title: Use of the waist-height ratio to predict metabolic syndrome in obese children and adolescents.
abstract: OBJECTIVE
  To demonstrate that the waist-height ratio (WHtR) is a simple and effective screening tool that could be used to identify obese children with the metabolic syndrome.
  
  
  METHODS
  Data from 109 obese boys and girls, aged 10.00-16.50 years, who were recruited as part of the Eat Smart study were analysed. Systolic (SBP) and diastolic (DBP) blood pressure, blood lipids (total cholesterol, triglycerides (TG), high- and low-density lipoproteins), insulin, glucose, height, weight and waist circumference (WC) were collected. These measurements were used to calculate WHtR, body mass index (BMI), Z-scores for BMI, WC, weight and homeostatic model assessment for insulin resistance (HOMA-IR). Correlations between anthropometric measures and blood pressure, lipids, insulin, glucose and HOMA-IR were assessed. Binary logistic regression was used to test which anthropometric measure was a significant predictor of the metabolic syndrome.
  
  
  RESULTS
  Among boys, WHtR was negatively correlated with glucose (P < 0.05); WHtR and BMI Z-score were positively correlated with insulin, HOMA-IR and TG (P < 0.05) and WC Z-score was significantly correlated with age. Among girls, WHtR, BMI Z-score and WC Z-score were positively correlated with insulin and HOMA-IR and negatively correlated with high-density lipoprotein-cholesterol (P < 0.05), whereas BMI Z-score was significantly correlated with SBP and DBP Z-scores. Twenty per cent of subjects were classified as having the metabolic syndrome, with WHtR, BMI Z-score and HOMA-IR being significant predictors.
  
  
  CONCLUSIONS
  The WHtR is a significant predictor of the metabolic syndrome in obese youth. The WHtR is the simplest index to calculate and interpret, making it an ideal non-invasive screening tool to use in clinical practice.
authors.affiliation: Children's Nutrition Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia. s.nambiar@uq.edu.au
authors.forename: Smita
authors.initials: S
authors.lastname: Nambiar
authors.forename: Helen
authors.initials: H
authors.lastname: Truby
authors.forename: Peter S W
authors.initials: PS
authors.lastname: Davies
authors.forename: Kimberley
authors.initials: K
authors.lastname: Baxter
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D001827:Body Height / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011793:Queensland; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides