Abstract 16843: Waist Measures are an Important Factor Further Specifying Adiposity-Related Cardiometabolic Risk for Children Classified by Body Mass Index

Background: Body mass index (BMI) is commonly used as an indirect indicator of adiposity in children reflective of its association with cardiometabolic risk. The interaction of waist circumference percentile (WC%) and waist-to-height ratio (WHtR) with BMI may provide further risk specification in children. Methods: Data were analyzed from 5 NHANES surveys from 1999-2008. Two sets of groups were created based on categories of BMI/WC% and BMI/WHtR to assess the interaction of waist measures and BMI percentile (WHO charts) in association with cardiometabolic risk factors, including fasting lipids, glucose and insulin, C-reactive protein (CRP) and blood pressure category. Results: Data were available for 14,802 subjects (age range 5-18.9 years, 50% male, 4,542 fasting blood work). Overweight (BMI≥85%) and obesity (BMI≥95%) were noted for 13% and 27%, respectively. WC% ≥ 90% and WHtR ≥ 0.6 were noted in 16% and 10%, respectively. Both between and within BMI categories, increasing waist measures were significantly associated with increased lipid abnormalities (Figure A), higher insulin and glucose values, increased likelihoods of higher hypertension categories, and higher CRP levels (Figure B). Adjusted multivariable regression models for cardiometabolic risk factors had similar R 2 and c statistic values when waist measure categories were studied independently of or interacting with BMI categories. Interactions remained significant with continuous variables. Conclusions: Waist measures further specify cardiometabolic risk within classifications based on BMI, and should be included in the routine screening and assessment of risk in the pediatric population.