Yonsei Med J.  2016 May;57(3):658-663. 10.3349/ymj.2016.57.3.658.

Waist-to-Height Ratio as an Index for Cardiometabolic Risk in Adolescents: Results from the 1998-2008 KNHANES

• Chung IH
• Park S
• Park MJ
• Yoo EG

• KMID: 2374086
• DOI: http://doi.org/10.3349/ymj.2016.57.3.658

Abstract

PURPOSE
To describe the relationship between the waist-to-height ratio (WHtR) and cardiometabolic risk factors (CMRFs) and to evaluate the validity of WHtR in identifying adolescents with metabolic syndrome.
MATERIALS AND METHODS
We analyzed data from a pooled population of 4068 adolescents aged 10-19 years from the Korean National Health and Nutrition Examination Surveys conducted between 1998 and 2008. Overweight individuals were defined by body mass index (BMI) ≥85th percentile. Those with at least 2 CMRFs among hypertension, hyperglycemia, hypertriglyceridemia, and decreased high-density lipoprotein cholesterol (HDL-C) were classified as having multiple CMRFs.
RESULTS
WHtR was significantly related to systolic blood pressure, HDL-C, and triglycerides in both non-overweight and overweight adolescents (all p<0.01). Among overweight adolescents, the area under the curve (AUC) for WHtR in identifying multiple CMRFs was significantly greater than that for BMI (p=0.014). Metabolic syndrome was more common in overweight adolescents with a WHtR of ≥0.5 than in those with a WHtR of <0.5 (p<0.001). In non-overweight adolescents, the prevalences of multiple CMRFs (p=0.001) and metabolic syndrome (p<0.001) were higher in those with a WHtR of ≥0.5 than in those with a WHtR of <0.5. Among those without central obesity, the prevalence of multiple CMRFs was higher in those with a WHtR of ≥0.5 than in those with a WHtR of <0.5 (p=0.021).
CONCLUSION
WHtR is a simple and valid index for identifying adolescents with increased cardiometabolic risk and is related to CMRFs even in non-overweight adolescents. In adolescents already screened via BMI and waist circumference (WC), WHtR seems to be of additional help in discriminating those at higher cardiometabolic risk.

Keyword

Waist; height; body mass index; metabolic syndrome; obesity

MeSH Terms

Adolescent
Blood Pressure/physiology
*Body Height
Body Mass Index
Cardiovascular Diseases/*epidemiology
Child
Cholesterol, HDL/blood
Female
Humans
Hypertension/complications/epidemiology
Male
Metabolic Syndrome X/*epidemiology
Nutrition Surveys
Obesity, Abdominal/complications/*epidemiology
Republic of Korea/epidemiology
Risk Factors
Triglycerides/blood
*Waist Circumference/physiology
*Waist-Height Ratio
Young Adult
Cholesterol, HDL
Triglycerides

Figure

• 

  Fig. 1 The prevalence of multiple CMRFs (A) and metabolic syndrome (B) in overweight (BMI ≥85 P) and non-overweight (BMI <85 P) adolescents further stratified by WHtR. *p<0.05 vs. BMI <85 P/WHtR <0.5 group, †p<0.05 vs. BMI ≥85 P/WHtR <0.5 group. WHtR, waist to height ratio; BMI, body mass index; CMRFs, cardiometabolic risk factors.

• 

  Fig. 2 The prevalence of multiple CMRFs (A) and metabolic syndrome (B) in adolescents those with central obesity (WC ≥90 P) and without central obesity (WC <90 P) further stratified by WHtR. *p<0.05 vs. WC <90 P/WHtR <0.5 group, †p<0.05 vs. WC ≥90 P/WHtR <0.5 group. WHtR, waist to height ratio; WC, waist circumference; CMRFs, cardiometabolic risk factors.

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