Key result
Adding waist-for-height ratio to BMI z-score did not substantially improve the identification of children with elevated blood pressure.
Why the study?
Does adding waist-for-height ratio to BMI improve the identification of elevated blood pressure in children?
Cross-Sectional (n=5,207)
Does adding waist-for-height ratio to BMI improve the identification of elevated blood pressure in children?
Adding waist-for-height ratio to BMI does not improve the identification of elevated blood pressure in children aged 10-14 years.
Answers are grounded in this paper and cite their sources.
Does not support adding waist-for-height ratio to BMI for BP screening in children; leaves open whether alternative adiposity indices enhance detection.
BACKGROUND: In children, waist-for-height ratio (WHtR) has been proposed to identify subjects at higher risk of cardiovascular diseases. The utility of WHtR to identify children with elevated blood pressure (BP) is unclear. Design. Cross-sectional population-based study of schoolchildren. METHODS: Weight, height, waist circumference and BP were measured in all sixth-grade schoolchildren of the canton de Vaud (Switzerland) in 2005/06. WHtR was computed as waist [cm]/height [cm]. Elevated BP was defined according to sex-, age- and height-specific US reference data. The area under the receiver operating characteristic curve (AUC) statistic was computed to compare the ability of body mass index (BMI) z-score and WHtR, alone or in combination, to identify children with elevated BP. RESULTS: 5207 children participated (76% response) [2621 boys, 2586 girls; mean (± SD) age, 12.3 ± 0.5 years; range: 10.1-14.9]. The prevalence of elevated BP was 11%. Mean WHtR was 0.44 ± 0.05 (range: 0.29- 0.77) and 11% had high WHtR (> 0.5). BMI z-score and WHtR were strongly correlated (Spearman correlation coefficient r = 0.76). Both indices were positively associated with elevated BP. AUCs for elevated BP was relatively low for BMI z-score (0.62) or for WHtR (0.62), and was not substantially improved when both indices were considered together (0.63). CONCLUSIONS: The ability of BMI z-score or WHtR to identify children aged 10-14 with elevated BP was weak. Adding WHtR did not confer additional discriminative power to BMI alone. These findings do not support the measurement of WHtR in addition to BMI to identify children with elevated BP.
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Chioléro et al. (2012) conducted a cross-sectional in Elevated blood pressure (n=5,207). Waist-for-height ratio (WHtR) combined with body mass index (BMI) vs. Body mass index (BMI) alone was evaluated on Ability to identify children with elevated blood pressure (Area under the receiver operating characteristic curve [AUC]). Adding waist-for-height ratio to BMI z-score did not substantially improve the identification of children with elevated blood pressure.
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