• Clinical and Experimental Pediatrics
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• v.59 no.11
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• pp.425-431
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• 2016

The waist-to-height ratio (WHtR), calculated by dividing the waist circumference (WC) by height, has recently gained attention as an anthropometric index for central adiposity. It is an easy-to-use and less age-dependent index to identify individuals with increased cardiometabolic risk. A WHtR cutoff of 0.5 can be used in different sex and ethnic groups and is generally accepted as a universal cutoff for central obesity in children (aged ${\geq}6$ years) and adults. However, the WHtR has not been validated in preschool children, and the routine use of WHtR in children under age 6 is not recommended. Prospective studies and meta-analysis in adults revealed that the WHtR is equivalent to or slightly better than WC and superior to body mass index (BMI) in predicting higher cardiometabolic risk. In children and adolescents, studies have shown that the WHtR is similar to both BMI and WC in identifying those at an increased cardiometabolic risk. Additional use of WHtR with BMI or WC may be helpful because WHtR considers both height and central obesity. WHtR may be preferred because of its simplicity and because it does not require sex- and age-dependent cutoffs; additionally, the simple message 'keep your WC to less than half your height' may be particularly useful. This review article summarizes recent publications on the usefulness of using WHtR especially when compared to BMI and WC as a screening tool for obesity and related cardiometabolic risks, and recommends the use of WHtR in clinical practice for obesity screening in children and adolescents.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.1
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• pp.44-53
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• 2018

The WHtR (waist to height ratio) and ABSI (a body shape index) are indicators that reflect abdominal obesity. This study examined the insulin resistance and metabolic syndrome prediction ability of ABSI and WHtR. In this study, 4,395 people aged 20 years or older, who underwent physical examinations at a General Hospital in Gyeonggi-do from January 2017 to September 2017 were assessed on a cross section survey. Metabolic syndrome was defined according to the criteria of the AHA/NHLBI. Insulin resistance was judged to be insulin resistance when the HOMA-IR value was 3.0 or more. Both men and women showed a stronger correlation between WHtR and the metabolic risk factors than ABSI. The AUC value of WHtR and ABSI was 0.849 and 0.676, respectively (p<0.001). The AUC value of WHtR and ABSI for predicting insulin resistance was 0.818 and 0.641, respectively (p<0.001). In conclusion, the ABSI has low predictive power of insulin resistance and metabolic syndrome whereas the WHtR has good predictive power for metabolic syndrome and insulin resistance.

• Journal of Integrative Natural Science
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• v.8 no.4
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• pp.305-312
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• 2015

The present study showed WHtR to be significantly better than BMI and WC for prediction of metabolic-related diseases in the middle-aged and older people in Korea, based on Bayesian ordered probit model analysis. The variations of WC, BMI and WHtR were compared according to the number of metabolic-related diseases such as hypertension, dyslipidemia, stroke, myocardial infarction, angina pectoris and diabetes. It was found that the three measures showed the similar variation except a very few extreme cases for age less than 40. For subjects over the age of 40, WC was not significant and WHtR gave more influence in greater variability than BMI on the number of metabolic diseases. Also, the rate of change for WHtR was higher than for BMI as the number of metabolic-related diseases increased. Specifically, the difference of the marginal effect of WHtR between no disease and only one disease was 1.81 times higher than that of BMI. Moreover, it was pointed out that the threshold value of WHtR for obesity should be considered differently by age.

• Exercise Science
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• v.28 no.1
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• pp.82-90
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• 2019

PURPOSE: The purpose of this study was to examine the association of waist to height ratio (WHtR) and resting heart rate (RHR) with cardio-metabolic risk factors among Korean postmenopausal women. METHODS: A cross-sectional analysis was performed using the 2015 Korea National Health and Nutrition Examination Survey. The analysis included a total of 1,540 postmenopausal women. RESULTS: Individuals with higher WHtR (>0.56) showed significantly higher glucose, triglyceride, insulin, Homeostatic Model Assessment for Insulin resistance (HOMA-IR), total cholesterol, systolic and diastolic blood pressure compared with ones with lower WHtR (≤0.51). Similar findings were found in those with higher RHR (≥90 bpm) compared with ones with lower RHR (<60 bpm) for glucose and HOMA-IR. When determining the combined effects of WHtR and RHR on the prevalence of metabolic syndrome, individual with WHtR above 0.5 and RHR above 80 bpm showed 10.39 times higher prevalence of metabolic syndrome compared with those with WHtR below 0.5 and RHR below 70 bpm. We further performed multiple linear regression analysis to understand how WHtR and RHR contribute to fasting glucose, and found that both WHtR and RHR contribute to fasting glucose levels independent of age, education level, marital status and income level. CONCLUSIONS: The current study showed that the WHtR and RHR are associated with cardio-metabolic risk factor and prevalence of metabolic syndrome in Korean postmenopausal women.

• Biomedical Science Letters
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• v.23 no.2
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• pp.57-63
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• 2017

A new body adiposity index (BAI) has been proposed that is expected to replace body mass index (BMI). We evaluated the correlations between metabolic syndrome risk factors and BAI, BMI, and other adiposity indices, such as waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), by sex in the Korean population. We also evaluated whether BAI would be useful to diagnose metabolic syndrome. A total of 20,961 Korean adults who underwent health examinations were included in this study. The metabolic syndrome diagnostic criteria used in this study were those set by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). In men (12,719), BMI and WHtR were more strongly correlated to metabolic syndrome risk than BAI, and in women (8,242), WHtR showed the strongest association with metabolic syndrome risk. BAI (area under the curve [AUC] = 0.678) presented lower discriminatory capacity than that of BMI (AUC = 0.836) for diagnosing metabolic syndrome. Moreover, BAI underestimated fat levels in men and women when considering the ability to discriminate overweight and obese individuals. In conclusion, WHtR and BMI in men, and WHtR in women may be better candidates than BAI to evaluate metabolic risk factors in Korean adults.

• Journal of Korean Medicine for Obesity Research
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• v.17 no.2
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• pp.127-132
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• 2017

Objectives: Recently, many studies have demonstrated that the waist-to-height ratio (WHtR) is more correlated with metabolic syndrome than the waist-hip ratio (WHR), body mass index (BMI). The aim of this study was to investigate and compare WHtR as a predictor of metabolic syndrome with other anthropometric indices. Methods: Approximately 3,800 data of subjects were used for the analysis, and data from Korean Medicine Data Centar). Receiver operating characteristic curve was performed and area under the curve (AUC) was calculated to find the usefulness of WHtR, WHR, and BMI. Results: WHtR was the most predictive factor with the highest diagnostic value for metabolic syndrome than WHR, BMI. AUC of WHtR was significantly higher in total subjects, men and women. Conclusions: WHtR may be the simple and effective anthropometric index for metabolic syndrome.

• Clinical and Experimental Pediatrics
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• v.58 no.5
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• pp.165-171
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• 2015

Purpose: To analyze the correlation between serum alanine aminotransferase (ALT) and obesity indices including body mass index (BMI), body fat percentage (BFP), total fat mass (FM), truncal fat mass (TFM), waist circumference (WC), and waist-to-height ratio (WHtR) in Korean adolescents. Methods: This was a cross-sectional study based on data derived from the 2010-2011 Korean National Health and Nutrition Examination Surveys (KNHANES). Subjects were Korean adolescents aged 10-18 years (871 total; 475 boys and 396 girls) who participated in KNHANES. Results: In both sexes, BMI, FM, TFM, WC, and WHtR were higher when ALT levels were in the 4th quartile. In boys, there was a significant positive correlation between ALT level and BMI, BFP, FM, TFM, WC, and WHtR (r=0.55, P<0.0001 for BMI; r=0.52, P<0.0001 for BFP; r=0.58, P<0.0001 for FM; r=0.61, P<0.0001 for TFM; and r=0.56, P<0.0001 for WC; r=0.62, P<0.0001 for WHtR), and the correlation coefficient was higher than that in girls. Conclusion: Our results suggest a significant positive association between serum ALT level and obesity indices in male adolescents.

• Journal of Digital Contents Society
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• v.19 no.4
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• pp.685-692
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• 2018

The purpose of this study is to develop a prediction model of hypertension in middle-aged adults using Statistical analysis. Statistical analysis and prediction models were developed using the National Health and Nutrition Survey (2013-2016).Binary logistic regression analysis showed statistically significant risk factors for hypertension, and a predictive model was developed using logistic regression and the Naive Bayes algorithm using Wrapper approach technique. In the statistical analysis, WHtR(p<0.0001, OR = 2.0242) in men and AGE (p<0.0001, OR = 3.9185) in women were the most related factors to hypertension. In the performance evaluation of the prediction model, the logistic regression model showed the best predictive power in men (AUC = 0.782) and women (AUC = 0.858). Our findings provide important information for developing large-scale screening tools for hypertension and can be used as the basis for hypertension research.

• Journal of radiological science and technology
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• v.43 no.3
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• pp.177-185
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• 2020

This study investigated the relationship between metabolic syndrom risk factors to patients with left atrial enlargement according to the results of echocardiography. Male were 269(8.9%) and female were 46(1.5%) that of the total 315 patients (10.5%) with left atrial enlargement. In the obesity factors analysis, BMI, WC, and WHtR were associated with left atrial enlargement. Among them, WHtR included the many obese people with left atrial enlargement. In the analysis of blood pressure, The systolic blood pressure was the highest in the borderline hypertension group in the left atrial enlargement and the diastolic blood pressure was the highest in the normal range group in the left atrial enlargement. In the blood result analysis, there was no correlation with left atrial enlargement that total cholesterol, HDL, LDL cholesterol, triglyceride, and fasting blood glucose level were within the normal range. Therefore, obesity and systolic blood pressure were associated with the left atrial enlargement group. However, the systolic blood pressure did not show pathological condition due to borderline hypertension, and the distribution of the left atrial enlargement group was smaller than that of obesity. Obesity, which includes the largest number of left atrial enlargement group, has been identified to be the highest risk factor for left atrial enlargement.

• Journal of the Korean Society of Clothing and Textiles
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• v.43 no.2
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• pp.184-203
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• 2019

This study examines the multilateral characteristics of elderly body shapes by applying body measurement items and obesity indices (BMI, WHR, WHtR, WC, and flatness). The subjects were 397 males, 378 females aged 70-85 from the $6^{th}$ Size Korea and 132 males, 212 females aged 60-69, 596 males, 650 females aged 20-29 from the $7^{th}$ Size Korea. In order to examine the body size differences among age groups, age was divided into 7 groups (20-24, 25-29, 60-64, 65-69, 70-74, 75-79, and 80-85). Both elderly males and females showed lower values of height and weight than those in their 20s. However, abdominal obesity indices (WHR and WHtR) showed higher values in the elderly than those of their 20s; in addition, they showed larger mean values as age increased. The chest and arm circumference tended to decrease in elderly males as age increased; however, elderly females tended to decrease in thigh and calf circumference size. There were gender differences in body changing due to aging. Obesity frequency was significantly higher in the elderly than in the 20s. The study represents basic data for product design for the elderly.