title: No use for waist-for-height ratio in addition to body mass index to identify children with elevated blood pressure.
abstract: 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.
authors: IUMSP, Lausanne University Hospital, Switzerland. arnaud.chiolero@chuv.ch
authors: Arnaud
authors: A
authors: Chiolero
authors: Gilles
authors: G
authors: Paradis
authors: Katerina
authors: K
authors: Maximova
authors: Michel
authors: M
authors: Burnier
authors: Pascal
authors: P
authors: Bovet
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D001794:Blood Pressure; D001827:Body Height; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D012372:ROC Curve; D012307:Risk Factors; D055105:Waist Circumference