Body Mass Index or Waist Circumference: Which Is the Better Predictor for Hypertension and Dyslipidemia in Overweight/Obese Children and Adolescents? Association of Cardiovascular Risk Related to Body Mass Index or Waist Circumference

Abstract

Background: In order to assess the relationship between hypertension or dyslipidemia and obesity, the body mass index (BMI) is usually used. Unlike waist circumference (WC), BMI does not reflect body fat distribution. The aim of this study is to investigate whether BMI or WC is a better predictor of hypertension or dyslipidemia in overweight/obese children and adolescents. Methods: As of November 2012, the APV database contained data on 81,819 patients from 189 specialized pediatric obesity institutions in Germany, Austria and Switzerland. Logistic regression analysis was conducted using odds ratios (OR) with 95% CI. Results: The average age of the youths (n = 5.978) was 13.9 ± 1.8 years. Mean BMI-SDS was 2.0 ± 0.5, and mean WC-SDS was 2.2 ± 0.5. Both BMI-SDS and WC-SDS are significant predictors of hypertension and dyslipidemia: BMI-SDS is a better predictor (OR = 2.60) for hypertension than WC-SDS (OR = 1.85), while WC-SDS (OR = 1.90) was slightly superior to BMI-SDS (OR = 1.86) in predicting adverse lipid profiles. Compared to normal-weight patients, obese patients (BMI ≥97th percentile) exhibited increased systolic (+6.3 mm Hg) and diastolic blood pressure (+3.9 mm Hg). However, this difference was only +4.8 mm Hg (systolic) and +2.6 mm Hg (diastolic) if WC >97th percentile was used. Conclusion: BMI-SDS is more closely associated with hypertension, while WC-SDS is more closely associated with dyslipidemia. However, the additional measurement of WC has only a small benefit in obese youths.

Dietary, Lifestyle and Socio-Economic Correlates of Overweight, Obesity and Central Adiposity in Lebanese Children and Adolescents

“…Current prevalence rates of abdominal obesity as assessed by WHtR (21.3%) were found to exceed those reported from several other countries including Germany (10.7% in boys and 8% in girls) [35] and Pakistan (16.5%) [16] while being lower than those reported from Italy (29.5%) [36]. The prevalence rates of elevated WC (14%) were similar to those reported from Pakistan (13%) [16] and Germany (17.3%) [37], but were lower than estimates reported from Italy (29%) [36]. …”

Mid-upper arm circumference as a screening measure for identifying children with hypertension

“…The database included data on 81 819 patients from 189 specialized pediatric obesity institutions in Germany, Austria, and Switzerland. Both BMI and WC are closely associated with hypertension [18]. Another study also found that BMI and WC showed a remarkable ability to discriminate hypertensive children [19].…”

Prevalence and Correlates of Suspected Nonalcoholic Fatty Liver Disease in Chinese Children

“…There is still no universally accepted threshold for the pediatric population [27]. Dyslipidemia was defined as at least one abnormal value for HDL, LDL, TC, or TG: low HDL was defined as an HDL < 0.9 mmol/L, elevated LDL as an LDL > 3.4 mmol/L, elevated TC as a TC > 5.1 mmol/L, and elevated TG as a TG > 1.7 mmol/L [28]. …”