title: Role of waist measures in characterizing the lipid and blood pressure assessment of adolescents classified by body mass index.
abstract: OBJECTIVE
  To determine if the interaction of waist circumference percentile and waist to height ratio(WHtR) with body mass index (BMI) may serve to provide further risk specification in the lipid and blood pressure assessment of adolescents beyond BMI classification.
  
  
  METHODS
  Population-based, cross-sectional study. Data collected during the 2009-2010 academic school year.
  
  
  METHODS
  Geographically and administratively defined Niagara Region, Ontario, Canada. Data collected in school, during subjects’ mandatory physical education class. Part of the Heart Niagara Inc Healthy Heart Schools’ Program.
  
  
  METHODS
  Entire population of grade 9 (14- and 15-year-old) students in the Niagara Region, Ontario.Four thousand eight hundred eighty-four students enrolled in grade 9 during the study period, of which 4104 participated (51% male) and 3248 (79%) had complete data.
  
  
  METHODS
  Nonfasting lipid values and blood pressure categories in subjects categorized based on BMI/waist circumference percentile and BMI/WHtR.
  
  
  RESULTS
  The associations between blood pressure, lipid profile, and measures of adiposity (BMI alone, BMI/waist circumference percentile, and BMI/WHtR) were statistically significant but had a limited strength and were not statistically significant from each other. For overweight and obese subjects, increased WHtR categories were associated with worsened lipid profile and increased odds of hypertension both relative to subjects with both normal BMI and normal WHtR and subjects with normal WHtR within each BMI category.
  
  
  CONCLUSIONS
  Waist measures should be included in the screening and assessment of overweight and obese adolescents.
authors.affiliation: Division of Cardiology, Labatt Family Heart Centre, Department of Pediatrics, University of Toronto, the Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Khoury
authors.forename: Cedric
authors.initials: C
authors.lastname: Manlhiot
authors.forename: Stafford
authors.initials: S
authors.lastname: Dobbin
authors.forename: Don
authors.initials: D
authors.lastname: Gibson
authors.forename: Nita
authors.initials: N
authors.lastname: Chahal
authors.forename: Helen
authors.initials: H
authors.lastname: Wong
authors.forename: Jolie
authors.initials: J
authors.lastname: Davies
authors.forename: Karen
authors.initials: K
authors.lastname: Stearne
authors.forename: Amanda
authors.initials: A
authors.lastname: Fisher
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001794:Blood Pressure; D001795:Blood Pressure Determination; D001823:Body Composition; D001827:Body Height; D015992:Body Mass Index; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis*; D008055:Lipids / Q000097:blood*; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D050177:Overweight / Q000097:blood / Q000175:diagnosis*; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D008055:Lipids