Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity
Abstract Background Childhood overweight/obesity has been associated with an elevated risk of insulin resistance and cardiometabolic disorders. Waist-to-height ratio (WHtR) may be a simple screening tool to quickly identify children at elevated risk for cardiometabolic disorders. The primary objecti...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-16418-9 |
| _version_ | 1797555905859944448 |
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| author | Tochi E. Ukegbu Judith Wylie-Rosett Adriana E. Groisman-Perelstein Pamela M. Diamantis Jessica Rieder Mindy Ginsberg Alice H. Lichtenstein Nirupa R. Matthan Viswanathan Shankar |
| author_facet | Tochi E. Ukegbu Judith Wylie-Rosett Adriana E. Groisman-Perelstein Pamela M. Diamantis Jessica Rieder Mindy Ginsberg Alice H. Lichtenstein Nirupa R. Matthan Viswanathan Shankar |
| author_sort | Tochi E. Ukegbu |
| collection | DOAJ |
| description | Abstract Background Childhood overweight/obesity has been associated with an elevated risk of insulin resistance and cardiometabolic disorders. Waist-to-height ratio (WHtR) may be a simple screening tool to quickly identify children at elevated risk for cardiometabolic disorders. The primary objective of the present study was to create sex-specific tertile cut points of WHtR and assess its association with Insulin resistance and elevated liver enzyme concentrations in children, factors using cross-sectional data from the randomized, controlled Family Weight Management Study. Methods Baseline data from 360 children (7–12 years, mean Body Mass Index (BMI) ≥ 85th percentile for age and sex) were used to calculate WHtR tertiles by sex, male: ≤ 0.55 (T1), > 0.55- ≤ 0.59 (T2), > 0.59 (T3); female: ≤ 0.56 (T1), > 0.56- ≤ 0.6 (T2), > 0.6 (T3). The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was used to categorize participants as insulin-resistant (HOMA-IR ≥ 2.6) and insulin-sensitive (HOMA-IR < 2.6). Liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were categorized as normal vs. elevated (AST of < 36.0 µkat/L or ≥ 36.0 µkat/L; ALT of < 30.0 µkat/L or ≥ 30.0 µkat/L; ALT > 26 µkat/L males, > 22 µkat/L females). We examined differences in baseline cardiometabolic risk factors by WHtR tertiles and sex-specific multivariable logistic regression models to predict HOMA-IR and elevation of liver enzymes. Results Study participants had a mean WHtR of 0.59 ([SD: 0.06]). Irrespective of sex, children in WHtR T3 had higher BMIz scores, blood pressure, triglycerides, 2-h glucose, fasting 2-h insulin, and lower high-density lipoprotein cholesterol (HDL-C) concentrations than those in T2 and T1. After adjusting for covariates, the odds of elevated HOMA-IR (> 2.6) were over five-fold higher among males in T3 versus T1 [OR, 95%CI: 5.83, 2.34–14.52] and T2 [OR, 95%CI: 4.81, 1.94–11.92] and females in T3 [OR, 95%CI: 5.06, 2.10–12.20] versus T1. The odds of elevated ALT values (≥ 30) were 2.9 [95%CI: 1.01–8.41] fold higher among females in T3 compared to T1. Conclusion In public health settings, WHtR may be a practical screening tool in pediatric populations to identify children at risk of metabolic syndrome. |
| first_indexed | 2024-03-10T16:54:08Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-10T16:54:08Z |
| publishDate | 2023-08-01 |
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| series | BMC Public Health |
| spelling | doaj.art-9d170957a2b34004827dbcaa4e034c372023-11-20T11:12:49ZengBMCBMC Public Health1471-24582023-08-012311910.1186/s12889-023-16418-9Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesityTochi E. Ukegbu0Judith Wylie-Rosett1Adriana E. Groisman-Perelstein2Pamela M. Diamantis3Jessica Rieder4Mindy Ginsberg5Alice H. Lichtenstein6Nirupa R. Matthan7Viswanathan Shankar8Sophie Davis School of Biomedical Education, The City College of New YorkDepartment of Epidemiology and Population Health, Albert Einstein College of MedicineDepartment of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical CenterDepartment of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical CenterDepartment of Pediatrics, Albert Einstein College of Medicine Children’s Hospital at MontefioreDepartment of Epidemiology and Population Health, Albert Einstein College of MedicineCardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts UniversityCardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts UniversityDepartment of Epidemiology and Population Health, Albert Einstein College of MedicineAbstract Background Childhood overweight/obesity has been associated with an elevated risk of insulin resistance and cardiometabolic disorders. Waist-to-height ratio (WHtR) may be a simple screening tool to quickly identify children at elevated risk for cardiometabolic disorders. The primary objective of the present study was to create sex-specific tertile cut points of WHtR and assess its association with Insulin resistance and elevated liver enzyme concentrations in children, factors using cross-sectional data from the randomized, controlled Family Weight Management Study. Methods Baseline data from 360 children (7–12 years, mean Body Mass Index (BMI) ≥ 85th percentile for age and sex) were used to calculate WHtR tertiles by sex, male: ≤ 0.55 (T1), > 0.55- ≤ 0.59 (T2), > 0.59 (T3); female: ≤ 0.56 (T1), > 0.56- ≤ 0.6 (T2), > 0.6 (T3). The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was used to categorize participants as insulin-resistant (HOMA-IR ≥ 2.6) and insulin-sensitive (HOMA-IR < 2.6). Liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were categorized as normal vs. elevated (AST of < 36.0 µkat/L or ≥ 36.0 µkat/L; ALT of < 30.0 µkat/L or ≥ 30.0 µkat/L; ALT > 26 µkat/L males, > 22 µkat/L females). We examined differences in baseline cardiometabolic risk factors by WHtR tertiles and sex-specific multivariable logistic regression models to predict HOMA-IR and elevation of liver enzymes. Results Study participants had a mean WHtR of 0.59 ([SD: 0.06]). Irrespective of sex, children in WHtR T3 had higher BMIz scores, blood pressure, triglycerides, 2-h glucose, fasting 2-h insulin, and lower high-density lipoprotein cholesterol (HDL-C) concentrations than those in T2 and T1. After adjusting for covariates, the odds of elevated HOMA-IR (> 2.6) were over five-fold higher among males in T3 versus T1 [OR, 95%CI: 5.83, 2.34–14.52] and T2 [OR, 95%CI: 4.81, 1.94–11.92] and females in T3 [OR, 95%CI: 5.06, 2.10–12.20] versus T1. The odds of elevated ALT values (≥ 30) were 2.9 [95%CI: 1.01–8.41] fold higher among females in T3 compared to T1. Conclusion In public health settings, WHtR may be a practical screening tool in pediatric populations to identify children at risk of metabolic syndrome.https://doi.org/10.1186/s12889-023-16418-9Cardiometabolic riskWaist-to-height ratioInsulin resistanceLiver enzymesASTALT |
| spellingShingle | Tochi E. Ukegbu Judith Wylie-Rosett Adriana E. Groisman-Perelstein Pamela M. Diamantis Jessica Rieder Mindy Ginsberg Alice H. Lichtenstein Nirupa R. Matthan Viswanathan Shankar Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity BMC Public Health Cardiometabolic risk Waist-to-height ratio Insulin resistance Liver enzymes AST ALT |
| title | Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity |
| title_full | Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity |
| title_fullStr | Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity |
| title_full_unstemmed | Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity |
| title_short | Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity |
| title_sort | waist to height ratio associated cardiometabolic risk phenotype in children with overweight obesity |
| topic | Cardiometabolic risk Waist-to-height ratio Insulin resistance Liver enzymes AST ALT |
| url | https://doi.org/10.1186/s12889-023-16418-9 |
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