Published September 2, 2016 | Version v1
Journal article Open

Comparing Two Waist-to-Height Ratio Measurements with Cardiometabolic Risk Factors among Youth with Diabetes

Creators

  • 1. University of Washington and Seattle Children's Hospital, Seattle, WA 98122, USA
  • 2. Centers for Disease Control and Prevention, Mail Stop K-10, 4770 Buford Highway, NE Atlanta, GA 30341-3717, USA
  • 3. 1001 Arbolado Road, Santa Barbara, CA 93103, USA
  • 4. Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
  • 5. Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, P. O. Box 6511, Mail Stop A140, Aurora, CO 80045, USA
  • 6. Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Mail Location 7012, Cincinnati, OH 45229, USA
  • 7. Department of Nutrition, University of North Carolina at Chapel Hill, 2211 McGavran Greenberg, CB 7461, Chapel Hill, NC 27599-7461, USA
  • 8. Department of Epidemiology and Biostatistics and Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC 29208, USA

Description

Background: Waist circumference (WC) is commonly measured by either the World Health Organization (WHO) or National Health and Nutrition Examination Survey (NHANES) protocol.

Objective: Compare the associations of WHO vs. NHANES WC-to-height ratio (WHtR) protocols with cardiometabolic risk factors (CMRFs) in a sample of youth with diabetes.

Methods: For youth (10–19 years old with type 1 [N=3082] or type 2 [N=533] diabetes) in the SEARCH for Diabetes in Youth Study, measurements were obtained of WC (by two protocols), weight, height, fasting lipids (total cholesterol, triglycerides, HDL cholesterol, Non-HDL cholesterol) and blood pressures. Associations of CMRFs with WHO and NHANES WHtR were modeled stratified by body mass index (BMI) percentiles for age/sex: lower BMI (<85th BMI percentile; N=2071) vs. higher BMI (≥85th percentile; N=1594).

Results: Among lower-BMI participants, both NHANES and WHO WHtR were associated (p<0.005) with all CMRFs except blood pressure. Among higher-BMI participants, both NHANES and WHO WHtR were associated (p<0.05) with all CMRFs. WHO WHtR was more strongly associated (p<0.05) than NHANES WHtR with triglycerides, non-HDL cholesterol, and systolic blood pressure in lower-BMI participants. Among high-BMI participants, WHO WHtR was more strongly associated (p<0.05) than NHANES WHtR with triglycerides and systolic blood pressure.

Conclusion: Among youth with diabetes, WHtR calculated from either WC protocol captures cardiometabolic risk. The WHO WC protocol may be preferable to NHANES WC.

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