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

Table 1

Evaluation metrics for ability of general obesity measures to predict cardiometabolic risk, ages 12–18, N = 12,268.

Cardiometabolic risk variables	General obesity measures						AUC difference between arm-to-height ratio and BMI percentile
	Arm-to-height ratio (sex-specific)			BMI percentile (age- and sex-specific)
	R^2	Max-rescaled R^2	AUC	R^2	Max-rescaled R^2	AUC
Overall risk	0.058	0.083	0.647	0.044	0.063	0.638	χ^2 = 4.18;
TC	0.018	0.025	0.585	0.012	0.017	0.577	χ^2 = 8.68;
LDL-C	0.021	0.033	0.607	0.014	0.022	0.595	χ^2 = 3.62;
HDL-C	0.098	0.136	0.691	0.088	0.122	0.689	χ^2 = 1.18;
TG	0.053	0.075	0.646	0.049	0.069	0.648	χ^2 = 0.24;
SBP	0.082	0.143	0.728	0.072	0.126	0.722	χ^2 = 5.10;
DBP	0.001	0.004	0.545	0.001	0.003	0.538	χ^2 = 0.35;
HbA1C	0.016	0.048	0.646	0.010	0.029	0.634	χ^2 = 5.24;
FPG	0.034	0.058	0.640	0.031	0.052	0.642	χ^2 = 0.70;

AUC = area under the curve; 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; unhealthy level of each cardiometabolic risk 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. Overall risk indicates unhealthy level on any of the eight CR variables.