Weight-to-height ratio and body roundness index are superior indicators to assess cardio-metabolic risks in Chinese children and adolescents: compared with body mass index and a body shape index

Rui Chen; Lang Ji; Yitong Chen; Linghui Meng

doi:10.21037/tp-21-479

Weight-to-height ratio and body roundness index are superior indicators to assess cardio-metabolic risks in Chinese children and adolescents: compared with body mass index and a body shape index

Transl Pediatr. 2022 Mar;11(3):318-329. doi: 10.21037/tp-21-479.

Authors

Rui Chen¹, Lang Ji², Yitong Chen³, Linghui Meng¹

Affiliations

¹ Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing, China.
² Central Laboratory, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
³ Infectious Diseases Control and Prevention Division, Daxing Center for Disease Control and Prevention, Beijing, China.

Abstract

Objective: To assess the relationship between five anthropometric indicators, which includes body mass index (BMI), weight-to-height ratio (WHtR), a body shape index (ABSI), ABSI-adolescents, and body roundness index (BRI) in Chinese children and adolescents, and select which could better predict cardio-metabolic risk factors (CMRFs).

Methods: Cross-sectional study with 1,587 participants aged 3 to 17 years. Five anthropometric indicators were calculated according to weight, height and waist circumference (WC). Anthropometric measurements and laboratory indicators were used to diagnose CMRFs, which included hypertension, dyslipidemia, impaired fasting glucose and abdominal obesity. Partial correlation analysis was used to evaluate the relationship among anthropometric indicators, area under the receiver operating characteristic curve (AUCs) were used to compare the predict ability of each anthropometric indicators, the cut-off value, sensitivity, specificity and Youden Index of each indicator were calculated.

Results: In 3-6 years old children, ABSI-adolescent positively correlated with WC (r=0.727, P<0.001), BMI (r=0.218, P<0.001) and WHtR (r=0.752, P<0.001), and in 7-17 years old participants, the correlation coefficients increased to 0.842, 0.563 and 0.850 (P<0.001), respectively. BRI were strong correlated with BMI, WHtR and ABSI-adolescents in both age group (P<0.001). In 3-6 years group, the ROC analysis showed that BMI and ABSI were significantly better in identifying hypertension in both genders, WHtR and BRI were significantly better in identifying abdominal obesity in girls, but all of them were failed in identifying dyslipidemia and hyperglycemia. In 7-17 years group, WHtR and BRI were significantly better in identifying hypertension, dyslipidemia, abdominal obesity in both genders, BMI and ABSI performed better in identifying hyperglycemia in girls.

Conclusions: In Chinese children aged 3-6 years, there is no indicator performed best in all the CMRFs, in 7-17 years old teenagers, WHtR and BRI can be recommended to identify hypertension, dyslipidemia, abdominal obesity and clustered CMRFs in both genders. However, ABSI showed weak discriminative power.

Keywords: Anthropometric indicators; a body shape index (ABSI); body roundness index (BRI); cardiometabolic risk factors; children and adolescents.