Waist-to-height ratio as a screening tool for children with risk factors for cardiovascular disease

Background: Waist-to-height ratio (WHtR) has been recommended as a tool for predicting cardiovascular risk in children. However, there is little evidence about the accuracy of using WHtR as a predictor of disease risk in pre-school children. Aims: To assess the accuracy of waist-to-height ratio (WHtR), waist circumference (WC) and body mass index (BMI) as well as to determine the optimal cut-off values for each of these measures in order to identify pre-school children with cardiovascular risks. Subjects and methods: This study conducted a cross-sectional analysis of 315 children between 3-4 years of age. Multiple risk factors for cardiovascular disease (MRFCD) were defined as having two or more of the following conditions: HDL-c < 35 mg/dL, LDL-c >= 110 mg/dL, triglycerides >= 150 mg/dL and systolic and/or diastolic blood pressure >= 90(th) percentile. Results: The accuracy of WHtR in identifying cardiovascular risk in pre-school children was not significantly different compared to BMI or WC, for both sexes. The optimal cut-off measures for predicting cardiovascular risk in boys and girls, respectively, were as follows: 0.51 and 0.49 for WHtR; 0.61 and 0.69 for BMI Z-score; and 51.2 cm and 50.2 cm for WC. Conclusions: The data support the use of a 0.5 cut-off value for WHtR to predict cardiovascular risk factors among pre-school children and suggest that using WHtR is comparable to both BMI and WC.