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Updated: Oct 14, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Performance of different adiposity measures for predicting left ventricular remodeling in Chinese hypertensive youth
Hong Cheng1, Bo Xi2, Junting Liu1
1Department of Epidemiology, Capital Institute of Pediatrics, Beijing, 10020, China.
Insights
Body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) similarly predict cardiovascular risk in Chinese youth. While WHtR is convenient for screening, all measures show limited predictive value for left ventricular abnormalities.
Area of Science:
- Cardiovascular Health
- Pediatric Cardiology
- Obesity Research
Background:
- Identifying optimal adiposity measures for predicting cardiovascular risk in youth remains challenging.
- Abnormal left ventricular structure is a key indicator of cardiovascular risk in hypertensive adolescents.
Purpose of the Study:
- To evaluate the predictive performance of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) for abnormal left ventricular structure in Chinese hypertensive youth.
- To compare the efficacy of these adiposity indices in identifying left ventricular hypertrophy (LVH) and left ventricular geometry (LVG).
Main Methods:
- Utilized data from the China Child and Adolescent Cardiovascular Health Study, including 1180 hypertensive youth aged 6-17 years.
- Employed logistic regression, receiver operator characteristic (ROC) curve analysis, and net reclassification improvement (NRI) to assess predictive performance.
- Analyzed the association between a 1-standard deviation increment in BMI, WC, and WHtR and the likelihood of LVH and LVG.
Main Results:
- All three adiposity indices (BMI, WC, WHtR) demonstrated similar performance in predicting LVH and LVG.
- Odds ratios for predicting LVH/LVG per 1-SD increment were comparable across the indices: BMI 1.34 (1.16-1.55), WC 1.25 (1.08-1.45), and WHtR 1.40 (1.20-1.62).
- ROC analysis and NRI confirmed the comparable predictive capabilities of BMI, WC, and WHtR, though their overall predictive value was limited.
Conclusions:
- BMI, WC, and WHtR exhibit similar, albeit limited, predictive value for abnormal left ventricular structure in Chinese hypertensive youth.
- Waist-to-height ratio (WHtR) is recommended as a simple and convenient screening tool for identifying youth at high risk of target organ damage.
- Further research may be needed to identify more robust predictors of cardiovascular risk in this population.
Abstract:
There is no consistent conclusion on which adiposity measure is best to predict cardiovascular risk factors in youth. The present study aims to assess the performance of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) in predicting abnormal left ventricular structure in Chinese hypertensive youth. A total of 1180 youth aged 6-17 years with hypertension from the China Child and Adolescent Cardiovascular Health Study were included in this study. Logistic regression model, receiver operator characteristic (ROC) curve analysis and net reclassification improvement (NRI) method were used to assess performance of BMI, WC, and WHtR in predicting left ventricular hypertrophy (LVH) and left ventricular geometry (LVG). A 1-standard deviation increment in any of three indexes in predicting LVH and LVG were similar, e.g., with the odds ratios and 95% confidence intervals of 1.34 (1.16-1.55), 1.25 (1.08-1.45) and 1.40 (1.20-1.62), respectively. In addition, ROC analysis and NRI method confirmed the similar performance of three adiposity indexes in predicting LVH and LVG. In conclusion, BMI, WC and WHtR had similar performance in predicting abnormal left ventricular structure in Chinese hypertensive youth, but all three indexes had limited value in prediction. WHtR is a simple and convenient adiposity index for screening youth at high risk of target organ damage.
