Assessing truncal obesity in predicting cardiometabolic risk in children: clinical measures versus dual-energy X-ray absorptiometry

Acta Paediatr. 2018 Jun;107(6):1065-1069. doi: 10.1111/apa.14175. Epub 2017 Dec 22.

Abstract

Aim: The objectives of this study were to 1) compare the accuracy of waist:hip ratio (WHR) and waist:height ratio (WHtR) by determining their association with reference-standard measures derived from dual-energy X-ray absorptiometry (DXA) and 2) assess the relationship of DXA, WHR and WHtR to measures of dyslipidemia, insulin resistance and inflammation in children.

Methods: Subjects aged four to 21 were prospectively recruited. Truncal obesity by DXA was defined as the trunk fat:height ratio and trunk fat:nontrunk fat ratio. Three hundred and eight subjects were studied, and 246 (80%) were obese.

Results: There was a strong correlation between WHtR and trunk fat:height (r = 0.84, p < 0.01). DXA measures of truncal obesity had stronger correlations with measures of cardiometabolic risk than WHR and WHtR. Upon multivariable regression, only WHtR had independent associations with cholesterol/HDL, HOMA-IR and high-sensitivity c-reactive protein.

Conclusion: WHtR is an accurate measure of truncal obesity. WHtR showed stronger associations with measures of insulin resistance and truncal obesity than WHR.

Keywords: Dyslipidemia; Insulin resistance; Obesity; Truncal fat.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon*
  • Adolescent
  • Anthropometry*
  • Child
  • Dyslipidemias / diagnostic imaging
  • Female
  • Humans
  • Inflammation / diagnostic imaging
  • Insulin Resistance
  • Male
  • Pediatric Obesity / diagnosis*
  • Retrospective Studies
  • Waist-Height Ratio*
  • Waist-Hip Ratio*
  • Young Adult