Background: Recently the prevalence of child hypertension and obesity were increased. Hypertension in obese child mostly influenced by visceral fat. Waist-to-Hip Circumference Ratio (WHR) is the most extensive indirect measurement for assessing visceral fat. There were still no research mentioning the cut-off point of WHR in hypertension and non hypertension in obese children in Indonesia.
Objective: This study aimed to analyze the relationship between WHR and hypertension in obese children.
Method: This study was a cross-sectional study, based on primary data on children aged 11-17 years at Rajawali Catholic Junior High School and Zion Makassar High School in South Sulawesi in May-July 2018. Using proportional Stratified Cluster Random Sampling method, BMI were taken to identify obese children (? 95th percentile BMI CDC 2000). Blood pressure were measured adjusting to AAP Guidelines 2017, where obese children are grouped into obese hypertensive and obese normotensive. Waist Circumference (WC) and Hip Circumference (HC) of both groups were measured using tape with 0,1 cm accuracy to assess the WHR. Data were analyzed bivariately using Chi Square analysis, independent-t test, Mann Whitney, Spearman correlation and Receiver Operating Characteristic curve.
Results: Out of 804 children, 146 were obese. Out of 146 obese children, 15 were excluded. Therefore only 131 children were analyzed, 53 with hypertension and 78 with normotension. Bivariate analysis showed a significant relationship between WHR and hypertension (p <0.01). Positive correlation was found between WHR and systolic either diastolic blood pressure (p <0.01). The WHR 1.00 value is selected as cut-off point WHR among obese hypertensive group with normotensive obese, sensitivity was 86,7%, specificity was 93,5%, positive prediction value was 90,1%, negative prediction value was 91.2% with Area Under the Curve was 0,902. An obese child with WHR >1.00 has a risk of 95.9 times experiencing hypertension compared to obese child with WHR <1.00.
Conclusion: An obese child with WHR >1.00 has a risk of 95.9 times experiencing hypertension compared to obese child with WHR <1.00.