Maryam Yazdi, Farahnak asadi, Mostafa Qorbani,  Seyedeh Shahrbanoo Daniali, Ramin Heshmat,  Roya Kelishadi


Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

1 Department of Urology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
2 Department of Biostatistics and Epidemiology, School of Public Health, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
3 Department of Physiology and Pharmacology, School of Medicine, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran


Anthropometric indices have been used as indicators for predicting hypertension
(HTN) in children and adolescents but it is not clear which anthropometric measures
are a better index for identifying elevated blood pressure (EBP) risk factors in pediatric population. Body mass index (BMI), waist circumference (WC), weight-height
ratio (WHR), a body shape index (ABSI) and blood pressure were measured in 14 008
children and adolescents aged 7-18 years in a national school-aged survey CASPIN
V. Hypertension (HTN) was defined according to the 2017 American Academy of
Pediatrics guidelines, using the 95th percentile. The predictive power of anthropometric indices for HTN risk factors was examined using receiver operating characteristic (ROC) analyses. Multivariate logistic regression analysis was used to compare
areas under ROC curves (AUCs) among the four anthropometric indices. BMI, WC,
WHR, and ABSI were significantly higher in adolescents than in children. EBP was
more prevalent in boys (7.2%) than girls (5.5%), whereas the prevalence of HTN was
higher in girls (11.3%) than boys 10.4%. Prevalence odds ratio was around 2 for BMI,
WC, and WHR with AUCs scores of nearly 0.6 to predict EBP in both children and
adolescents of both sexes. Thus, the ability of BMI z-score, WC, WHR or ASBI to
identify Iranian children and adolescents at higher risk of EBP was week. WC, WHR
or ASBI in combination with BMI did not improve predictive power to identify subjects at higher risk of EBP.