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17-04-2012 | Cardiology | Article

Waist measures may improve pediatric cardiometabolic risk screening

Abstract

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MedWire News: Waist measures should be included in cardiometabolic risk assessment of overweight and obese adolescents, suggest findings of a study published in the Archives of Pediatrics and Adolescent Medicine.

The researchers found that inclusion of waist circumference (WC) percentile and waist-to-height ratio (WHtR) improved the risk stratification of lipid and blood pressure values in adolescents.

"Body mass index (BMI) is currently the most commonly used measure of adiposity in children," explain Brian McCrindle (University of Toronto, Ontario, Canada) and colleagues. "However, BMI itself cannot differentiate between fat and fat-free mass."

WC and WHtR have been identified as "convenient" and "effective" indicators of abdominal adiposity. However, the combined utility of these measures with BMI in screening for cardiometabolic risk in children has not been studied, they add.

To address this, McCrindle and team recruited 3248 adolescents (aged 14-15 years) who had complete anthropomorphic and clinical data available.

Overall, increasing measures of obesity, whether assessed by BMI alone, BMI/WC percentile, or BMI/WHtR, were significantly associated with hypertension and a worsened lipid profile, although these associations had limited strength and were not statistically significant from each other, report the authors

Multivariate regression analysis revealed that overweight and obese adolescents (BMI ≥85th percentile) with increased waist measures had significantly worse lipid profiles than those with waist measures in lower categories, with the greatest associations seen in those who were obese

In addition, obese adolescents (BMI ≥95th percentile) had increased odds for a higher hypertension category, and those with an increased WHtR had further increased odds for hypertension relative to those with more normal waist measures.

"Though guidelines from the major Canadian, American, and British medical associations acknowledge the potential added benefits of the use of waist measures, they are not in full agreement with respect to their use in screening the pediatric population," write the researchers.

"Our present study shows that the incorporation of waist measures in the assessment of adolescents improves the risk stratification of lipid and blood pressure values, indicating that waist measures should be considered in the routine pediatric assessment."

By Nikki Withers

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