Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield S10 2TN, UK; Healthy Lifespan Institution, University of Sheffield, S10 2TN, UK.
Obes Res Clin Pract. 2024 Jul-Aug;18(4):249-254. doi: 10.1016/j.orcp.2024.07.002. Epub 2024 Jul 16.
Central obesity has been shown to better indicate health risks compared to general obesity. Measures of central obesity include waist-to-height ratio (WHtR), waist-to-hip ratio (WHR) and waist circumference (WC). The National Institute of Health and Care Excellence (NICE) recently recommended the use of WHtR alongside body mass index (BMI) to identify risks in adults and children, whilst recognising the need for more evidence relating to WHtR in children. This study explores risk thresholds for central obesity measures throughout adolescence. It compares these with those currently recommended in England and discusses whether these thresholds are age- and sex-specific.
Data on adolescents aged 11 to 18 years from the Health Survey for England (HSE) during 2005 to 2014 was used to calculate WHtR, WHR and WC percentiles. Next, smoothed lambda-mu-sigma (LMS) curves were created and the percentiles which align with the adult thresholds at age 18 years identified. This allows the most appropriate risk related thresholds for each measure during adolescence to be determined.
WHtR LMS curves are stable and flat throughout adolescence. WHR decreases in girls and WC increases in both boys and girls, during adolescence. Across all measures, there is slightly more fluctuation in higher percentiles, and in girls' WHR.
In practice, WHtR thresholds are simple to use to identify central obesity related risks. In particular, they are recommended because the same thresholds can be used for males and females and for adolescents and adults. The results support NICE guidance to use WHtR thresholds alongside BMI thresholds to identify individual risk.
This study uses central obesity measures, including waist-to-height and waist-to-hip ratios, to investigate risk-related thresholds for adolescents. It is the first to do so using English data. It provides support for current NICE recommendations to use adult waist-to-height thresholds in adults and children, alongside BMI measures in clinical and non-clinical settings.
与一般肥胖相比，中心性肥胖已被证明能更好地指示健康风险。中心性肥胖的衡量标准包括腰高比（WHtR）、腰臀比（WHR）和腰围（WC）。国家卫生与保健卓越研究所（NICE）最近建议将 WHtR 与身体质量指数（BMI）一起用于识别成人和儿童的风险，同时认识到需要更多关于儿童 WHtR 的证据。本研究探讨了整个青春期中心性肥胖衡量标准的风险阈值。它将这些与目前在英格兰推荐的标准进行了比较，并讨论了这些阈值是否具有年龄和性别特异性。
使用英格兰健康调查（HSE）在 2005 年至 2014 年间收集的 11 至 18 岁青少年的数据，计算 WHtR、WHR 和 WC 的百分位数。然后，创建了平滑的 lambda-mu-sigma（LMS）曲线，并确定了与 18 岁成人阈值相对应的百分位数。这使得可以确定每个衡量标准在青春期的最合适的风险相关阈值。
WHtR LMS 曲线在整个青春期都保持稳定和平坦。在青春期，女孩的 WHR 下降，而男孩和女孩的 WC 增加。在所有衡量标准中，较高百分位数的波动略大，而女孩的 WHR 则波动更大。
在实践中，WHtR 阈值易于用于识别与中心性肥胖相关的风险。特别是，它们被推荐使用，因为相同的阈值可以用于男性和女性以及青少年和成年人。结果支持 NICE 指南，建议将 WHtR 阈值与 BMI 阈值一起用于识别个体风险。
本研究使用中心性肥胖衡量标准，包括腰高比和腰臀比，来研究青少年的风险相关阈值。这是首次使用英国数据进行此类研究。它为 NICE 目前的建议提供了支持，即在临床和非临床环境中，建议在成人和儿童中使用成人腰高比阈值，同时使用 BMI 衡量标准。
