What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiometabolic risk in overweight and obese children (n=14493). Intervention: Waist/height ratio (WHtR) vs. Lower WHtR (<0.5). Primary outcome: Cardiometabolic risk (lipid and glycemic profiles, C-reactive protein, liver transaminases, hypertension, and metabolic syndrome).

What question did this study set out to answer?

To determine the clinical utility of the waist/height ratio (WHtR) in refining cardiometabolic risk assessment among children and adolescents already categorized by body mass index (BMI) percentile.

August 24, 2026Journal of the American College of CardiologyOpen Access

Role of the Waist/Height Ratio in the Cardiometabolic Risk Assessment of Children Classified by Body Mass Index

Q: What are the key findings of this study?

Increasing waist/height ratio was significantly associated with increased cardiometabolic risk in overweight and obese children, with 32% of obese children with WHtR ≥0.6 having metabolic syndrome.

Q: What question did this study set out to answer?

To determine the clinical utility of the waist/height ratio (WHtR) in refining cardiometabolic risk assessment among children and adolescents already categorized by body mass index (BMI) percentile.

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Key result

Higher waist/height ratio is linked to increased cardiometabolic risk in overweight and obese youth.

n=14,493

Why the study?

Does waist/height ratio (WHtR) improve cardiometabolic risk stratification in children already classified by BMI?

Key Points

To determine the clinical utility of the waist/height ratio (WHtR) in refining cardiometabolic risk assessment among children and adolescents already categorized by body mass index (BMI) percentile.
Conducted a cross-sectional analysis using data from 5 National Health and Nutrition Examination Surveys (NHANES 1999–2008) in participants aged 5 to 18 years (N=14,493).
Stratified children across BMI categories (normal, overweight, and obese) and further subclassified them by WHtR tiers (<0.5, 0.5 to <0.6, and ≥0.6) to evaluate lipid profiles, glycemic status, C-reactive protein, liver transaminases, hypertension, and metabolic syndrome.
Overweight and obese subjects with a WHtR <0.5 demonstrated cardiometabolic risk levels approaching those observed in peers with a normal BMI percentile.
Increasing WHtR was significantly associated with elevated cardiometabolic risk among overweight and obese cohorts, with the strongest associations present in obese participants.
Among obese youths with a WHtR ≥0.6, 26% presented with elevated non-high-density lipoprotein cholesterol, 18% had elevated C-reactive protein, 69% exhibited elevated homeostatic model assessment-insulin resistance, and 32% met criteria for metabolic syndrome.

Study Design

Type

Cross-Sectional (n=14,493)

Multicenter

Yes

Structured PICO

Does waist/height ratio (WHtR) improve cardiometabolic risk stratification in children already classified by BMI?

Population

14,493 children ages 5 to 18 years from the NHANES 1999-2008 surveys, evaluated to determine the utility of waist/height ratio in specifying cardiometabolic risk.

Exposure

Waist/height ratio (WHtR) stratification (<0.5, 0.5 to <0.6, ≥ 0.6) within BMI percentile categories (normal, overweight, and obese)

Outcome

Cardiometabolic risk markers including lipid and glycemic profiles, C-reactive protein, liver transaminases, prevalence of hypertension, and metabolic syndromesurrogate

Discussion

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Implication

Waist/height ratio further specifies cardiometabolic risk in overweight and obese children, identifying a subset with significantly higher risk factor levels.

Cite This Study

Khoury et al. (2013) conducted a cross-sectional in Cardiometabolic risk in overweight and obese children (n=14,493). Waist/height ratio (WHtR) vs. Lower WHtR (<0.5) was evaluated on Cardiometabolic risk (lipid and glycemic profiles, C-reactive protein, liver transaminases, hypertension, and metabolic syndrome). Increasing waist/height ratio was significantly associated with increased cardiometabolic risk in overweight and obese children, with 32% of obese children with WHtR ≥0.6 having metabolic syndrome.

synapsesocial.com/papers/6a8c60da133d286cb12e2b48 https://doi.org/10.1016/j.jacc.2013.01.026

Topics

Women and heart disease

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Implication

Waist/height ratio further specifies cardiometabolic risk in overweight and obese children, identifying a subset with significantly higher risk factor levels.

Role of the Waist/Height Ratio in the Cardiometabolic Risk Assessment of Children Classified by Body Mass Index

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Topics

Role of the Waist/Height Ratio in the Cardiometabolic Risk Assessment of Children Classified by Body Mass Index

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider