Waist Circumference is Better Than Other Anthropometric Indices for Predicting Cardiovascular Disease Risk Factors in Chinese Children-a Cross-Sectional Study in Guangzhou

Aim: To determine the best anthropometric index among body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) and to derive optimal thresholds for predicting CVD risk factors in Chinese children. Methods: A total of 2563 children aged 8-12 years were recruited in Guangzhou, China. Anthropometric indices were measured in all participants. Systolic and diastolic blood pressure (SBP and DBP, respectively), glucose, triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol (HDLC) and low-density lipoprotein cholesterol (LDL-C) were measured in a subsample of 1609 children. Results: In partial correlation analyses, the highest coefficients were found for WC in four risk factors in both genders. The receiver operating characteristic (ROC) analyses showed that WC was comparably consistent among the best in predicting BP and risk factor clustering, WC and WSR were the best in predicting HDL-C and TG in boys; WC, slightly better than BMI, was the best in distinguishing high BP and risk factor clustering in girls. In contrast, WHR was consistently the poorest index in both genders. Optimal age- and gender-specific thresholds to identify individual and clustering risk factors were provided; the thresholds for WC were 57.4-80.4 cm and 55.8-69.6 cm in boys and girls, respectively. Conclusions: WC was the comparatively consistent and best predictor of CVD risk factors compared with WSR and BMI, although the differences were small and depended on the type of risk factor and gender, and WHR was consistently the poorest predictor in Chinese children.