Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Truncal-to-Leg Ratio and Cardiometabolic Disease

Pediatr Obes; ePub 2019 Jan 25; Cioffi, et al

In a cohort of adolescents, truncal‐to‐leg fat ratio (TLR) was associated with several risk factors independent of body mass index (BMI) z‐score, although some findings were sex or race/ethnicity specific. Therefore, according to this recent study, body fat distribution may be an important determinant of future cardiometabolic (CMD) risk factors. Data were from 3,810 adolescents (12‐19 years old) in the National Health and Examination Survey (NHANES) 2003‐2006. Body fat was assessed by dual‐energy X‐ray absorptiometry, and CMD risk factors were determined by blood samples and physical examination. Linear and logistic regressions adjusted for BMI z‐score and other covariates were used to examine associations of TLR with CMD risk factors as continuous and dichotomized outcomes, respectively. Researchers found:

  • Adolescents who were Mexican American, who have lower income, and with obesity had the highest mean TLR.
  • In linear regression, increasing TLR was associated positively with homeostasis model assessment of insulin resistance (HOMA‐IR), triglycerides, total cholesterol, systolic blood pressure (BP), c‐reactive protein, and alanine aminotransferase (ALT), and negatively with high‐density lipoprotein (HDL) cholesterol in both sexes.
  • TLR was also associated with diastolic BP in boys and low‐density lipoprotein cholesterol in girls.


Cioffi CE, Alvarez JA, Welsh JA, Vos MB. Truncal‐to‐leg fat ratio and cardiometabolic disease risk factors in US adolescents: NHANES 2003‐2006. [Published online ahead of print January 25, 2019]. Pediatr Obes. doi:10.1111/ijpo.12509.