher prevalence of metabolic syndrome (p < 0.0001). In the overweight/obese group, those without central obesity were 0.53 and 0.27 times less likely to have significant adverse levels of HDL cholesterol and HOMA-IR, respectively (p < 0.05), as compared to those with central obesity. These overweight/obese children without central obesity also showed significantly lower prevalence of parental history of hypertension (p = 0.002), type 2 diabetes mellitus (p = 0.03) and metabolic syndrome (p < 0.0001). Conclusion: WHtR not only detects central obesity and related adverse cardiometabolic risk among normal weight children, but also identifies those without such conditions among the overweight/obese children, which has implications for pediatric primary care practice.
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页数:7
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共 33 条
[1]  
[Anonymous], DIABETOLOGIA
[2]   Persistent elevation of plasma insulin levels is associated with increased cardiovascular risk in children and young adults - The Bogalusa Heart Study [J].
Bao, WH ;
Srinivasan, SR ;
Berenson, GS .
CIRCULATION, 1996, 93 (01) :54-59
[3]  
Berenson GS., 1980, Cardiovascular risk factors in children: The early natural history of atherosclerosis and essential hypertension
[4]   Value of body fat mass vs anthropometric obesity indices in the assessment of metabolic risk factors [J].
Bosy-Westphal, A ;
Geisler, C ;
Onur, S ;
Korth, O ;
Selberg, O ;
Schrezenmeir, J ;
Müller, MJ .
INTERNATIONAL JOURNAL OF OBESITY, 2006, 30 (03) :475-483
[5]  
BUCOLO G, 1973, CLIN CHEM, V19, P476
[6]   Prevalence of a metabolic syndrome phenotype in adolescents - Findings from the Third National Health and Nutrition Examination Survey, 1988-1994 [J].
Cook, S ;
Weitzman, M ;
Auinger, P ;
Nguyen, M ;
Dietz, WH .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2003, 157 (08) :821-827
[7]   Abdominal obesity and the metabolic syndrome:: Contribution to global cardiometabolic risk [J].
Despres, Jean-Pierre ;
Lemieux, Isabelle ;
Bergeron, Jean ;
Pibarot, Philippe ;
Mathieu, Patrick ;
Larose, Eric ;
Rodes-Cabau, Josep ;
Bertrand, Olivier F. ;
Poirier, Paul .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2008, 28 (06) :1039-1049
[8]   Phenotypic characteristics associated with insulin resistance in metabolically obese but normal-weight young women [J].
Dvorak, RV ;
DeNino, WF ;
Ades, PA ;
Poehlman, ET .
DIABETES, 1999, 48 (11) :2210-2214
[9]   Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: the Bogalusa Heart Study [J].
Freedman, David S. ;
Kahn, Henry S. ;
Mei, Zuguo ;
Grummer-Strawn, Laurence M. ;
Dietz, William H. ;
Srinivasan, Sathanur R. ;
Berenson, Gerald S. .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 2007, 86 (01) :33-40
[10]  
GOULDING A, INT J OBES LOND