title: Waist-to-height ratio, waist circumference and BMI as indicators of percentage fat mass and cardiometabolic risk factors in children aged 3-7 years.
abstract: OBJECTIVE
  To assess whether waist-to-height-ratio (WHtR) is a better estimate of body fat percentage (BF%) and a better indicator of cardiometabolic risk factors than BMI or waist circumference (WC) in young children.
  
  
  METHODS
  WHtR, WC and BMI were measured by trained staff according to standardized procedures. (2)H2O and (2)H2(18)O isotope dilution were used to assess BF% in 61 children (3-7 years) from the general population, and bioelectrical impedance (Horlick equation) was used to assess BF% in 75 overweight/obese children (3-5 years). Cardiometabolic risk factors, including diastolic and systolic blood pressure, HOMA2-IR, leptin, adiponectin, triglycerides, total cholesterol, HDL- and LDL-cholesterol, TNFα and IL-6 were determined in the overweight/obese children.
  
  
  RESULTS
  In the children from the general population, after adjustments for age and gender, BMI had the highest explained variance for BF% compared to WC and WHtR (R(2) = 0.32, 0.31 and 0.23, respectively). In the overweight/obese children, BMI and WC had a higher explained variance for BF% compared to WHtR (R(2) = 0.68, 0.70 and 0.50, respectively). In the overweight/obese children, WHtR, WC and BMI were all significantly positively correlated with systolic blood pressure (r = 0.23, 0.30, 0.36, respectively), HOMA2-IR (r = 0.53, 0.62, 0.63, respectively), leptin (r = 0.70, 0.77, 0.78, respectively) and triglycerides (r = 0.33, 0.36, 0.24, respectively), but not consistently with other parameters.
  
  
  CONCLUSIONS
  In young children, WHtR is not superior to WC or BMI in estimating BF%, nor is WHtR better correlated with cardiometabolic risk factors than WC or BMI in overweight/obese children. These data do not support the use of WHtR in young children.
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Anna
authors.initials: A
authors.lastname: Sijtsma
authors.affiliation: Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Gianni
authors.initials: G
authors.lastname: Bocca
authors.affiliation: Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Carianne
authors.initials: C
authors.lastname: L'abée
authors.affiliation: Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Eryn T
authors.initials: ET
authors.lastname: Liem
authors.affiliation: Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Pieter J J
authors.initials: PJ
authors.lastname: Sauer
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: e.corpeleijn@umcg.nl.
authors.forename: Eva
authors.initials: E
authors.lastname: Corpeleijn
mesh_terms: D052242:Adiponectin / Q000097:blood; D050154:Adiposity; D001794:Blood Pressure / Q000502:physiology; D001827:Body Height; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D016014:Linear Models; D008297:Male; D050177:Overweight / Q000097:blood / Q000150:complications; D063766:Pediatric Obesity / Q000097:blood / Q000150:complications; D018570:Risk Assessment; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055105:Waist Circumference
chemical_list: D052242:Adiponectin; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015850:Interleukin-6; D020738:Leptin; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha
keywords: Anthropometry; Blood pressure; Body composition; Cholesterol; Insulin; Lipid