Waist to Height Ratio As an Index for Cardiometabolic Risk in Adolescents: Result from Knhanes 1998-2008

Presentation Number: THR-542
Date of Presentation: March 5th, 2015

In-Hyuk Chung*1, Sangshin Park2, Mi Jung Park3 and Eun-Gyong Yoo4
1National Health Insurance Service Ilsan Hospital, Kyonggi, Korea, Republic of (South), 2The Warren Alpert Medical School of Brown University, Providence, RI, 3College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea, Republic of (South), 4College of Medicine, CHA University, Sungnam, Korea, Republic of (South)



This study was performed to describe the relationship between waist to height ratio (WHtR) and cardiometabolic risk factors (CMRFs), and to evaluate the validity of WHtR in identifying adolescents with metabolic syndrome.


We analyzed data from a pooled population of 4,068 adolescents aged 10-19 years from the Korean National Health and Nutrition Examination Surveys conducted between 1998 and 2008. To describe the trend of CMRFs with increasing WHtR, participants were divided into WHtR quartile groups. For subgroup analysis, participants categorized according to body mass index (BMI; <85th or ≥85th percentile) and waist circumference (WC; <90th or ≥90th percentile) were further stratified by WHtR (<0.5 or ≥0.5). Metabolic syndrome was defined by the presence of ≥3 CMRFs.


The WHtR was significantly related with systolic blood pressure (P<0.0001), diastolic blood pressure (P<0.0001), high-density lipoprotein cholesterol (P<0.0001), and triglyceride (P<0.0001) after adjusting for age in both genders. The prevalence of metabolic syndrome was very low in the 1st to 3rd quartile groups in both genders, but increased to 12% in boys and to 8.5% in girls in the 4th WHtR quartile group (P for trend <0.001 in each gender). The prevalence of metabolic syndrome further increased with higher WHtR in adolescents screened by BMI or WC (5.5% in those with increased BMI/low WHtR vs. 18.0% in those with increased BMI/high WHtR (P<0.0001), and 8.6% in those with increased WC/low WHtR vs. 20.1% in those with increased WC/high WHtR (P=0.0235).


WHtR is a simple and valid index for identifying adolescents with increased cardiometabolic risks.  Our results suggest that additional use of WHtR can be helpful when screening obesity with BMI in adolescents, because the WHtR represents central adiposity. Since the WHtR is an index adjusted for height, it might be useful when used together with WC.


Nothing to Disclose: IHC, SP, MJP, EGY