title: Waist-to-height ratio and cardiometabolic risk factors in adolescence: findings from a prospective birth cohort.
abstract: OBJECTIVE
  To examine the associations between body mass index (BMI) and waist-to-height ratio (WHtR) measured in childhood and adolescence and cardiometabolic risk factors in adolescence.
  
  
  METHODS
  Secondary data analysis of the Avon Longitudinal Study of Parents and Children, a population based cohort. Data from 2858 adolescents aged 15.5 (standard deviation 0.4) years and 2710 of these participants as children aged 7-9 years were used in this analysis. Outcome measures were cardiometabolic risk factors, including triglycerides, low density lipoprotein cholesterol, high density lipoprotein cholesterol, insulin, glucose and blood pressure at 15 years of age.
  
  
  RESULTS
  Both BMI and WHtR measured at ages 7-9 years and at age 15 years were associated with cardiometabolic risk factors in adolescents. A WHtR ≥0.5 at 7-9 years increased the odds by 4.6 [95% confidence interval 2.6 to 8.1] for males and 1.6 [0.7 to 3.9] for females of having three or more cardiometabolic risk factors in adolescence. Cross-sectional analysis indicated that adolescents who had a WHtR ≥0.5, the odds ratio of having three or more cardiometabolic risk factors was 6.8 [4.4 to 10.6] for males and 3.8 [2.3 to 6.3] for females. The WHtR cut-point was highly specific in identifying cardiometabolic risk co-occurrence in male children and adolescents as well as female children (90 to 95%), but had poor sensitivity (17 to 53%). Similar associations were observed when BMI was used to define excess adiposity.
  
  
  CONCLUSIONS
  WHtR is a simple alternative to age and sex adjusted BMI for assessing cardiometabolic risk in adolescents.
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Graves
authors.forename: S P
authors.initials: SP
authors.lastname: Garnett
authors.forename: C T
authors.initials: CT
authors.lastname: Cowell
authors.forename: L A
authors.initials: LA
authors.lastname: Baur
authors.forename: A
authors.initials: A
authors.lastname: Ness
authors.forename: N
authors.initials: N
authors.lastname: Sattar
authors.forename: D A
authors.initials: DA
authors.lastname: Lawlor
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D009765:Obesity / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D065927:Waist-Height Ratio
keywords: ALSPAC longitudinal study; Waist-to-height ratio; cardiometabolic risk
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