Alternative waist-to-height ratios associated with risk biomarkers in youth with diabetes: comparative models in the SEARCH for Diabetes in Youth Study

Details

• Alternative Title:
  Int J Obes (Lond)
• Personal Author:
  Kahn, Henry S. ; Divers, Jasmin ; Fino, Nora F. ; Dabelea, Dana ; Bell, Ronny ; Liu, Lenna L. ; Zhong, Victor W. ; Saydah, Sharon
• Description:
  Background/objectives
  
  The waist-to-height ratio (WHtR) estimates cardiometabolic risk in youth without need for growth charts by sex and age. Questions remain about whether waist circumference measured per protocol of the National Health and Nutrition Examination Survey (WNHAHtR) or World Health Organization (WWHOHtR) can better predict blood pressures and lipid parameters in youth.
  
  Participants/methods
  
  WHtR was measured under both anthropometric protocols among participants in the SEARCH Study, who were recently diagnosed with diabetes (ages 5–19 years; N = 2 773). Biomarkers were documented concurrently with baseline anthropometry and again ~7 years later (ages 10–30 years; N = 1 712). For prediction of continuous biomarker outcomes, baseline WNHAHtR or WWHOHtR entered semiparametric regression models employing restricted cubic splines. To predict binary biomarkers (high-risk group defined as the most adverse quartile) linear WNHAHtR or WWHOHtR terms entered logistic models. Model covariates included demographic characteristics, pertinent medication use, and (for prospective predictions) the follow-up time since baseline. We used measures of model fit, including the adjusted-R2 and the area under the receiver operator curves (AUC) to compare WNHAHtR and WWHOHtR.
  
  Results
  
  For the concurrent biomarkers, the proportion of variation in each outcome explained by full regression models ranged from 23 to 46%; for the prospective biomarkers, the proportions varied from 11 to 30%. Nonlinear relationships were recognized with the lipid outcomes, both at baseline and at follow-up. In full logistic models, the AUCs ranged from 0.75 (diastolic pressure) to 0.85 (systolic pressure) at baseline, and from 0.69 (triglycerides) to 0.78 (systolic pressure) at the prospective follow-up. To predict baseline elevations of the triglycerides/HDL cholesterol ratio, the AUC was 0.816 for WWHOHtR compared with 0.810 for WNHAHtR (p = 0.003), but otherwise comparisons between alternative WHtR protocols were not significantly different.
  
  Conclusions
  
  Among youth with recently diagnosed diabetes, measurements of WHtR by either waist circumference protocol similarly helped estimate current and prospective cardiometabolic risk biomarkers.
  
  
• Subjects:
  Adolescent Adult Article Biomarkers Body Mass Index Cardiovascular Diseases Child Cross-Sectional Studies Diabetes Mellitus, Type 2 Female Follow-Up Studies Humans Male Metabolic Syndrome Nutrition Surveys Pediatric Obesity Predictive Value Of Tests United States Waist-Height Ratio Waist Circumference Young Adult

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• Source:
  Int J Obes (Lond). 43(10):1940-1950
• Pubmed ID:
  30926953
• Pubmed Central ID:
  PMC9425551
• Document Type:
  Journal Article
• Funding:
  P30 DK057516/DK/NIDDK NIH HHSUnited States/ ; U18 DP002710/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006134/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006138/ACL/ACL HHSUnited States/ ; UL1 TR000154/TR/NCATS NIH HHSUnited States/ ; U18 DP002714/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000248/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000244/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR000062/TR/NCATS NIH HHSUnited States/ ; U18DP006131/ACL/ACL HHSUnited States/ ; UL1 TR001425/TR/NCATS NIH HHSUnited States/ ; UL1 TR000077/TR/NCATS NIH HHSUnited States/ ; HIR 10-001/HX/HSRD VAUnited States/ ; U18DP006139/ACL/ACL HHSUnited States/ ; UC4 DK108173/DK/NIDDK NIH HHSUnited States/ ; U01 DP000247/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006139/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006131/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006134/ACL/ACL HHSUnited States/ ; U18 DP006138/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006136/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP002709/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006133/DP/NCCDPHP CDC HHSUnited States/ ; R01 DK127208/DK/NIDDK NIH HHSUnited States/ ; UL1 TR000423/TR/NCATS NIH HHSUnited States/ ; U18DP006136/ACL/ACL HHSUnited States/ ; U01 DP000250/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000246/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000254/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006133/ACL/ACL HHSUnited States/ ; U18 DP002708/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  43
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:43ee70652941af185689ac76ca0bb91cf25c24a3e1b80f420ff0fd3d6adc4696
• Download URL:
  https://stacks.cdc.gov/view/cdc/121161/cdc_121161_DS1.pdf
• File Type:
  [PDF - 368.63 KB ]