The Journal of Pediatrics
Volume 152, Issue 2 , Pages 207-213.e2, February 2008

Waist-to-Height Ratio, a Useful Index to Identify High Metabolic Risk in Overweight Children

  • Claudio Maffeis, MD

      Affiliations

    • Department of Mother and Child, Biology-Genetics, Pediatric Unit, University of Verona, Verona, Italy
    • Corresponding Author InformationReprint requests: Prof Claudio Maffeis, Department of Mother and Child, Biology-Genetics, Section of Pediatrics, University of Verona, P.zzale LA Scuro 10, 37134 Verona, Italy.
    • ,
  • Claudia Banzato, MD

      Affiliations

    • Department of Mother and Child, Biology-Genetics, Pediatric Unit, University of Verona, Verona, Italy
    • ,
  • Giorgio Talamini, MD

      Affiliations

    • Department of Biomedical and Surgical Science, University of Verona, Verona, Italy.
    • ,
  • Obesity Study Group of the Italian Society of Pediatric Endocrinology and Diabetology

      Affiliations

    • Brambilla Paolo, MD, Cerutti Franco, MD, Corciulo Nicola, MD, Cuccarolo Giuliano, MD, Di Pietro Mario, MD, Falorni Adriano, MD, Franzese Adriana, MD, Gennari Monia, MD, Grugni Graziano, MD, Iughetti Lorenzo, MD, Miraglia Del Giudice Emanuele, MD, Petri Antonella, MD, Trada Marcello, MD, and Yiannakou Petros, MD.

Received 28 March 2007; received in revised form 25 July 2007; accepted 10 September 2007. published online 19 November 2007.

Objective

To determine whether using a combination of body mass index (BMI) and waist circumference (WC) or waist-to-height ratio (W/Hr) is clinically helpful in identifying children with high metabolic and cardiovascular risks.

Study design

Caucasian children (M/F: 740/739; n = 1479; ages 5 to 15 years) were studied. Anthropometry, blood pressure, and venous fasting blood samples tested for triacylglycerol, HDL cholesterol, and glucose were measured.

Results

Overweight children with a large waist (>90th percentile) or high W/Hr (>0.5) but not obese or normal-weight children had significantly greater chances of being at high metabolic and cardiovascular risk than normal-weight children (OR: 7; 95% CI: 3.63-13.48; P < .001, OR: 8.16; 95% CI: 3.87-17.23; P < .001, respectively) with a low waist measurement (≤90th percentile) or W/Hr (≤0.5). Interestingly, waist and W/Hr cutoffs (90th percentile and 0.5, respectively) were both able to identify children with the highest metabolic and cardiovascular risks among those who were overweight. However, contrary to waist circumference, W/Hr has the advantage of not requiring population specific reference tables as well as age and sex specific cutoffs.

Conclusions

Waist circumference and W/Hr are helpful in detecting, among overweight children, those with a higher likelihood of having metabolic and cardiovascular risks.

Abbreviations: AUC, Area under the curve, BMI, Body mass index, MCVRFs, Metabolic and cardiovascular risk factors, TG, Triglycerides, W/Hr, Waist-to-height ratio

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PII: S0022-3476(07)00877-3

doi:10.1016/j.jpeds.2007.09.021

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The Journal of Pediatrics
Volume 152, Issue 2 , Pages 207-213.e2, February 2008

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