International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years
Year: 2019
Type: article
Abstract: CONTEXT: No universal waist circumference (WC) percentile cutoffs used have been proposed for screening central obesity in children and adolescents. OBJECTIVE: To develop international WC percentile cutoffs for children and adolescents with normal weight based on data from 8 countries in different global regions and to examine the relation with cardiovascular risk. DESIGN AND SETTING: We used pooled data on WC in 113,453 children and adolescents (males 50.2%) aged 4 to 20 years from 8 countries in different regions (Bulgaria, China, Iran, Korea, Malaysia, Poland, Seychelles, and Switzerland). We calculated WC percentile cutoffs in samples including or excluding children with obesity, overweight, or underweight. WC percentiles were generated using the general additive model for location, scale, and shape (GAMLSS). We also estimated the predictive power of the WC 90th percentile cutoffs to predict cardiovascular risk using receiver operator characteristics curve analysis based on data from 3 countries that had available data (China, Iran, and Korea). We also examined which WC percentiles linked with WC cutoffs for central obesity in adults (at age of 18 years). MAIN OUTCOME MEASURE: WC measured based on recommendation by the World Health Organization. RESULTS: We validated the performance of the age- and sex-specific 90th percentile WC cutoffs calculated in children and adolescents (6-18 years of age) with normal weight (excluding youth with obesity, overweight, or underweight) by linking the percentile with cardiovascular risk (area under the curve [AUC]: 0.69 for boys; 0.63 for girls). In addition, WC percentile among normal weight children linked relatively well with established WC cutoffs for central obesity in adults (eg, AUC in US adolescents: 0.71 for boys; 0.68 for girls). CONCLUSION: The international WC cutoffs developed in this study could be useful to screen central obesity in children and adolescents aged 6 to 18 years and allow direct comparison of WC distributions between populations and over time.
Authors: Bo Xi, Xin’nan Zong, Roya Kelishadi, Mieczysław Litwin, Young Mi Hong, Bee Koon Poh, Lyn M Steffen, Sonya V Galcheva, Isabelle Herter-Aeberli, Tadeusz Nawarycz, Małgorzata Krzywińska-Wiewiorowska, Anuradha Khadilkar, Michael D Schmidt, Hannelore Neuhauser, Anja Schienkiewitz, Zbigniew Kułaga, Hae Soon Kim, Barbara Stawińska-Witoszyńska, Mohammad Esmaeil Motlagh, Abd Talib Ruzita, Violeta M Iotova, Aneta Grajda, Mohd Noor Ismail, Alicja Krzyżaniak, Ramin Heshmat, Velin Stratev, Agnieszka Różdżyńska-Świątkowska, Gelayol Ardalan, Mostafa Qorbani, Anna Świąder-Leśniak, Lidia Ostrowska-Nawarycz, Yoto Yotov, Veena Ekbote, Vaman Khadilkar, Alison J Venn, Terence Dwyer, Min Zhao, Costan G Magnussen, Pascal Bovet
Institutions: Shandong University, Capital Institute of Pediatrics, Isfahan University of Medical Sciences, Children's Memorial Health Institute, Ewha Womans University, Ewha Womans University Seoul Hospital, National University of Malaysia, University of Minnesota, Medical University of Varna, ETH Zurich, Institute of Food, Nutrition, and Health, Medical University of Lodz, Poznan University of Medical Sciences, Jehangir Hospital, University of Georgia, Robert Koch Institute, German Centre for Cardiovascular Research, Ahvaz Jundishapur University of Medical Sciences, Taylor's University, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Alborz University of Medical Sciences, University of Tasmania, Menzies Institute for Medical Research, The George Institute for Global Health, University of Oxford, University of Turku, Centre universitaire de médecine générale et santé publique, Lausanne, University of Lausanne
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2984564756