title: Anthropometric indices as measures of body fat assessed by DXA in relation to cardiovascular risk factors in children and adolescents: NHANES 1999-2004.
abstract: OBJECTIVE
  Anthropometrics are commonly used indices of total and central adiposity. No study has compared anthropometric measurements to dual-energy X-ray absorptiometry (DXA) measurements as correlates of cardiovascular risks in a nationally representative sample of youth. We aimed to evaluate the validity of anthropometrics compared to DXA-assessed adiposity in relation to cardiovascular risks in youth aged 8-19 years.
  
  
  METHODS
  Data were from the National Health and Nutrition Examination Survey 1999-2004 (n=7013). We examined the correlations between anthropometric and DXA measures of adiposity (i.e., body mass index (BMI) versus percent fat mass (%FM) and fat mass index, and waist circumference (WC) and waist-to-height ratio (WHtR) versus percent trunk fat mass (%TFM)) with nine cardiovascular risks, stratified by sex and age, or race-ethnicity.
  
  
  RESULTS
  Anthropometric and DXA adiposity measures were significantly correlated with insulin (r: 0.48 to 0.66), C-reactive protein (r: 0.47 to 0.58), triglycerides (r: 0.15 to 0.41), high-density lipoprotein cholesterol (HDL-C, r: -0.44 to -0.22), systolic blood pressure (SBP, r: 0.10 to 0.31), low-density lipoprotein cholesterol (r: 0.09 to 0.30), total cholesterol (TC, r: 0.01 to 0.29) and glucose (r: 0.05 to 0.20). Only in all youth, BMI was more strongly correlated with SBP (0.22 vs. 0.12,P<0.0001) and HDL-C (-0.34 vs. -0.25,P<0.0001) than %FM; WC but not WHtR was more strongly correlated with HDL-C (-0.37 vs. -0.30,P<0.0001) but less strongly associated with TC (0.12 vs. 0.21,P<0.0001) than %TFM.
  
  
  CONCLUSIONS
  DXA adiposity measures do not produce stronger associations with cardiovascular risk factors in youth than BMI or WC.
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Cui
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
authors.forename: Kimberly P
authors.initials: KP
authors.lastname: Truesdale
authors.affiliation: Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
authors.forename: Jianwen
authors.initials: J
authors.lastname: Cai
authors.affiliation: Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Michaela B
authors.initials: MB
authors.lastname: Koontz
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC ; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: June
authors.initials: J
authors.lastname: Stevens
keywords: body mass index; trunk fat; waist circumference; waist-to-height ratio