Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Apr;93(5):1294-1301.
doi: 10.1038/s41390-022-02223-4. Epub 2022 Aug 1.

Diagnosis accuracy of waist-to-height ratio to predict cardiometabolic risk in children with obesity

Judit Muñoz-Hernando  1 , Veronica Luque  2   3 , Natalia Ferré  1 , Albert Feliu  1   4 , Ricardo Closa-Monasterolo  1 , Desirée Gutiérrez-Marin  5 , Josep Basora  6 , Ana Pedraza  7 , Olga Salvado  7 , Susana Vidal-Piedra  8 , Joaquín Escribano  9   10 ; OBEMAT2.0 Study Group
Collaborators, Affiliations
Observational Study

Diagnosis accuracy of waist-to-height ratio to predict cardiometabolic risk in children with obesity

Judit Muñoz-Hernando et al. Pediatr Res. 2023 Apr.

Abstract

Background: Waist-to-height ratio (WHtR) predicts abdominal fat and cardiometabolic risk. In children with obesity, the most adequate cut-off to predict cardiometabolic risk as well as its ability to predict risk changes over time has not been tested. Our aim was to define an appropriate WHtR cut-off to predict cardiometabolic risk in children with obesity, and to analyze its ability to predict changes in cardiometabolic risk over time.

Methods: This is an observational prospective study secondary to the OBEMAT2.0 trial. We included data from 218 participants (8-15 years) who attended baseline and final visits (12 months later). The main outcome measure was a cardiometabolic risk score derived from blood pressure, lipoproteins, and HOMA index of insulin resistance.

Results: The optimal cut-off to predict the cardiometabolic risk score was WHtR ≥0.55 with an area under the curve of 0.675 (95% CI: 0.589-0.760) at baseline and 0.682 (95% CI: 0.585-0.779) at the final visit. Multivariate models for repeated measures showed that changes in cardiometabolic risk were significantly associated with changes in WHtR.

Conclusion: This study confirms the clinical utility of WHtR to predict changes in cardiometabolic risk over time in children with obesity. The most accurate cut-off to predict cardiometabolic risk in children with obesity was WHtR ≥0.55.

Impact: In children, there is no consensus on a unique WHtR cut-off to predict cardiometabolic risk. The present work provides sufficient evidence to support the use of the 0.55 boundary. We have a large sample of children with obesity, with whom we compared the previously proposed boundaries according to cardiometabolic risk, and we found the optimal WHtR cut-off to predict it. We also analyzed if a reduction in the WHtR was associated with an improvement in their cardiometabolic profile.

PubMed Disclaimer

References

    1. Avolio, E. et al. Obesity and body composition in man and woman: associated diseases and the new role of gut microbiota. Curr. Med. Chem. 27, 216–229 (2019).
    1. Bays, H. Adiposopathy, ‘sick fat,’ Ockham’s razor, and resolution of the obesity paradox. Curr. Atheroscler. Rep. 16, 409 (2014). - PubMed - PMC
    1. Borga, M. et al. Advanced body composition assessment: from body mass index to body composition profiling. J. Investig. Med. 66, 887–895 (2018).
    1. Juonala, M. et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N. Engl. J. Med. 365, 1876–1885 (2011). - PubMed
    1. Baker, J. L., Olsen, L. W. & Sørensen, T. I. A. Childhood body-mass index and the risk of coronary heart disease in adulthood. N. Engl. J. Med. 357, 2329–2337 (2007). - PubMed - PMC

Publication types

LinkOut - more resources