International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years.
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Xi Bo, Zong Xin'nan, Kelishadi Roya, Litwin Mieczysław, Hong Young Mi, Poh Bee Koon, Steffen Lyn M, Galcheva Sonya V, Herter-Aeberli Isabelle, Nawarycz Tadeusz, Krzywińska-Wiewiorowska Małgorzata, Khadilkar Anuradha, Schmidt Michael D, Neuhauser Hannelore, Schienkiewitz Anja, Kułaga Zbigniew, Kim Hae Soon, Stawińska-Witoszyńska Barbara, Motlagh Mohammad Esmaeil, Ruzita Abd Talib, Iotova Violeta M, Grajda Aneta, Ismail Mohd Noor, Krzyżaniak Alicja, Heshmat Ramin, Stratev Velin, Różdżyńska-Świątkowska Agnieszka, Ardalan Gelayol, Qorbani Mostafa, Świąder-Leśniak Anna, Ostrowska-Nawarycz Lidia, Yotov Yoto, Ekbote Veena, Khadilkar Vaman, Venn Alison J, Dwyer Terence, Zhao Min, Magnussen Costan G, Bovet Pascal
Аннотация
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.