Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children

Objective To determine whether using a combination of body mass index (BMI) and waist circumference (WC) or waist-to-h eight ratio (W/Hr) is clinically helpful in identifying children with high metabolic and cardiovascular risks. Study design Caucasian children M/F: 740/739; n = 1479; ages S to 15 years) were studied. Anthropometry, blood pressure, and venous fasting blood samples tested for triacylglycerol, HDL cholesterol, and glucose were measured. Results Overweight children with a large waist (>90(th) percentile) or high W/Hr (>0.5) but not obese or normal-weight children had significantly greater chances of being at high metabolic and cardiovascular risk than normal-weight children (OR: 7; 9.5% Cl: 3.63-13.48; P <.001, OR: 8.16; 95% Cl: 3.87-17.23; P <.001, respectively) with a low waist measurement (<= 90(th) percentile) or W/Hr (<= 0.5). Interestingly, waist and W/Hr cutoffs (90(th) percentile and 0.5, respectively) were both able to identify children with the highest metabolic and cardiovascular risks among those who were overweight. However, contrary to waist circumference, W/Hr has the advantage of not requiring population specific reference tables as well as age and sex specific cutoffs. Conclusions Waist circumference and W/Hr are helpful in detecting, among overweight children, those with a higher likelihood of having metabolic and cardiovascular risks.