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Utility of Waist-To-Height Ratio, Waist Circumference and Body Mass Index in Predicting Clustered Cardiometabolic Risk Factors and Subclinical Vascular Phenotypes in Children and Adolescents: A Pooled Analysis of Individual Data From 14 Countries Publisher Pubmed



Zong X1, 2 ; Kelishadi R3 ; Kim HS4 ; Schwandt P5 ; Matsha TE6 ; Mill JG7 ; Whincup PH8 ; Pacifico L9 ; Lopezbermejo A10, 11, 12 ; Caserta CA13 ; Medeiros CCM14 ; Yan WL15 ; Kollias A16 ; Skidmore P17 Show All Authors
Authors
  1. Zong X1, 2
  2. Kelishadi R3
  3. Kim HS4
  4. Schwandt P5
  5. Matsha TE6
  6. Mill JG7
  7. Whincup PH8
  8. Pacifico L9
  9. Lopezbermejo A10, 11, 12
  10. Caserta CA13
  11. Medeiros CCM14
  12. Yan WL15
  13. Kollias A16
  14. Skidmore P17
  15. Correiacosta L18, 19, 20
  16. Khadilkar A21
  17. Jazi FS22
  18. Gong Z23
  19. Zhang C24
  20. Magnussen CG25, 26, 27
  21. Zhao M28
  22. Xi B1
Show Affiliations
Authors Affiliations
  1. 1. Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
  2. 2. Department of Growth and Development, Capital Institute of Pediatrics, Beijing, China
  3. 3. Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, South Korea
  5. 5. Atherosclerosis Prevention Institute, Munich-Nuremberg, Munich, Germany
  6. 6. Department of Biomedical Sciences, Faculty of Health & Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
  7. 7. Department of Physiological Sciences, Center of Health Sciences, Federal University of Espirito Santo, Vitoria, Brazil
  8. 8. Population Health Research Institute, St George's, University of London, London, United Kingdom
  9. 9. Department of Maternal and Child Health, Sapienza University of Rome, Rome, Italy
  10. 10. Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
  11. 11. Department of Pediatrics, Hospital Dr. Josep Trueta, Girona, Spain
  12. 12. Department of Medical Sciences, University of Girona, Girona, Spain
  13. 13. Associazione Calabrese Di Epatologia - Medicina Solidale - A.C.E. ETS, Reggio Calabria, Italy
  14. 14. Department of Public Health, State University of Paraiba, Campina Grande, Brazil
  15. 15. Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
  16. 16. Hypertension Center STRIDE-7, School of Medicine, Third Department of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
  17. 17. Department of Human Nutrition, University of Otago, Dunedin, New Zealand
  18. 18. EPIUnit - Instituto de Saude Publica, Universidade do Porto & Laboratorio para a Investigacao Integrativa e Translacional em Saude Populacional (ITR), Universidade do Porto, Porto, Portugal
  19. 19. Division of Pediatric Nephrology, Centro Materno-Infantil do Norte, Centro Hospitalar Universitario de Santo Antonio, Porto, Portugal
  20. 20. CAC ICBAS-CHP – Centro Academico Clinico Instituto de Ciencias Biomedicas Abel Salazar - Centro Hospitalar Universitario de Santo Antonio, Porto, Portugal
  21. 21. Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
  22. 22. School of Science and Technology, University of Georgia, Tbilisi, Georgia
  23. 23. School of Public Health, Changsha Medical University, Changsha, China
  24. 24. National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
  25. 25. Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
  26. 26. Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
  27. 27. Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
  28. 28. Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China

Source: Diabetes and Metabolic Syndrome: Clinical Research and Reviews Published:2024


Abstract

Aims: The clinical utility of waist-to-height ratio (WHtR) in predicting cardiometabolic risk factors (CMRFs) and subclinical markers of cardiovascular disease remains controversial. We aimed to compare the utility of WHtR with waist circumference (WC) and body mass index (BMI) in identifying children and adolescents (youths) at risk for cardiometabolic outcomes, including clustered CMRFs, high carotid intima-media thickness (cIMT), and arterial stiffness (assessed as high pulse wave velocity, PWV). Methods: We analyzed data from 34,224 youths (51.0 % boys, aged 6–18 years) with CMRFs, 5004 (49.5 % boys, aged 6–18 years) with cIMT measurement, and 3100 (56.4 % boys, aged 6–17 years) with PWV measurement from 20 pediatric samples across 14 countries. Results: WHtR, WC, and BMI z-scores had similar performance in discriminating youths with ≥3 CMRFs, with the area under the curve (AUC) (95 % confidence interval, CI)) ranging from 0.77 (0.75–0.78) to 0.78 (0.76–0.80) using the modified National Cholesterol Education Program (NCEP) definition, and from 0.77 (0.74–0.79) to 0.77 (0.74–0.80) using the International Diabetes Federation (IDF) definition. Similarly, all three measures showed similar performance in discriminating youths with subclinical vascular outcomes, with AUC (95 % CI) ranging from 0.67 (0.64–0.71) to 0.70 (0.66–0.73) for high cIMT (≥P95 values) and from 0.60 (0.58–0.66) to 0.62 (0.58–0.66) for high PWV (≥P95 values). Conclusions: Our findings suggest that WHtR, WC, and BMI are equally effective in identifying at-risk youths across diverse pediatric populations worldwide. Given its simplicity and ease of use, WHtR could be a preferable option for quickly screening youths with increased cardiometabolic risk in clinical settings. © 2024
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