Department of Epidemiology/Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, School of Public Health/Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Toxicology and Nutrition, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Front Endocrinol (Lausanne). 2021 Nov 16;12:762250. doi: 10.3389/fendo.2021.762250. eCollection 2021.
Previous studies have shown that waist-to-height ratio (WHtR) performed similarly well when compared to body mass index (BMI) and waist circumference (WC) for identifying cardiovascular risk factors. However, to our knowledge, the performance of these three adiposity indices for identifying left ventricular hypertrophy (LVH) and left ventricular geometric (LVG) remodeling in youth has not been assessed. We aimed to determine the utility of BMI, WC and WHtR for identifying LVH and LVG in Chinese children.
This study included 1,492 Chinese children aged 6-11 years. Adiposity indices assessed were BMI, WC and WHtR. LVH and high relative wall thickness (RWT) were defined using sex- and age-specific 90th percentile values of left ventricular mass index and RWT, respectively, based on the current population. LVG remodeling included concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH), which was defined based on the combination of LVH and high RWT.
The magnitude of association of central obesity defined by WHtR with LVH [odds ratio () =10.09, 95% confidence interval () =6.66-15.29] was similar with general obesity defined by BMI (=10.49, 95% =6.97-15.80), and both were higher than central obesity defined by WC (=6.87, 95% =4.57-10.33). Compared with BMI, WHtR had better or similar predictive utility for identifying LVH, EH, and CH [the area under the curve (AUC): 0.84 0.79; 0.84 0.77; 0.87 0.88, respectively]; WC had worse or similar discriminatory utility with AUCs of 0.73, 0.70, 0.83, respectively.
WHtR performed similarly or better than BMI or WC for identifying LVH and LVG remodeling among Chinese children. WHtR provides a simple and convenient measure of central obesity that might improve the discrimination of children with cardiac structural damage.
先前的研究表明，腰围身高比（WHtR）在识别心血管危险因素方面与体重指数（BMI）和腰围（WC）表现相当。然而，据我们所知，这三种肥胖指数在识别青少年左心室肥厚（LVH）和左心室几何重构（LVG）方面的性能尚未得到评估。我们旨在确定 BMI、WC 和 WHtR 在中国儿童中识别 LVH 和 LVG 的效用。
本研究纳入了 1492 名 6-11 岁的中国儿童。评估的肥胖指数包括 BMI、WC 和 WHtR。LVH 和高相对室壁厚度（RWT）分别通过左心室质量指数和 RWT 的性别和年龄特异性第 90 百分位数值来定义，基于当前人群。LVG 重构包括同心重构（CR）、偏心肥厚（EH）和同心肥厚（CH），根据 LVH 和高 RWT 的组合来定义。
WHtR 定义的中心性肥胖与 LVH 的关联程度[比值比（OR）=10.09，95%置信区间（CI）=6.66-15.29]与 BMI 定义的全身性肥胖相似（OR=10.49，95%CI=6.97-15.80），均高于 WC 定义的中心性肥胖（OR=6.87，95%CI=4.57-10.33）。与 BMI 相比，WHtR 对识别 LVH、EH 和 CH 的预测效用更好或相似[曲线下面积（AUC）：0.84 0.79；0.84 0.77；0.87 0.88，分别]；WC 的判别效用较差或相似，AUC 分别为 0.73、0.70、0.83。
WHtR 在识别中国儿童 LVH 和 LVG 重构方面的表现与 BMI 或 WC 相似或更好。WHtR 提供了一种简单方便的中心性肥胖衡量标准，可能会提高对心脏结构损伤儿童的识别能力。
