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WAIST TO HIP RATIO VERSUS OBESITY SEVERITY IN PREDICTING CARDIOMETABOLIC RISK IN CHILDREN
1991 JACC April 5, 2016 Volume 67, Issue 13
Prevention WAIST TO HIP RATIO VERSUS OBESITY SEVERITY IN PREDICTING CARDIOMETABOLIC RISK IN CHILDREN Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 3:45 p.m.-4:30 p.m. Session Title: Preventive Cardiology Potpourri Abstract Category: 33. Prevention: Clinical Presentation Number: 1236-383 Authors: Shahryar Chowdhury, Selina Juarez, Janet Carter, Melissa Henshaw, Medical University of South Carolina, Charleston, SC, USA Background: The objective of this study was to assess the relationship of obesity severity and abdominal obesity to measures of dyslipidemia and insulin resistance in children.
Methods: A secondary analysis was performed on obese subjects aged 4 to 21 previously recruited for a research protocol. Non-severe obesity was defined as body mass index (BMI) for age between 100 - 120% of the 95th percentile. Severe obesity was defined as BMI for age > 120% of the 95th percentile. Abdominal obesity was assessed by dividing patients into those with waist:hip ratio < 0.85 and those with ratio ≥ 0.85. Vital signs, anthropometric measures, and fasting laboratory values were obtained. Comparison of means and multivariable regression were performed.
Results: 184 subjects were studied, see the table for comparisons between groups. Upon multivariable regression, waist:hip ratio was the only variable independently associated with triglyceride:HDL (β = 0.25, p < 0.01) and LDL+VLDL to HDL ratio (β = 0.16, p < 0.01). Both waist:hip ratio and BMI were independently associated with HOMA-IR (β = 0.18, p = 0.01 and β = 0.17, p = 0.02, respectively). Conclusions: Elevated waist:hip ratio is associated with dyslipidemia in children. BMI and waist:hip ratio are both associated with insulin resistance. Children with BMI > 120% of the 95th percentile for age have an elevated risk for insulin resistance compared to less obese children. It appears both waist:hip ratio and BMI have a role in the assessment of cardiometabolic risk in children. Measure
Obese (n = 54)
Severely Obese (n = 130)
p-value
WHR ≤ 0.85 (n = 84)
WHR > 0.85 (n = 100)
p-value
Age (years) Female, n (%) White, n (%) Height (cm) Weight (kg) Patient BMI (kg/m^2) Systolic blood pressure (mm Hg) Diastolic blood pressure (mm Hg) Hip (cm) Waist (cm) Cholesterol (mg/dL) Triglycerides (mg/dL) High-density Lipoprotein (HDL) (mg/dL) Low-density Lipoprotein (LDL) (mg/dL) Very-low-density Lipoprotein (VLDL) (mg/dL) TG/HDL (LDL+VLDL)/HDL Insulin (µIU/mL) Glucose (mg/dL) Glucose/Insulin HOMA-IR Total fat (kg) % Fat
12.2 ± 3.4 36 (67%) 26 (48%) 152 ± 16 66.2 ± 20.9 27.6 (5.9) 110 ± 15 60 ± 6 99 ± 14 87 ± 13 162 ± 29 72 (51) 44 ± 8 100 ± 27
12.5 ± 3.2 68 (52%) 52 (40%) 156 ± 15 91.9 ± 29.3 34.9 (11.4) 114 ± 14 61 ± 8 114 ± 17 101 ± 18 162 ± 27 76 (54) 42 ± 9 102 ± 23
0.53 0.06 0.27 0.10 < 0.01 <0.01 0.07 0.16 <0.01 <0.01 0.99 0.28 0.05 0.63
12.7 ± 3.2 57 (68%) 25 (30%) 156 ± 15 86.2 ± 28.9 33.1 (10.3) 114 ± 15 61 ± 7 112 ± 17 93 ± 14 157 (31) 68 (39) 42 ± 8 99 ± 23
12.2 ± 3.3 46 (46%) 52 (52%) 154 ± 16 83.2 ± 30.3 34.1 (11.5) 112 ± 15 61 ± 8 108 ± 17 101 ± 17 167 (46) 101 (67) 43 ± 9 104 ± 25
0.28 <0.01 <0.01 0.40 0.49 0.66 0.26 0.70 0.06 <0.01 0.02 0.03 0.66 0.16
14 (10)
15 (11)
0.27
14 (8)
20 (14)
0.02
1.6 (1.5) 2.6 (1.5) 28 ± 21 93 ± 10 3.9 (3.1) 5.4 (3.9) 24.8 ± 8.4 38 ± 5
1.9 (1.7) 2.9 (1.3) 35 ± 22 92 ± 7 3.1 (2.4) 7.0 (5.3) 38.8 ± 14.2 43 ± 5
0.13 0.09 0.04 0.39 <0.01 0.02 <0.01 <0.01
2.0 (1.3) 2.7 (1.0) 25 (17) 92 ± 8 3.7 (2.3) 5.7 (4.1) 33.1 (19.4) 41 ± 6
2.0 (2.0) 2.9 (1.4) 30 (24) 94 ± 8 4.0 (2.7) 7.1 (6.0) 34.5 (22.9) 41 ± 5
0.07 0.26 0.13 0.09 0.21 0.10 0.92 0.52
Prevention WAIST TO HIP RATIO VERSUS OBESITY SEVERITY IN PREDICTING CARDIOMETABOLIC RISK IN CHILDREN Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 3:45 p.m.-4:30 p.m. Session Title: Preventive Cardiology Potpourri Abstract Category: 33. Prevention: Clinical Presentation Number: 1236-383 Authors: Shahryar Chowdhury, Selina Juarez, Janet Carter, Melissa Henshaw, Medical University of South Carolina, Charleston, SC, USA Background: The objective of this study was to assess the relationship of obesity severity and abdominal obesity to measures of dyslipidemia and insulin resistance in children.
Methods: A secondary analysis was performed on obese subjects aged 4 to 21 previously recruited for a research protocol. Non-severe obesity was defined as body mass index (BMI) for age between 100 - 120% of the 95th percentile. Severe obesity was defined as BMI for age > 120% of the 95th percentile. Abdominal obesity was assessed by dividing patients into those with waist:hip ratio < 0.85 and those with ratio ≥ 0.85. Vital signs, anthropometric measures, and fasting laboratory values were obtained. Comparison of means and multivariable regression were performed.
Results: 184 subjects were studied, see the table for comparisons between groups. Upon multivariable regression, waist:hip ratio was the only variable independently associated with triglyceride:HDL (β = 0.25, p < 0.01) and LDL+VLDL to HDL ratio (β = 0.16, p < 0.01). Both waist:hip ratio and BMI were independently associated with HOMA-IR (β = 0.18, p = 0.01 and β = 0.17, p = 0.02, respectively). Conclusions: Elevated waist:hip ratio is associated with dyslipidemia in children. BMI and waist:hip ratio are both associated with insulin resistance. Children with BMI > 120% of the 95th percentile for age have an elevated risk for insulin resistance compared to less obese children. It appears both waist:hip ratio and BMI have a role in the assessment of cardiometabolic risk in children. Measure
Obese (n = 54)
Severely Obese (n = 130)
p-value
WHR ≤ 0.85 (n = 84)
WHR > 0.85 (n = 100)
p-value
Age (years) Female, n (%) White, n (%) Height (cm) Weight (kg) Patient BMI (kg/m^2) Systolic blood pressure (mm Hg) Diastolic blood pressure (mm Hg) Hip (cm) Waist (cm) Cholesterol (mg/dL) Triglycerides (mg/dL) High-density Lipoprotein (HDL) (mg/dL) Low-density Lipoprotein (LDL) (mg/dL) Very-low-density Lipoprotein (VLDL) (mg/dL) TG/HDL (LDL+VLDL)/HDL Insulin (µIU/mL) Glucose (mg/dL) Glucose/Insulin HOMA-IR Total fat (kg) % Fat
12.2 ± 3.4 36 (67%) 26 (48%) 152 ± 16 66.2 ± 20.9 27.6 (5.9) 110 ± 15 60 ± 6 99 ± 14 87 ± 13 162 ± 29 72 (51) 44 ± 8 100 ± 27
12.5 ± 3.2 68 (52%) 52 (40%) 156 ± 15 91.9 ± 29.3 34.9 (11.4) 114 ± 14 61 ± 8 114 ± 17 101 ± 18 162 ± 27 76 (54) 42 ± 9 102 ± 23
0.53 0.06 0.27 0.10 < 0.01 <0.01 0.07 0.16 <0.01 <0.01 0.99 0.28 0.05 0.63
12.7 ± 3.2 57 (68%) 25 (30%) 156 ± 15 86.2 ± 28.9 33.1 (10.3) 114 ± 15 61 ± 7 112 ± 17 93 ± 14 157 (31) 68 (39) 42 ± 8 99 ± 23
12.2 ± 3.3 46 (46%) 52 (52%) 154 ± 16 83.2 ± 30.3 34.1 (11.5) 112 ± 15 61 ± 8 108 ± 17 101 ± 17 167 (46) 101 (67) 43 ± 9 104 ± 25
0.28 <0.01 <0.01 0.40 0.49 0.66 0.26 0.70 0.06 <0.01 0.02 0.03 0.66 0.16
14 (10)
15 (11)
0.27
14 (8)
20 (14)
0.02
1.6 (1.5) 2.6 (1.5) 28 ± 21 93 ± 10 3.9 (3.1) 5.4 (3.9) 24.8 ± 8.4 38 ± 5
1.9 (1.7) 2.9 (1.3) 35 ± 22 92 ± 7 3.1 (2.4) 7.0 (5.3) 38.8 ± 14.2 43 ± 5
0.13 0.09 0.04 0.39 <0.01 0.02 <0.01 <0.01
2.0 (1.3) 2.7 (1.0) 25 (17) 92 ± 8 3.7 (2.3) 5.7 (4.1) 33.1 (19.4) 41 ± 6
2.0 (2.0) 2.9 (1.4) 30 (24) 94 ± 8 4.0 (2.7) 7.1 (6.0) 34.5 (22.9) 41 ± 5
0.07 0.26 0.13 0.09 0.21 0.10 0.92 0.52