TY - JOUR
T1 - 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
T2 - A pooled analysis of individual data from 14 countries
AU - Zong, Xin'nan
AU - Kelishadi, Roya
AU - Kim, Hae Soon
AU - Schwandt, Peter
AU - Matsha, Tandi E.
AU - Mill, Jose G.
AU - Whincup, Peter H.
AU - Pacifico, Lucia
AU - López-Bermejo, Abel
AU - Caserta, Carmelo Antonio
AU - Medeiros, Carla Campos Muniz
AU - Yan, Wei Li
AU - Kollias, Anastasios
AU - Skidmore, Paula
AU - Correia-Costa, Liane
AU - Khadilkar, A.
AU - Jazi, Fariborz Sharifian
AU - Gong, Zhuo
AU - Zhang, Cheng
AU - Magnussen, Costan G.
AU - Zhao, Min
AU - Xi, Bo
N1 - Publisher Copyright:
© 2024
PY - 2024/5
Y1 - 2024/5
N2 - 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.
AB - 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.
KW - Adolescent
KW - Body mass index
KW - Cardiometabolic risk factors
KW - Carotid intima-media thickness
KW - Child
KW - Obesity
KW - Pulse wave velocity
KW - Waist circumference
KW - Waist-to-height ratio
UR - http://www.scopus.com/inward/record.url?scp=85193611245&partnerID=8YFLogxK
U2 - 10.1016/j.dsx.2024.103042
DO - 10.1016/j.dsx.2024.103042
M3 - Article
C2 - 38781718
AN - SCOPUS:85193611245
SN - 1871-4021
VL - 18
JO - Diabetes and Metabolic Syndrome: Clinical Research and Reviews
JF - Diabetes and Metabolic Syndrome: Clinical Research and Reviews
IS - 5
M1 - 103042
ER -