Usefulness of the Waist Circumference-to-Height Ratio in Screening for Obesity and Metabolic Syndrome among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2010–2014
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Anthropometric Measurements
2.2.1. Anthropometric Measurements
2.2.2. Blood Pressure
2.2.3. Laboratory Tests
2.3. Diagnostic Criteria
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Conflicts of Interest
References
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Total (n = 3057) | Boys (n = 1625) | Girls (n = 1432) | p-Value | |
---|---|---|---|---|
Age (years) | 14.26 ± 0.06 | 14.26 ± 0.07 | 14.26 ± 0.09 | 0.965 |
Height (cm) | 161.69 ± 0.25 | 165.25 ± 0.38 | 157.61 ± 0.25 | <0.001 ** |
Weight (kg) | 54.80 ± 0.32 | 58.03 ± 0.49 | 51.10 ± 0.36 | <0.001 ** |
BMI, (kg/m2) | 20.71 ± 0.08 | 20.96 ± 0.12 | 20.42 ± 0.11 | 0.001 ** |
WC (cm) | 69.45 ± 0.22 | 71.33 ± 0.33 | 67.29 ± 0.29 | <0.001 ** |
WHtR | 0.430 ± 0.00 | 0.432 ± 0.00 | 0.427 ± 0.00 | 0.038 * |
Systolic BP (mmHg) | 107.22 ± 0.25 | 109.56 ± 0.34 | 104.54 ± 0.33 | <0.001 ** |
Diastolic BP (mmHg) | 66.33 ± 0.23 | 66.72 ± 0.32 | 65.88 ± 0.28 | 0.035 * |
FPG (mg/dL) | 89.15 ± 0.18 | 89.49 ± 0.22 | 88.76 ± 0.22 | 0.006 ** |
Total cholesterol (mg/dL) | 157.75 ± 0.66 | 153.03 ± 0.85 | 163.16 ± 0.87 | <0.001 ** |
Triglyceride (mg/dL) | 83.15 ± 1.22 | 81.67 ± 1.58 | 84.82 ± 1.64 | 0.135 |
HDL cholesterol (mg/dL) | 49.97 ± 0.25 | 48.53 ± 0.29 | 51.62 ± 0.34 | <0.001 ** |
LDL cholesterol (mg/dL) | 91.92 ± 0.55 | 88.98 ± 0.73 | 95.28 ± 0.75 | <0.001 ** |
Obesity (BMI percentile ≥95 or BMI ≥25 kg/m2) (%) | 12.0 (0.7) | 14.1 (1.1) | 9.7 (1.1) | 0.009 ** |
Overweight (BMI percentile 85–94) (%) | 6.0 (0.5) | 4.4 (0.5) | 7.9 (0.8) | <0.001 ** |
Normal weight (BMI percentile 5–84) (%) | 76.2 (0.9) | 75.6 (1.3) | 76.9 (1.3) | 0.519 |
Underweight (BMI percentile <5) (%) | 5.8 (0.5) | 6.1 (0.8) | 5.5 (0.7) | 0.582 |
Central obesity (WC ≥the 90th percentile) (%) | 8.9 (0.6) | 7.6 (0.8) | 10.5 (1.0) | 0.026 * |
High BP (%) | 25.6 (1.0) | 26.7 (1.4) | 24.2 (1.3) | 0.166 |
High FPG (%) | 0.5 (0.1) | 0.6 (0.2) | 0.4 (0.2) | 0.604 |
High triglyceride (%) | 19.7 (1.0) | 20.3 (1.3) | 19.0 (1.3) | 0.435 |
Low HDL cholesterol (%) | 14.5 (0.8) | 17.9 (1.2) | 10.7 (1.1) | <0.001 ** |
At least one non-WC components of MS † (%) | 45.6 (1.2) | 48.4 (1.5) | 42.5 (1.6) | 0.005 ** |
Two or more non-WC components of MS † (%) | 12. (0.8) | 14.4 (1.2) | 10.2 (1.0) | 0.007 ** |
MS (%) | 6.2 (0.5) | 7.0 (0.8) | 5.2 (0.8) | 0.102 |
AUC | Cutoff Values ‡ | Sensitivity (%) | Specificity (%) | J Value † | p-Value | |
---|---|---|---|---|---|---|
Total (N = 3057) | ||||||
Overweight (BMI ≥ 85th percentiles) | 0.846 | 0.44 | 93.1 | 70.5 | 0.636 | <0.001 ** |
Obesity (BMI ≥ 95th percentiles or BMI ≥ 25 kg/m2) | 0.957 | 0.47 | 92.6 | 87.1 | 0.767 | <0.001 ** |
WC (≥75th percentiles) | 0.973 | 0.45 | 93.9 | 90.2 | 0.841 | <0.001 ** |
WC (≥90th percentiles) | 0.978 | 0.48 | 96.4 | 90.6 | 0.870 | <0.001 ** |
High BP a | 0.513 | 0.49 | 18.5 | 87.6 | 0.061 | 0.298 |
High FPG b | 0.623 | 0.43 | 68.8 | 61.0 | 0.297 | 0.167 |
High triglyceride c | 0.664 | 0.43 | 62.2 | 64.8 | 0.270 | <0.001 ** |
Low HDL cholesterol d | 0.658 | 0.44 | 56.0 | 71.4 | 0.273 | <0.001 ** |
Two or more non-WC components of MS | 0.690 | 0.43 | 69.8 | 62.2 | 0.320 | <0.001 ** |
Boys (n = 1625) | ||||||
Overweight (BMI ≥ 85th percentiles) | 0.861 | 0.45 | 95.8 | 70.2 | 0.660 | <0.001 ** |
Obesity (BMI ≥ 95th percentiles or BMI ≥ 25 kg/m2) | 0.950 | 0.47 | 91.1 | 85.9 | 0.770 | <0.001 ** |
WC (≥75th percentiles) | 0.978 | 0.46 | 96.9 | 89.9 | 0.868 | <0.001 ** |
WC (≥90th percentiles) | 0.990 | 0.50 | 97.5 | 94.4 | 0.919 | <0.001 ** |
High BP a | 0.523 | 0.50 | 17.7 | 89.4 | 0.071 | 0.191 |
High FPG b | 0.621 | 0.43 | 70.0 | 58.4 | 0.284 | 0.206 |
High triglyceride c | 0.689 | 0.44 | 63.3 | 66.2 | 0.296 | <0.001 ** |
Low HDL cholesterol d | 0.631 | 0.44 | 56.3 | 67.8 | 0.240 | <0.001 ** |
Two or more non-WC components of MS | 0.691 | 0.44 | 67.7 | 64.6 | 0.323 | <0.001 ** |
Girls (n = 1432) | ||||||
Overweight (BMI ≥ 85th percentiles) | 0.856 | 0.44 | 90.2 | 75.5 | 0.657 | <0.001 ** |
Obesity (BMI ≥ 95th percentiles or BMI ≥ 25 kg/m2 | 0.965 | 0.47 | 92.7 | 90.2 | 0.829 | <0.001 ** |
WC (≥75th percentiles) | 0.980 | 0.44 | 94.7 | 89.9 | 0.846 | <0.001 ** |
WC (≥90th percentiles) | 0.985 | 0.48 | 94.6 | 94.6 | 0.892 | <0.001 ** |
High BP a | 0.501 | 0.49 | 14.7 | 90.9 | 0.056 | 0.9474 |
High FPG b | 0.611 | 0.49 | 50.0 | 92.4 | 0.424 | 0.5554 |
High triglyceride c | 0.638 | 0.43 | 58.0 | 67.8 | 0.258 | <0.001 ** |
Low HDL cholesterol d | 0.699 | 0.44 | 60.8 | 71.2 | 0.320 | <0.001 ** |
Two or more non-WC components of MS | 0.684 | 0.43 | 66.4 | 66.9 | 0.333 | <0.001 ** |
Cutoff Values † | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | J Value * | ||
---|---|---|---|---|---|---|---|
Total (N = 3057) | |||||||
WHtR | Optimal | 0.43 | 69.8 | 62.2 | 19.0 | 94.2 | 0.320 |
0.5 | 27.8 | 91.6 | 29.1 | 90.9 | 0.189 | ||
0.6 | 2.6 | 99.7 | 52.9 | 89.0 | 0.023 | ||
Boys (n = 1625) | |||||||
WHtR | Optimal | 0.44 | 67.7 | 0.646 | 21.5 | 93.3 | 0.323 |
0.5 | 32.4 | 0.889 | 29.5 | 90.2 | 0.212 | ||
0.6 | 4.4 | 0.996 | 60.0 | 87.9 | 0.040 | ||
Girls (n = 1432) | |||||||
WHtR | Optimal | 0.43 | 66.4 | 66.9 | 17.9 | 94.8 | 0.333 |
0.5 | 20.0 | 94.4 | 28.0 | 91.6 | 0.144 | ||
0.6 | 0.7 | 99.9 | 33.3 | 90.3 | 0.006 |
BMI Percentile | WC Percentile | WHtR | |
---|---|---|---|
AUC (95% CI) | AUC (95% CI) | AUC (95% CI) | |
Total (N = 3057) | |||
High BP # | 0.515 (0.491–0.540) | 0.502 (0.477–0.527) | 0.513 (0.488–0.538) |
High FPG † | 0.668 (0.504–0.832) * | 0.653 (0.480–0.825) | 0.623 (0.449–0.796) |
High triglyceride ‡ | 0.654 (0.629–0.679) ** | 0.659 (0.634–0.684) ** | 0.664 (0.639–0.689) ** |
Low HDL cholesterol § | 0.668 (0.639–0.698) ** | 0.687 (0.658–0.715) ** | 0.658 (0.628–0.689) ** |
At least one non-WC components of MS | 0.600 (0.580–0.620) ** | 0.592 (0.572–0.612) ** | 0.592 (0.572–0.613) ** |
Two or more non-WC components of MS | 0.679 (0.647–0.710) ** | 0.690 (0.659–0.721) ** | 0.690 (0.658–0.721) ** |
Boys (n = 1625) | |||
High BP # | 0.528 (0.494–0.562) | 0.515 (0.481–0.549) | 0.523 (0.489–0.557) |
High FPG † | 0.670 (0.482–0.857) | 0.654 (0.457–0.851) | 0.621 (0.434–0.808) |
High triglyceride ‡ | 0.678 (0.644–0.712) ** | 0.689 (0.655–0.723) ** | 0.689 (0.656–0.723) ** |
Low HDL cholesterol § | 0.649 (0.612–0.686) ** | 0.655 (0.617–0.693) ** | 0.631 (0.592–0.669) ** |
At least one non-WC components of MS | 0.612 (0.584–0.639) ** | 0.606 (0.578–0.634) ** | 0.599 (0.571–0.627) ** |
Two or more non-WC components of MS | 0.683 (0.642–0.725) ** | 0.684 (0.641–0.727) ** | 0.691 (0.650–0.732) ** |
Girls (n = 1432) | |||
High BP # | 0.501 (0.466–0.536) | 0.522 (0.486–0.557) | 0.501 (0.465–0.537) |
High FPG † | 0.646 (0.316–0.976) | 0.612 (0.242–0.981) | 0.611 (0.241–0.981) |
High triglyceride ‡ | 0.629 (0.591–0.660) ** | 0.638 (0.601–0.674) ** | 0.638 (0.600–0.675) ** |
Low HDL cholesterol § | 0.690 (0.642–0.738) ** | 0.715 (0.670–0.761) ** | 0.699 (0.652–0.747) ** |
At least one non-WC components of MS | 0.585 (0.555–0.615) ** | 0.573 (0.543–0.603) ** | 0.583 (0.553–0.613) ** |
Two or more non-WC components of MS | 0.668 (0.620–0.717) ** | 0.682 (0.635–0.730) ** | 0.684 (0.636–0.733) ** |
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Choi, D.-H.; Hur, Y.-I.; Kang, J.-H.; Kim, K.; Cho, Y.G.; Hong, S.-M.; Cho, E.B. Usefulness of the Waist Circumference-to-Height Ratio in Screening for Obesity and Metabolic Syndrome among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2010–2014. Nutrients 2017, 9, 256. https://doi.org/10.3390/nu9030256
Choi D-H, Hur Y-I, Kang J-H, Kim K, Cho YG, Hong S-M, Cho EB. Usefulness of the Waist Circumference-to-Height Ratio in Screening for Obesity and Metabolic Syndrome among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2010–2014. Nutrients. 2017; 9(3):256. https://doi.org/10.3390/nu9030256
Chicago/Turabian StyleChoi, Dong-Hyun, Yang-Im Hur, Jae-Heon Kang, Kyoungwoo Kim, Young Gyu Cho, Soo-Min Hong, and Eun Byul Cho. 2017. "Usefulness of the Waist Circumference-to-Height Ratio in Screening for Obesity and Metabolic Syndrome among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2010–2014" Nutrients 9, no. 3: 256. https://doi.org/10.3390/nu9030256