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J Obes. 2014;2014:421658. doi: 10.1155/2014/421658. Epub 2014 Jul 14.

Cardiometabolic risk assessments by body mass index z-score or waist-to-height ratio in a multiethnic sample of sixth-graders.

Author information

1
Division of Diabetes Translation, Centers for Disease Control & Prevention, CDC Mail Stop F-73, 4770 Buford Highway, Atlanta, GA 30341, USA.
2
The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
3
School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK.
4
Center for Obesity Research and Education, Temple University, Philadelphia, PA 19122, USA.
5
Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA.
6
Division of Endocrinology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA.
7
Division of Health Promotion & Sports Medicine, Oregon Health & Science University, Portland, OR 97239, USA.
8
Social & Health Research Center, San Antonio, TX 78210, USA.
9
Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA.

Abstract

Convention defines pediatric adiposity by the body mass index z-score (BMIz) referenced to normative growth charts. Waist-to-height ratio (WHtR) does not depend on sex-and-age references. In the HEALTHY Study enrollment sample, we compared BMIz with WHtR for ability to identify adverse cardiometabolic risk. Among 5,482 sixth-grade students from 42 middle schools, we estimated explanatory variations (R (2)) and standardized beta coefficients of BMIz or WHtR for cardiometabolic risk factors: insulin resistance (HOMA-IR), lipids, blood pressures, and glucose. For each risk outcome variable, we prepared adjusted regression models for four subpopulations stratified by sex and high versus lower fatness. For HOMA-IR, R (2) attributed to BMIz or WHtR was 19%-28% among high-fatness and 8%-13% among lower-fatness students. R (2) for lipid variables was 4%-9% among high-fatness and 2%-7% among lower-fatness students. In the lower-fatness subpopulations, the standardized coefficients for total cholesterol/HDL cholesterol and triglycerides tended to be weaker for BMIz (0.13-0.20) than for WHtR (0.17-0.28). Among high-fatness students, BMIz and WHtR correlated with blood pressures for Hispanics and whites, but not black boys (systolic) or girls (systolic and diastolic). In 11-12 year olds, assessments by WHtR can provide cardiometabolic risk estimates similar to conventional BMIz without requiring reference to a normative growth chart.

PMID:
25132986
PMCID:
PMC4123559
DOI:
10.1155/2014/421658
[Indexed for MEDLINE]
Free PMC Article

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