title: Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children.
abstract: OBJECTIVE
  To determine whether using a combination of body mass index (BMI) and waist circumference (WC) or waist-to-height ratio (W/Hr) is clinically helpful in identifying children with high metabolic and cardiovascular risks.
  
  
  METHODS
  Caucasian children (M/F: 740/739; n = 1479; ages 5 to 15 years) were studied. Anthropometry, blood pressure, and venous fasting blood samples tested for triacylglycerol, HDL cholesterol, and glucose were measured.
  
  
  RESULTS
  Overweight children with a large waist (>90(th) percentile) or high W/Hr (>0.5) but not obese or normal-weight children had significantly greater chances of being at high metabolic and cardiovascular risk than normal-weight children (OR: 7; 95% CI: 3.63-13.48; P < .001, OR: 8.16; 95% CI: 3.87-17.23; P < .001, respectively) with a low waist measurement (</=90(th) percentile) or W/Hr (</=0.5). Interestingly, waist and W/Hr cutoffs (90(th) percentile and 0.5, respectively) were both able to identify children with the highest metabolic and cardiovascular risks among those who were overweight. However, contrary to waist circumference, W/Hr has the advantage of not requiring population specific reference tables as well as age and sex specific cutoffs.
  
  
  CONCLUSIONS
  Waist circumference and W/Hr are helpful in detecting, among overweight children, those with a higher likelihood of having metabolic and cardiovascular risks.
authors.affiliation: Department of Mother and Child, Biology-Genetics, Pediatric Unit, University of Verona, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Maffeis
authors.forename: Claudia
authors.initials: C
authors.lastname: Banzato
authors.forename: Giorgio
authors.initials: G
authors.lastname: Talamini
mesh_terms: D000293:Adolescent; D000886:Anthropometry / Q000379:methods*; D001823:Body Composition; D001827:Body Height; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis*; D009765:Obesity; D016017:Odds Ratio; D050177:Overweight / Q000150:complications / Q000175:diagnosis*; D010372:Pediatrics / Q000379:methods*; D012372:ROC Curve; D012680:Sensitivity and Specificity