Optimal waist-to-height ratio values for cardiometabolic risk screening in an ethnically diverse sample of South African urban and rural school boys and girls

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dc.contributor.authorMatsha, Tandi Een_ZA
dc.contributor.authorKengne, Andre-Pascalen_ZA
dc.contributor.authorYako, Yandiswa Yen_ZA
dc.contributor.authorHon, Gloudina Men_ZA
dc.contributor.authorHassan, Mogamat Sen_ZA
dc.contributor.authorErasmus, Rajiv Ten_ZA
dc.date.accessioned2016-01-11T06:56:12Z
dc.date.available2016-01-11T06:56:12Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: The proposed waist-to-height ratio (WHtR) cut-off of 0.5 is less optimal for cardiometabolic risk screening in children in many settings. The purpose of this study was to determine the optimal WHtR for children from South Africa, and investigate variations by gender, ethnicity and residence in the achieved value. METHODS: Metabolic syndrome (MetS) components were measured in 1272 randomly selected learners, aged 10-16 years, comprising of 446 black Africans, 696 mixed-ancestry and 130 Caucasians. The Youden's index and the closest-top-left (CTL) point approaches were used to derive WHtR cut-offs for diagnosing any two MetS components, excluding the waist circumference. RESULTS: The two approaches yielded similar cut-off in girls, 0.465 (sensitivity 50.0, specificity 69.5), but two different values in boys, 0.455 (42.9, 88.4) and 0.425 (60.3, 67.7) based on the Youden's index and the CTL point, respectively. Furthermore, WHtR cut-off values derived differed substantially amongst the regions and ethnic groups investigated, whereby the highest cut-off was observed in semi-rural and white children, respectively, Youden's index0.505 (31.6, 87.1) and CTL point 0.475 (44.4, 75.9). CONCLUSION: The WHtR cut-off of 0.5 is less accurate for screening cardiovascular risk in South African children. The optimal value in this setting is likely gender and ethnicity-specific and sensitive to urbanization.en_ZA
dc.identifier.apacitationMatsha, T. E., Kengne, A., Yako, Y. Y., Hon, G. M., Hassan, M. S., & Erasmus, R. T. (2013). Optimal waist-to-height ratio values for cardiometabolic risk screening in an ethnically diverse sample of South African urban and rural school boys and girls. <i>PLoS One</i>, http://hdl.handle.net/11427/16308en_ZA
dc.identifier.chicagocitationMatsha, Tandi E, Andre-Pascal Kengne, Yandiswa Y Yako, Gloudina M Hon, Mogamat S Hassan, and Rajiv T Erasmus "Optimal waist-to-height ratio values for cardiometabolic risk screening in an ethnically diverse sample of South African urban and rural school boys and girls." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/16308en_ZA
dc.identifier.citationMatsha, T. E., Kengne, A. P., Yako, Y. Y., Hon, G. M., Hassan, M. S., & Erasmus, R. T. (2013). Optimal waist-to-height ratio values for cardiometabolic risk screening in an ethnically diverse sample of South African urban and rural school boys and girls. PloS one, 8(8), e71133. doi:10.1371/journal.pone.0071133en_ZA
dc.identifier.ris TY - Journal Article AU - Matsha, Tandi E AU - Kengne, Andre-Pascal AU - Yako, Yandiswa Y AU - Hon, Gloudina M AU - Hassan, Mogamat S AU - Erasmus, Rajiv T AB - BACKGROUND: The proposed waist-to-height ratio (WHtR) cut-off of 0.5 is less optimal for cardiometabolic risk screening in children in many settings. The purpose of this study was to determine the optimal WHtR for children from South Africa, and investigate variations by gender, ethnicity and residence in the achieved value. METHODS: Metabolic syndrome (MetS) components were measured in 1272 randomly selected learners, aged 10-16 years, comprising of 446 black Africans, 696 mixed-ancestry and 130 Caucasians. The Youden's index and the closest-top-left (CTL) point approaches were used to derive WHtR cut-offs for diagnosing any two MetS components, excluding the waist circumference. RESULTS: The two approaches yielded similar cut-off in girls, 0.465 (sensitivity 50.0, specificity 69.5), but two different values in boys, 0.455 (42.9, 88.4) and 0.425 (60.3, 67.7) based on the Youden's index and the CTL point, respectively. Furthermore, WHtR cut-off values derived differed substantially amongst the regions and ethnic groups investigated, whereby the highest cut-off was observed in semi-rural and white children, respectively, Youden's index0.505 (31.6, 87.1) and CTL point 0.475 (44.4, 75.9). CONCLUSION: The WHtR cut-off of 0.5 is less accurate for screening cardiovascular risk in South African children. The optimal value in this setting is likely gender and ethnicity-specific and sensitive to urbanization. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0071133 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Optimal waist-to-height ratio values for cardiometabolic risk screening in an ethnically diverse sample of South African urban and rural school boys and girls TI - Optimal waist-to-height ratio values for cardiometabolic risk screening in an ethnically diverse sample of South African urban and rural school boys and girls UR - http://hdl.handle.net/11427/16308 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16308
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0071133
dc.identifier.vancouvercitationMatsha TE, Kengne A, Yako YY, Hon GM, Hassan MS, Erasmus RT. Optimal waist-to-height ratio values for cardiometabolic risk screening in an ethnically diverse sample of South African urban and rural school boys and girls. PLoS One. 2013; http://hdl.handle.net/11427/16308.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Matsha et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherChildrenen_ZA
dc.subject.otherChildhood obesityen_ZA
dc.subject.otherMetabolic disordersen_ZA
dc.subject.otherSchoolsen_ZA
dc.subject.otherAfricansen_ZA
dc.subject.otherBlood pressureen_ZA
dc.subject.otherHipen_ZA
dc.subject.otherObesityen_ZA
dc.titleOptimal waist-to-height ratio values for cardiometabolic risk screening in an ethnically diverse sample of South African urban and rural school boys and girlsen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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