Cardiometabolic Risk Assessments by Body Mass Index z -Score or Waist-to-Height Ratio in a Multiethnic Sample of Sixth-Graders

Healthy Study Group

Research output: Contribution to journalArticle

14 Citations (Scopus)

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 (R2) 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, R2 attributed to BMIz or WHtR was 19%-28% among high-fatness and 8%-13% among lower-fatness students. R2 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.

Original languageEnglish (US)
Article number421658
JournalJournal of Obesity
Volume2014
DOIs
StatePublished - 2014

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Body Mass Index
Growth Charts
Students
Blood Pressure
Lipids
Adiposity
Waist-Height Ratio
Hispanic Americans
HDL Cholesterol
Insulin Resistance
Blood Glucose
Triglycerides
Cholesterol
Pediatrics

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Cardiometabolic Risk Assessments by Body Mass Index z -Score or Waist-to-Height Ratio in a Multiethnic Sample of Sixth-Graders. / Healthy Study Group.

In: Journal of Obesity, Vol. 2014, 421658, 2014.

Research output: Contribution to journalArticle

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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 (R2) 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, R2 attributed to BMIz or WHtR was 19{\%}-28{\%} among high-fatness and 8{\%}-13{\%} among lower-fatness students. R2 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.",
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