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

Details

• Alternative Title:
  J Obes
• Personal Author:
  Kahn, Henry S. ; El ghormli, Laure ; Jago, Russell ; Foster, Gary D. ; McMurray, Robert G. ; Buse, John B. ; Stadler, Diane D. ; Treviño, Roberto P. ; Baranowski, Tom ; HEALTHY Study Group,
• Description:
  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 (R (2)) 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, R (2) attributed to BMIz or WHtR was 19%-28% among high-fatness and 8%-13% among lower-fatness students. R (2) 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.
• Subjects:
  Adiposity Blood Glucose Blood Pressure Body Mass Index Cardiovascular Diseases/ethnology Cardiovascular Diseases/prevention & Control Child Child Behavior Cholesterol, HDL Female Health Education Health Knowledge, Attitudes, Practice Humans Insulin Resistance Lipids Male Pediatric Obesity/ethnology Pediatric Obesity/prevention & Control Pediatric Obesity/psychology Predictive Value Of Tests Risk Assessment Risk Factors Students/psychology Triglycerides Waist-Height Ratio

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• Source:
  J Obes. 2014; 2014.
• Document Type:
  Journal Article
• Funding:
  U01-DK61223/DK/NIDDK NIH HHS/United States ; U01-DK61230/DK/NIDDK NIH HHS/United States ; U01-DK61231/DK/NIDDK NIH HHS/United States ; U01-DK61249/DK/NIDDK NIH HHS/United States ; UL1RR025747/RR/NCRR NIH HHS/United States ; UL1TR000083/TR/NCATS NIH HHS/United States ; UL1TR001111/TR/NCATS NIH HHS/United States
• Place as Subject:
  United States
• Volume:
  2014
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2ae6eb1cd8df958f430f646bf4b6c6117ade64ab0e8cee4e45978c6957ffd15f
• Download URL:
  https://stacks.cdc.gov/view/cdc/24811/cdc_24811_DS1.pdf
• File Type:
  [PDF - 628.14 KB ]