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Ann Hum Biol. 2011 May;38(3):265-70. doi: 10.3109/03014460.2010.526147. Epub 2010 Nov 2.

Waist-to-height ratio as a screening tool for children with risk factors for cardiovascular disease.

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PhD Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.



Waist-to-height ratio (WHtR) has been recommended as a tool for predicting cardiovascular risk in children. However, there is little evidence about the accuracy of using WHtR as a predictor of disease risk in pre-school children.


To assess the accuracy of waist-to-height ratio (WHtR), waist circumference (WC) and body mass index (BMI) as well as to determine the optimal cut-off values for each of these measures in order to identify pre-school children with cardiovascular risks.


This study conducted a cross-sectional analysis of 315 children between 3-4 years of age. Multiple risk factors for cardiovascular disease (MRFCD) were defined as having two or more of the following conditions: HDL-c < 35 mg/dL, LDL-c ≥ 110 mg/dL, triglycerides ≥ 150 mg/dL and systolic and/or diastolic blood pressure ≥ 90(th) percentile.


The accuracy of WHtR in identifying cardiovascular risk in pre-school children was not significantly different compared to BMI or WC, for both sexes. The optimal cut-off measures for predicting cardiovascular risk in boys and girls, respectively, were as follows: 0.51 and 0.49 for WHtR; 0.61 and 0.69 for BMI Z-score; and 51.2 cm and 50.2 cm for WC.


The data support the use of a 0.5 cut-off value for WHtR to predict cardiovascular risk factors among pre-school children and suggest that using WHtR is comparable to both BMI and WC.

[Indexed for MEDLINE]

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