Format

Send to

Choose Destination
Pediatr Obes. 2015 Oct;10(5):329-37. doi: 10.1111/ijpo.267. Epub 2014 Dec 17.

Cardio-metabolic risk screening among adolescents: understanding the utility of body mass index, waist circumference and waist to height ratio.

Author information

1
Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA.
2
Department of Public Health, Temple University, Philadelphia, PA, USA.
3
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
4
The Biostatistics Center, George Washington University, Rockville, MD, USA.
5
National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.

Abstract

BACKGROUND:

Few studies have assessed how well body mass index (BMI), waist circumference (WC), or waist to height ratio (WtHR) perform in identifying cardio-metabolic risk among youth.

OBJECTIVE:

The objective of this study was to evaluate the utility of BMI and WC percentiles and WtHR to distinguish adolescents with and without cardio-metabolic risk.

METHODS:

A cross-sectional analysis of data from 6097 adolescents aged 10-13 years who participated in the HEALTHY study was conducted. Receiver operating characteristic curves determined the discriminatory ability of BMI and WC percentiles and WtHR.

RESULTS:

The discriminatory ability of BMI percentile was good (area under the curve [AUC] ≥ 0.80) for elevated insulin and clustering of ≥3 risk factors, with optimal cut-points of 96 and 95, respectively. BMI percentile performed poor to fair (AUC = 0.57-0.75) in identifying youth with the majority of individual risk factors examined (elevated glucose, total cholesterol, low-density lipoprotein, blood pressure, triglycerides and high-density lipoprotein). WC percentile and WtHR performed similarly to BMI percentile.

CONCLUSIONS:

The current definition of obesity among US children performs well at identifying adolescents with elevated insulin and a clustering of ≥3 cardio-metabolic risk factors. Evidence does not support WC percentile or WtHR as superior screening tools compared with BMI percentile for identifying cardio-metabolic risk.

KEYWORDS:

Adolescents; cardiovascular risk; screening

PMID:
25515620
PMCID:
PMC4470887
DOI:
10.1111/ijpo.267
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center