Original ArticleA population-based comparison of BMI percentiles and waist-to-height ratio for identifying cardiovascular risk in youth
Section snippets
Methods
Our analytic population was drawn from the third National Health and Nutrition Examination Survey (NHANES III), a probability sample of the noninstitutionalized US population studied in 1988–1994. This complex, multistage survey oversampled non-Hispanic blacks and Mexican Americans. Each participant was assigned a sampling weight that accounted for unequal selection probabilities (clustered design, planned oversampling, and differential nonresponse).10 Our final analytic population contained
Results
Our analysis of discordant subpopulations found that youth whose WHtR stratum was higher than their BMI-percentile stratum included a disproportionately high percentage of girls (55.7% ± 3.2%), a disproportionately low percentage of non-Hispanic blacks (7.0% ± 0.8%), and a disproportionately high percentage of Mexican Americans (13.9% ± 1.5%) when compared with our estimated total youth population. Those subpopulations whose BMI-percentile stratum was higher than their WHtR stratum had
Discussion
Our population-based comparison of two anthropometric indices demonstrated that WHtR could serve better than sex- and age-specific BMI percentiles for identifying US youth with high heart rate or adverse concentrations of LDL cholesterol, triglycerides, and total cholesterol. There also was a suggestion (nonsignificant) that youth with elevated total cholesterol/HDL cholesterol, apolipoprotein B, or apolipoprotein B/apolipoprotein AI would be better identified by WHtR. For adverse levels of HDL
References (46)
- et al.
Waist to stature ratio is more strongly associated with cardiovascular risk factors than other simple anthropometric indices
Ann Epidemiol
(2003) - et al.
Waist circumference and not body mass index explains obesity-related health risk
Am J Clin Nutr
(2004) - et al.
Interpretation of children's blood pressure using a physiologic height correction
J Chron Dis
(1986) - et al.
Visceral fat in white and African American prepubertal children
Am J Clin Nutr
(1997) - et al.
Metabolic risks identified by the combination of enlarged waist and elevated triacylglycerols
Am J Clin Nutr
(2003) Lipid overload and overflow: metabolic trauma and the metabolic syndrome
Trends Endocrinol Metab
(2003)- et al.
Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocellular and abdominal fat partitioning
Lancet
(2003) - et al.
Overweight, fat patterning, and cardiovascular disease risk factors in black and white boys
J Pediatr
(1999) - et al.
Overweight, fat patterning, and cardiovascular disease risk factors in black and white girls: the National Heart, Lung, and Blood Institute Growth and Health Study
J Pediatr
(1999) - et al.
Simple anthropometric indices associated with ischemic heart disease
J Clin Epidemiol
(1996)
Comparisons of waist circumferences measured at 4 sites
Am J Clin Nutr
Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index
Am J Clin Nutr
Body mass index as a measure of adiposity among children and adolescents: a validation study
J Pediatr
Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents
Am J Clin Nutr
Five-year obesity incidence in the transition period between adolescence and adulthood: the National Longitudinal Study of Adolescent Health
Am J Clin Nutr
Abdominal adiposity in U.S. adults: prevalence and trends, 1960-2000
Prev Med
Visceral fat mass in childhood: a potential early marker for increased risk of cardiovascular disease
Am J Clin Nutr
Prevalence and trends in overweight among US children and adolescents, 1999-2000
JAMA
Extent of overweight among US children and adolescents from 1971 to 2000
Int J Obes Relat Metab Disord
Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version
Pediatrics
Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index
Int J Obes Relat Metab Disord
Waist-to-height ratio is the best predictor of cardiovascular disease risk factors in Japanese schoolchildren
J Atheroscler Thromb
Waist/height ratio as a simple and useful predictor of coronary heart disease risk factors in women
Intern Med
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