Waistline may help predict cardiovascular risk in teens

Waist Measurements Specify Lipid, BP Levels in Obese Teens
Waist Measurements Specify Lipid, BP Levels in Obese Teens

HealthDay News -- Waist measurements may help predict cardiovascular risk factors in obese teens, data suggests.

A high waist-to height ratio was associated with higher total cholesterol (P<0.05) and hypertension in obese 14- to 15-year olds, Brian W. McCrindle, MD, MPH, of the Hospital for Sick Children in Toronto, and colleagues reported in Archives of Pediatrics & Adolescent Medicine.

"Waist-to-height ratio was as strong as waist circumference percentile in its association with cardiometabolic risk and, given its convenience and consistency of threshold values, may serve as a useful clinical marker for both families and physicians to follow," the researchers wrote.

They conducted a population-based cross-sectional study of 4,104 ninth-grade students in one region of Ontario during the 2009-2010 academic school year as part of the Heart Niagara Healthy Heart Schools' Program. Complete data were available for 3,428 students. Those with a BMI in the 85th to less than 95th percentile were judged to be overweight; those with BMI in the 95th or greater percentile were considered obese.

The researchers found that there were significant correlations between BP, lipid profile and measures of adiposity (including BMI, BMI/waist circumference, and BMI/waist-to-height ratio), but the correlations had limited strength and were not significantly or clinically different from each other.

Waist-to-height ratio did not predict risk of elevated lipid levels among normal weight teens. However, elevated height-to-waist categories correlated with higher total and non-HDL cholesterol, lower HDL cholesterol, higher total-to-HDL cholesterol ratio and increased likelihood of hypertension for overweight and obese students, compared with normal weight peers who had a weight-to-height ratio less than 0.5 (P<0.05).

Although the addition of either waist circumference percentile or waist-to-height ratio had no improvement compared with BMI alone in assessing risk, incorporating waist-to-height ratio measurements improved risk stratification, and therefore, "should be considered in the routine pediatric assessment," the researchers concluded.

Cross-sectional design and a lack of multiple BP and fasting serum measurements were study limitations.

"The cardiometabolic risk of overweight and obese subjects with lower waist measures needs to be further explored with prospective longitudinal studies using standardized diagnostic evaluations," the researchers wrote.

Khoury M et al. Arch Pediatr Adolesc Med. 2012; doi:10.1001/archpediatrics.2012.126.

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