Effectiveness of a body shape index in predicting pediatric high blood pressure.

Background: A body shape index (ABSI) is an emerging anthropometric indicator, challenging two traditional parameters: body mass index (BMI) and waist circumference (WC). We aimed to systematically compare and validate the capability of anthropometric indicators for determining pediatric high blood pressure (HBP).

Methods: A total of 3150 participants aged 7-17 years were enrolled from Suzhou, China. Areas under the receiver operating characteristic curve (AUC) were obtained to evaluate the performance of anthropometric indicators in detecting HBP. DeLong's test was used to examine whether the AUCs of anthropometric indicators in contrast to BMI or original ABSI were statistically different. Furthermore, a meta-analysis was performed to combine results from this study and five similar articles from databases.

Results: In Suzhou population, BMI exhibited the largest AUC (AUC = 0.705), followed by WC (AUC = 0.669) and original ABSI (AUC = 0.514). Modified ABSI (AUC: 0.537-0.681), although had slightly better performance than original ABSI, was still less valuable than BMI (P < 0.05), either in the total sample or in boys. The meta-analysis with 21108 children and adolescents subsequently confirms the results derived from Suzhou population.

Conclusions: In predicting pediatric HBP, original ABSI and modified ABSI underperform BMI and WC.

Impact: The current study is the first to evaluate whether original ABSI or modified ABSI is comparable to BMI and WC for screening HBP in children and adolescents. In predicting pediatric HBP, original ABSI and modified ABSI do not perform as well as traditional anthropometric indicators, such as BMI and WC. BMI remains the optimal indicator in pediatric HBP screening. This study provides a theoretical basis for the early identification of HBP in children and adolescents by adopting effective predictors.