title: Waist-to-Height Ratio as an Index for Cardiometabolic Risk in Adolescents: Results from the 1998-2008 KNHANES.
abstract: OBJECTIVE
  To describe the relationship between the waist-to-height ratio (WHtR) and cardiometabolic risk factors (CMRFs) and to evaluate the validity of WHtR in identifying adolescents with metabolic syndrome.
  
  
  METHODS
  We analyzed data from a pooled population of 4068 adolescents aged 10-19 years from the Korean National Health and Nutrition Examination Surveys conducted between 1998 and 2008. Overweight individuals were defined by body mass index (BMI) ≥85th percentile. Those with at least 2 CMRFs among hypertension, hyperglycemia, hypertriglyceridemia, and decreased high-density lipoprotein cholesterol (HDL-C) were classified as having multiple CMRFs.
  
  
  RESULTS
  WHtR was significantly related to systolic blood pressure, HDL-C, and triglycerides in both non-overweight and overweight adolescents (all p<0.01). Among overweight adolescents, the area under the curve (AUC) for WHtR in identifying multiple CMRFs was significantly greater than that for BMI (p=0.014). Metabolic syndrome was more common in overweight adolescents with a WHtR of ≥0.5 than in those with a WHtR of <0.5 (p<0.001). In non-overweight adolescents, the prevalences of multiple CMRFs (p=0.001) and metabolic syndrome (p<0.001) were higher in those with a WHtR of ≥0.5 than in those with a WHtR of <0.5. Among those without central obesity, the prevalence of multiple CMRFs was higher in those with a WHtR of ≥0.5 than in those with a WHtR of <0.5 (p=0.021).
  
  
  CONCLUSIONS
  WHtR is a simple and valid index for identifying adolescents with increased cardiometabolic risk and is related to CMRFs even in non-overweight adolescents. In adolescents already screened via BMI and waist circumference (WC), WHtR seems to be of additional help in discriminating those at higher cardiometabolic risk.
authors.affiliation: Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
authors.forename: In Hyuk
authors.initials: IH
authors.lastname: Chung
authors.affiliation: Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA.|Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Sangshin
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea. pmj@paik.ac.kr.
authors.forename: Mi Jung
authors.initials: MJ
authors.lastname: Park
authors.affiliation: Department of Pediatrics, College of Medicine, CHA University, Seongnam, Korea. pedyoo@cha.ac.kr.
authors.forename: Eun-Gyong
authors.initials: EG
authors.lastname: Yoo
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D001827:Body Height; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D009749:Nutrition Surveys; D056128:Obesity, Abdominal / Q000150:complications / Q000453:epidemiology*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference / Q000502:physiology; D065927:Waist-Height Ratio; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: Waist; body mass index; height; metabolic syndrome; obesity