title: Performance of different adiposity measures for predicting cardiovascular risk in adolescents.
abstract: This study aims to compare the performance of body mass index (BMI), waist circumference (WC), and waist-to-height-ratio (WHtR) to predict the presence of at least 3 main CV risk factors in US adolescents. A total of 3621 adolescents (boys: 49.9%) aged 12-17 years from the US National Health and Nutrition Examination Survey (1999-2012) were included in this study. Measured CV risk factors included systolic/diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and fasting plasma glucose. The AUC of BMI-z score, WC-z score and WHtR-z score to predict at least three CV risk factors were similar (~0.85), irrespective of criteria used to define abnormal levels of CV risk factors. A 1-SD increase in any of three indices to predict CV risk was also similar for the three adiposity scores. For instance, a 1-SD increase risk in BMI-z score, WC-z score and WHtR-z score was 3.32 (95%CI 2.53-4.36), 3.43 (95%CI 2.64-4.46), and 3.45 (95%CI 2.64-4.52), respectively, in the total population using the International Diabetes Federation definition. In addition, the most efficient WHtR cut-off for screening CV risk was ~0.50 in US adolescents. In summary, BMI, WC and WHtR performed similarly well to predict the presence of at least 3 main CV risk factors among US adolescents.
authors.affiliation: Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Bovet
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan, China.
authors.forename: Chuanwei
authors.initials: C
authors.lastname: Ma
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Xi
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000367:Age Factors; D019540:Area Under Curve; D015415:Biomarkers; D015992:Body Mass Index; D001837:Body Weights and Measures; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference; D065927:Waist-Height Ratio; D049629:Waist-Hip Ratio
chemical_list: D015415:Biomarkers