Waist circumference, blood pressure, and lipid components of the metabolic syndrome

Objectives To examine whether waist circumference (WC) predicts blood pressure (BP) and lipid components of the metabolic syndrome independent of body mass index (BMI) percentile in youths. Study design The study group comprised 70 African-American youths and 97 Caucasian youths. Outcome measures included BP, lipid profile, and abdominal adipose tissue (AT). Results Both BMI percentile and WC were significantly (P < .05) associated with daytime and nighttime systolic and diastolic BP, triglycerides (TG), high-density lipoprotein (HDL), and TG/HDL ratio independent of race. In African-Americans and Caucasians, WC remained a significant (P < .05) correlate of daytime (r = .50 and .59, respectively) and nighttime (r = .49 and .62, respectively) systolic BP, and in Caucasians, TG, HDL, TG/HDL and very-low-density lipoprotein after controlling for BMI percentile. After accounting for age, set, and race, the addition of WC to BMI percentile increased the variance (R-2) in systolic BP by 15% (P < .05). The inclusion of WC with BMI percentile explained an additional 3% and 7% of the variance in TG and HDI, respectively (P < .05). Conclusions The prediction of childhood obesity-related health risks is significantly improved by the inclusion of WC in addition to BMI percentile. This observation supports the notion that WC should be included in the evaluation of childhood obesity along with BDI percentile to identify those at increased health risks due to excess abdominal fat.