Published September 2, 2016 | Version v1

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

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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References

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