Sijtsma Anna, Bocca Gianni, L'abée Carianne, Liem Eryn T, Sauer Pieter J J, Corpeleijn Eva
Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Clin Nutr. 2014 Apr;33(2):311-5. doi: 10.1016/j.clnu.2013.05.010. Epub 2013 May 23.
To assess whether waist-to-height-ratio (WHtR) is a better estimate of body fat percentage (BF%) and a better indicator of cardiometabolic risk factors than BMI or waist circumference (WC) in young children.
WHtR, WC and BMI were measured by trained staff according to standardized procedures. (2)H2O and (2)H2(18)O isotope dilution were used to assess BF% in 61 children (3-7 years) from the general population, and bioelectrical impedance (Horlick equation) was used to assess BF% in 75 overweight/obese children (3-5 years). Cardiometabolic risk factors, including diastolic and systolic blood pressure, HOMA2-IR, leptin, adiponectin, triglycerides, total cholesterol, HDL- and LDL-cholesterol, TNFα and IL-6 were determined in the overweight/obese children.
In the children from the general population, after adjustments for age and gender, BMI had the highest explained variance for BF% compared to WC and WHtR (R(2) = 0.32, 0.31 and 0.23, respectively). In the overweight/obese children, BMI and WC had a higher explained variance for BF% compared to WHtR (R(2) = 0.68, 0.70 and 0.50, respectively). In the overweight/obese children, WHtR, WC and BMI were all significantly positively correlated with systolic blood pressure (r = 0.23, 0.30, 0.36, respectively), HOMA2-IR (r = 0.53, 0.62, 0.63, respectively), leptin (r = 0.70, 0.77, 0.78, respectively) and triglycerides (r = 0.33, 0.36, 0.24, respectively), but not consistently with other parameters.
In young children, WHtR is not superior to WC or BMI in estimating BF%, nor is WHtR better correlated with cardiometabolic risk factors than WC or BMI in overweight/obese children. These data do not support the use of WHtR in young children.
评估在幼儿中，腰高比（WHtR）相较于体重指数（BMI）或腰围（WC），是否能更好地估计体脂百分比（BF%）以及是否是更好的心脑血管代谢风险因素指标。
由经过培训的工作人员按照标准化程序测量WHtR、WC和BMI。采用（2）H2O和（2）H2（18）O同位素稀释法评估61名普通人群中3至7岁儿童的BF%，采用生物电阻抗法（霍利克方程）评估75名超重/肥胖的3至5岁儿童的BF%。测定超重/肥胖儿童的心脑血管代谢风险因素，包括舒张压和收缩压、稳态模型评估的胰岛素抵抗指数（HOMA2-IR）、瘦素、脂联素、甘油三酯、总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇、肿瘤坏死因子α（TNFα）和白细胞介素-6（IL-6）。
在普通人群的儿童中，在对年龄和性别进行调整后，与WC和WHtR相比，BMI对BF%的解释方差最高（R（2）分别为0.32、0.31和0.23）。在超重/肥胖儿童中，与WHtR相比，BMI和WC对BF%的解释方差更高（R（2）分别为0.68、0.70和0.50）。在超重/肥胖儿童中，WHtR、WC和BMI均与收缩压（r分别为0.23、0.30、0.36）、HOMA2-IR（r分别为0.53、0.62、0.63）、瘦素（r分别为0.70、0.77、0.78）和甘油三酯（r分别为0.33、0.36、0.24）显著正相关，但与其他参数的相关性并不一致。
在幼儿中，WHtR在估计BF%方面并不优于WC或BMI，在超重/肥胖儿童中，WHtR与心脑血管代谢风险因素的相关性也不比WC或BMI更好。这些数据不支持在幼儿中使用WHtR。
