Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index

BACKGROUND: Visceral adipose tissue is associated with increased risk for c ardiovascular disease risk factors and morbidity from cardiovascular diseas es. Waist measurement and waist-to-height ratio (WHtR) have been used as pr oxy measures of visceral adipose tissue, mainly in adults. OBJECTIVE: To validate body mass index (BMI), waist circumference and WHtR as predictors for the presence of cardiovascular disease risk factors in ch ildren of Greek-Cypriot origin. SUBJECTS AND METHODS: A total of 1037 boys and 950 girls with mean age 11.4 +/- 0.4 y were evaluated, Dependent variables for the study were total cho lesterol (TC), triglycerides (TG), high-density lipoprotein cholestrol (HDL -C), low-density lipoprotein cholesterol (LDL-C), and systolic (SBP) and di astolic (DBP) blood pressure. RESULTS: When children were divided into two groups according to the 75th p ercentile for BMI, waist circumference and WHtR, all dependent variables ha d higher mean values in the highest percentile groups in WHtR groups and al most all variables in BMI and waist circumference groups. Adjusted odds rat ios for predicting pathological values of cardiovascular disease risk facto rs were slightly higher for the highest WHtR group for predicting lipid and lipoprotein pathological values and for the highest BMI groups in predicti ng high blood pressure measurement. Using stepwise multiple regression anal ysis to explain the Variance of the dependent variables, waist circumferenc e was the most significant predictor for all variables both for boys and gi rls, whereas BMI had the lowest predictive value for the detection of cardi ovascular disease risk factors. CONCLUSION: Waist circumference and WHtR are better predictors of cardiovas cular disease risk factors in children than BMI. Further studies are necess ary to determine the cutoff points for these indices for an accurate predic tion of risk factors.