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1、JournaloftheAmericanCollegeofCardiologyVol.xx,No.x,2013©2013bytheAmericanCollegeofCardiologyFoundationISSN0735-1097/$36.00PublishedbyElsevierInc.http://dx.doi.org/10.1016/j.jacc.2013.01.026RoleoftheWaist/HeightRatiointheCardiometabolicRiskAssessmento
2、fChildrenClassifiedbyBodyMassIndexMichaelKhoury,MD,CedricManlhiot,BSC,BrianW.McCrindle,MD,MPHToronto,CanadaObjectivesTheaimofthisstudywastodeterminetheutilityofwaist/heightratio(WHtR)inthespecificationofcardiometa-bolicriskinchildrenalreadystratifiedbyb
3、odymassindex(BMI).BackgroundReflectiveofitsassociationwithcardiometabolicrisk,BMIisacommonlyusedindirectindicatorofadiposityinchildren.TheWHtR,amarkerofcentraladiposity,hasbeenadvocatedasapossiblysuperiorindicatorofcardio-metabolicrisk.MethodsCross-se
4、ctionalanalysisof5NationalHealthandNutritionExaminationSurveysfrom1999to2008(ages5to18yearsofage).TheBMIpercentilecategories(normal,overweight,andobese)werefurtherstratifiedonthebasisofWHtR(0.5,0.5to0.6,0.6).Outcomemeasureswerelipidandglycemicprofil
5、es,C-reactivepro-tein,livertransaminases,prevalenceofhypertension,andmetabolicsyndrome.ResultsDatawereavailablefor14,493subjects.OverweightandobesesubjectswithaWHtR0.5hadacardiometa-bolicriskapproachingthatofsubjectswithanormalBMIpercentilecategory.
6、IncreasingWHtRwassignificantlyassociatedwithincreasedcardiometabolicriskinoverweightandobesesubjects,withthegreatestassociationsobservedintheobesepopulation.OfobesesubjectswithWHtR0.6,26%hadelevatednon–high-densitylipo-proteinlevels,18%hadelevatedC-r
7、eactiveproteinlevels,69%hadanelevatedhomeostaticmodelassessment–insulinresistance,and32%hadmetabolicsyndrome.ConclusionsTheWHtRfurtherspecifiescardiometabolicriskwithinclassificationsstratificationonthebasisofBMIpercen-tile.Asignificantproportionofobesec
8、hildrenwithincreasedWHtRshaveabnormalcardiometabolicriskfactorlevels.TheWHtRshouldbeincludedintheroutinescreeningandassessmentofoverweightandobesechildren,andthosewithanelevatedWHtRshouldundergoafurthercardiometabolicriskassessment.(JAmCollCar-diol20
