Arm Circumference-to-Height Ratio as a Situational Alternative to BMI Percentile in Assessing Obesity and Cardiometabolic Risk in Adolescents

Figure 1

Changes in general obesity measures and corresponding cardiometabolic risk probabilities, ages 12–18 by sex, N = 12,268. (a) Probability of unacceptable outcomes, for females, (b) probability of unacceptable outcomes, for males, (c) BMI percentile and unhealthy level of each variable, for females, and (d) BMI percentile and unhealthy level of each variable, for females. CR = cardiometabolic risk; TC = total cholesterol; LDL-C = low-density lipoprotein cholesterol; HDL-C = high-density lipoprotein cholesterol; TG = triglycerides; SBP = systolic blood pressure; DBP = diastolic blood pressure; HbA1c = glycated hemoglobin; FPG = fasting plasma glucose; “Any” = unhealthy level on any of the eight CR variables (indicates “overall” CR). Unhealthy level of each CR variable includes both borderline-risk and high-risk levels, defined according to National Heart, Lung, and Blood Institute Expert Panel Report 2012, American Academy of Pediatrics, and American Diabetes Association. Arm-to-height ratio ≥ 0.19 in females and ≥ 0.16 in males regardless of age were identified as the best CR cutoffs, indicating ≥0.71 probability of having unhealthy level in any of the eight CR variables. BMI ≥ 94^th percentile in females and ≥64^th percentile in males at a given age were identified as the best CR cutoffs, indicating ≥0.73 probability of having unhealthy level in any of the eight CR variables.

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