title: Role of waist measures in addition to body mass index to assess the hypertension risk in children.
abstract: This study aimed to evaluate whether waist measures, including waist circumference (WC) and waist-to-height ratio (WHtR), can improve the ability of body mass index (BMI) to assess the hypertension risk when used as continuous variables.
  
  
  
  In this cross-sectional study, 82 432 Chinese children aged 9-17 years were included. Elevated BP was defined using age-sex-and-height-specific references. Logistic regression model and area under the receiver operating characteristic curve (AUC) were performed after BMI and waist measures were converted into age-and-sex-based z-scores.
  
  
  
  WHtR, but not WC, was associated with elevated BP after adjusting for BMI, with the odds ratios ranging between 1.14 (95% confidence interval: 1.04, 1.25) and 1.30 (1.21, 1.39) for one unit increase in WHtR z-score. Combined use of BMI and WHtR z-scores showed a significantly larger AUC than BMI alone (p < 0.05), while joint use of BMI and WC was not better than BMI alone.
  
  
  
  WHtR, rather than WC, provided further information on hypertension risk beyond that provided by BMI alone when used as a continuous variable. This study suggests WHtR, in addition to BMI, should be included for the assessment of childhood adiposity in routine paediatric practice.
authors.affiliation: a Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center , Beijing , PR China.|b Centre for Chronic Disease, School of Medicine, The University of Queensland , Brisbane , Queensland , Australia.
authors.forename: Bin
authors.initials: B
authors.lastname: Dong
authors.affiliation: a Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center , Beijing , PR China.|b Centre for Chronic Disease, School of Medicine, The University of Queensland , Brisbane , Queensland , Australia.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: b Centre for Chronic Disease, School of Medicine, The University of Queensland , Brisbane , Queensland , Australia.
authors.forename: Luke W
authors.initials: LW
authors.lastname: Arnold
authors.affiliation: a Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center , Beijing , PR China.
authors.forename: Yide
authors.initials: Y
authors.lastname: Yang
authors.affiliation: a Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center , Beijing , PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
mesh_terms: D001827:Body Height; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D006801:Humans; D006973:Hypertension; D009765:Obesity; D012372:ROC Curve; D012307:Risk Factors; D055105:Waist Circumference
keywords: Adolescent; body mass index; child; hypertension; waist circumference; waist-height ratio