Waist-to-height ratio may be an alternative tool to the body mass index for identifying Colombian adolescents with cardiometabolic risk factors

Background: there is limited information about the usefulness of the waist-to-height ratio (WHtR) to identify Colombian adolescents with cardiometabolic risk factors (CRF). Objective: to compare the utility of WHtR, body mass index (BMI), and waist circumference (WC) to identify adolescents with CRF. Methods: a study with 346 youths (aged 14.0 +/- 2.3 years) was performed. Anthropometric measurements were collected and BMI, WC and WHtR were calculated. Fasting blood lipids, glucose and insulin were measured; the homeostasis model assessment of insulin resistance (HOMA-IR) was computed. The presence of multiple non-WC metabolic syndrome (MetS) factors (high HOMA-IR, high triglycerides and low high-density lipoprotein cholesterol [HDL-C]) was analyzed. The area under the curve (AUC) and the odds ratios (OR) were calculated. Results: the BMI, WC and WHtR were comparable at identifying adolescents with high HOMA-IR (AUC = 0.686, 0.694 and 0.641, respectively), low HDL-C (AUC = 0.623, 0.652 and 0.572, respectively) and multiple non-WC MetS factors (AUC = 0.694, 0.715 and 0.688, respectively). The OR of having multiple non-WC MetS factors was similar in overweight adolescents (1.65, 95% CI: 0.86-3.14) and those with WHtR >= 0.50 (3.76, 95% CI: 1.95-7.3). There were no OR differences of having multiple non-WC MetS factors among adolescent with obesity (9.88, 95% CI: 3.1-31.7), WC >= P90 (18.3, 95% CI: 4.0-83.5) and WHtR >= 0.55 (11.0, 95% CI: 3.0-4.4). Conclusions: WHtR, BMI and WC have similar capacities to identify Colombian adolescents with CRF. WHtR showed to be an alternative tool to BMI and WC measurements when screening adolescents for cardiometabolic risk.