Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-06T10:33:43.523Z Has data issue: false hasContentIssue false

Waist circumference to height ratio and left ventricular mass in children and adolescents

Published online by Cambridge University Press:  21 May 2015

Sudhir Ken Mehta*
Affiliation:
Department of Pediatric Cardiology, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic Children’s, Cleveland, Ohio, United States of America
*
Correspondence to: S. K. Mehta, MD, MBA, Chairman of Pediatrics, Fairview Hospital, 18101 Lorain Avenue, Cleveland, Ohio 44111-5656, United States of America. Tel: +216 476 7236; Fax: +216 476 7021; E-mail: [email protected]

Abstract

Objectives

Waist circumference to height ratio, a measure of central obesity, is a better predictor of cardiovascular risk than body mass index in the paediatric population. Increased left ventricular mass secondary to obesity and hypertension increases the risk for death and cardiovascular disease in adults. Similar data on left ventricular mass are lacking among young patients with central obesity, as defined by waist circumference/height. The present study evaluates left ventricular mass in young patients with central obesity as defined by waist circumference/height.

Methods

A total of 156 patients, 2- to 20-years old, without evidence of structural heart disease were studied. As the left ventricular mass is related to age and gender, 52 patients with central obesity – waist circumference/height ⩾0.55 – were randomly matched for age and gender with 52 patients at risk for central obesity – waist circumference/height ⩾0.5 to <0.55 – and 52 patients with no central obesity – waist circumference/height <0.5. The left ventricular mass parameters measured by echocardiography were compared across the three groups.

Results

Patients with central obesity had significantly (p<0.05) increased Z scores for left ventricular mass, left ventricular mass/height2.7, and left ventricular mass/height1.7 compared with patients at risk for central obesity and patients with no central obesity. Z scores for left ventricular mass were higher among patients at risk for central obesity compared with patients with no central obesity.

Conclusions

Left ventricular mass data of the present study support maintaining an ideal waist circumference/height <0.5. Aggressive efforts to identify and manage patients with central obesity are warranted.

Type
Original Articles
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Savva, SC, Tornaritis, M, Savva, ME, et al. Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Int J Obes Relat Metab Disord 2000; 24: 14531458.Google Scholar
2. Maffeis, C, Banzato, C, Talamini, G, Obesity Study Group of the Italian Society of Pediatric Endocrinology and Diabetology. Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children. J Pediatr 2008; 152: 207213.Google Scholar
3. Hsieh, SD, Muto, T. The superiority of waist-to-height ratio as an anthropometric index to evaluate clustering of coronary risk factors among non-obese men and women. Prev Med 2005; 40: 216220.Google Scholar
4. McCarthy, HD, Ashwell, M. A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message—‘keep your waist circumference to less than half your height’. Int J Obes (Lond) 2006; 30: 988992.Google Scholar
5. Mehta, S. Waist circumference to height ratio in children and adolescents. Clin Pediatr (Phila) 2015; 54: 652658.Google Scholar
6. Bluemke, DA, Kronmal, RA, Lima, JA, et al. The relationship of left ventricular mass and geometry to incident cardiovascular events: the MESA (Multi-Ethnic Study of Atherosclerosis) study. J Am Coll Cardiol 2008; 52: 21482155.CrossRefGoogle ScholarPubMed
7. Barbieri, A, Bursi, F, Mantovani, F, et al. Prognostic impact of left ventricular mass severity according to the classification proposed by the American Society of Echocardiography/European Association of Echocardiography. J Am Soc Echocardiogr 2011; 24: 13831391.Google Scholar
8. Lai, CC, Sun, D, Cen, R, et al. Impact of long-term burden of excessive adiposity and elevated blood pressure from childhood on adulthood left ventricular remodeling patterns: the Bogalusa Heart Study. J Am Coll Cardiol 2014; 64: 15801587.Google Scholar
9. Di Bonito, P, Moio, N, Sibilio, G, et al. Cardiometabolic phenotype in children with obesity. J Pediatr 2014; 165: 11841189.Google Scholar
10. Kuczmarski, RJ, Ogden, CL, Guo, SS, et al. 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat 11 2002; 246: 1190.Google Scholar
11. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics 2004; 114: 555576.Google Scholar
12. Centers for Disease Control and Prevention. NHANES 2003–2004 public data release file documentation. Retrieved February 28, 2014, from http://www.cdc.gov/nchs/data/nhanes/nhanes_03_04/BM.pdf Google Scholar
13. Foster, BJ, Mackie, AS, Mitsnefes, M, Ali, H, Mamber, S, Colan, SD. A novel method of expressing left ventricular mass relative to body size in children. Circulation 2008; 117: 27692775.Google Scholar
14. Lang, RM, Bierig, M, Devereux, RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. J Am Soc Echocardiogr 2005; 18: 14401463.CrossRefGoogle Scholar
15. Mehta, SK. Left ventricular mass in children and adolescents with elevated body mass index and normal waist circumference. Am J Cardiol 2014; 113: 10541057.CrossRefGoogle ScholarPubMed
16. Khoury, M, Manlhiot, C, McCrindle, BW. Role of the waist/height ratio in the cardio-metabolic risk assessment of children classified by body mass index. J Am Coll Cardiol 2013; 62: 742751.CrossRefGoogle Scholar
17. Freedman, DS, Kahn, HS, Mei, Z, et al. Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 2007; 86: 3340.Google Scholar
18. Ashwell, M, Mayhew, L, Richardson, J, Rickayzen, B. Waist-to-height ratio is more predictive of years of life lost than body mass index. PLoS One 2014; 9: e103483.Google Scholar
19. Nagy, P, Kovacs, E, Moreno, LA, et al. Percentile reference values for anthropometric body composition indices in European children from the IDEFICS study. Int J Obes (Lond) 2014; 38 (Suppl 2): S15S25.Google Scholar
20. Morandi, A, Miraglia Del Giudice, E, Martino, F, Martino, E, Bozzola, M, Maffeis, C. Anthropometric indices are not satisfactory predictors of metabolic comorbidities in obese children and adolescents. J Pediatr 2014; 165: 11781183.Google Scholar
21. McCrindle, BW. The contribution of anthropometry, adiposity, and adiposopathy to cardiometabolic disturbances in obese youth. J Pediatr 2014; 165: 10831084.Google Scholar