Key result
Anthropometric indices including BMI, waist circumference, waist-to-height ratio, and a body shape index demonstrated weak predictive power (AUCs ~0.6) for identifying elevated blood pressure in Iranian children and adolescents.
Why the study?
It was unclear which anthropometric indices best identify elevated blood pressure risk factors in pediatric populations.
Which anthropometric index best predicts elevated blood pressure risk factors in Iranian children and adolescents?
Cross-Sectional (n=14,008)
Yes
Which anthropometric index best predicts elevated blood pressure risk factors in Iranian children and adolescents?
Effect estimate: AUC 0.571 (95% CI 0.552-0.590)
Anthropometric indices such as BMI, WC, WHR, and ABSI have weak predictive ability for identifying elevated blood pressure in Iranian children and adolescents.
Anthropometric indices should not guide BP screening in Iranian youth; leaves open need for stronger predictors in prospective studies.
Anthropometric indices have been used as indicators for predicting hypertension (HTN) in children and adolescents but it is not clear which anthropometric measures are a better index for identifying elevated blood pressure (EBP) risk factors in pediatric population. Body mass index (BMI), waist circumference (WC), weight-height ratio (WHR), a body shape index (ABSI) and blood pressure were measured in 14 008 children and adolescents aged 7-18 years in a national school-aged survey CASPIN V. Hypertension (HTN) was defined according to the 2017 American Academy of Pediatrics guidelines, using the 95th percentile. The predictive power of anthropometric indices for HTN risk factors was examined using receiver operating characteristic (ROC) analyses. Multivariate logistic regression analysis was used to compare areas under ROC curves (AUCs) among the four anthropometric indices. BMI, WC, WHR, and ABSI were significantly higher in adolescents than in children. EBP was more prevalent in boys (7.2%) than girls (5.5%), whereas the prevalence of HTN was higher in girls (11.3%) than boys 10.4%. Prevalence odds ratio was around 2 for BMI, WC, and WHR with AUCs scores of nearly 0.6 to predict EBP in both children and adolescents of both sexes. Thus, the ability of BMI z-score, WC, WHR or ASBI to identify Iranian children and adolescents at higher risk of EBP was week. WC, WHR or ASBI in combination with BMI did not improve predictive power to identify subjects at higher risk of EBP.
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Yazdi et al. (2020) conducted a cross-sectional in Elevated blood pressure and hypertension (n=14,008). Anthropometric indices (BMI, WC, WHR, ABSI) vs. Normal anthropometric indices was evaluated on Predictive power (AUC) of BMI z-score for elevated blood pressure (AUC 0.571, 95% CI 0.552-0.590). Anthropometric indices including BMI, waist circumference, waist-to-height ratio, and a body shape index demonstrated weak predictive power (AUCs ~0.6) for identifying elevated blood pressure in Iranian children and adolescents.
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