title: Utility of three anthropometric indices in assessing the cardiometabolic risk profile in children.
abstract: OBJECTIVE
  To evaluate the ability of BMI, WC, and WHtR to identify increased cardiometabolic risk in pre-adolescents.
  
  
  METHODS
  This is a cross-sectional study involving 192 children (10.92 ± 0.58 years, 56% female) from the United Kingdom between 2010 and 2013. Receiver operating characteristic curves determined the discriminatory ability of BMI, WC and WHtR to identify individuals with increased cardiometabolic risk (increased clustered triglycerides, HDL-cholesterol, systolic blood pressure, cardiorespiratory fitness, and glucose).
  
  
  RESULTS
  A WHtR ≥ 0.5 increased the odds by 5.2 (95% confidence interval 2.6 - 10.3) of having increased cardiometabolic risk. Similar associations were observed for BMI and WC. Both BMI-z and WHtR were fair predictors of increased cardiometabolic risk, although BMI-z demonstrated the best trade-off between sensitivity and specificity, 76.1% and 63.6%, compared with 68.1% and 65.5% for WHtR. Cross-validation analysis revealed that BMI-z and WHtR correctly classified 84% of individuals (kappa score = 0.671, 95% CI 0.55, 0.79). The sensitivity of the cut-points suggests that 89.3% of individuals were correctly classified as being at risk with only 10.7% misdiagnosed whereas the specificity of the cut-points indicated that 77.8% of individuals were correctly identified as being healthy with 22.2% of individuals incorrectly diagnosed as being at risk.
  
  
  CONCLUSIONS
  Findings suggest that WHtR provides similar cardiometabolic risk estimates to age and sex adjusted BMI.
authors: Institute of Clinical Exercise and Health Science, University of the West of Scotland, Lanarkshire, Hamilton, ML3 0JB, United Kingdom.
authors: Duncan S
authors: DS
authors: Buchan
authors: The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, United Kingdom.
authors: Lynne M
authors: LM
authors: Boddy
authors: Institute of Clinical Exercise and Health Science, University of the West of Scotland, Lanarkshire, Hamilton, ML3 0JB, United Kingdom.
authors: Fergal M
authors: FM
authors: Grace
authors: School of Health Sciences, Oakland University, 2200 N. Squirrel Road, Rochester, Michigan, 48309-4401.
authors: Elise
authors: E
authors: Brown
authors: Institute of Clinical Exercise and Health Science, University of the West of Scotland, Lanarkshire, Hamilton, ML3 0JB, United Kingdom.
authors: Nicholas
authors: N
authors: Sculthorpe
authors: School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Health Sciences Building, 97 Lisburn Road, Belfast, BT9 7BL, United Kingdom.
authors: Conor
authors: C
authors: Cunningham
authors: Sport and Exercise Sciences Research Institute, Ulster Sports Academy, Ulster University, Jordanstown Campus, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, United Kingdom.
authors: Marie H
authors: MH
authors: Murphy
authors: Department of Health Sciences, Liverpool Hope University, Hope Park, Liverpool, L16 9JD, United Kingdom.
authors: Rebecca
authors: R
authors: Dagger
authors: The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, United Kingdom.|Department of Sport and Physical Activity, Edge Hill University, St Helens Road, Ormskirk, L39 4QP.
authors: Lawrence
authors: L
authors: Foweather
authors: The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, United Kingdom.
authors: Lee E F
authors: LEF
authors: Graves
authors: The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, United Kingdom.
authors: Nicola D
authors: ND
authors: Hopkins
authors: Applied Sports Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Singleton Park, Swansea, SA2 8PP, United Kingdom.|School of Sports Science, Exercise and Health, the University of Western Australia, Perth, Australia.
authors: Gareth
authors: G
authors: Stratton
authors: Institute of Clinical Exercise and Health Science, University of the West of Scotland, Lanarkshire, Hamilton, ML3 0JB, United Kingdom.
authors: Julien S
authors: JS
authors: Baker
mesh_terms: D000886:Anthropometry / Q000379:methods*; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D000072599:Cardiorespiratory Fitness; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology; D009660:Northern Ireland / Q000453:epidemiology; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D065927:Waist-Height Ratio
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: adiposity; cardiometabolic risk; screening; waist-to-height ratio; youth