TY - JOUR
T1 - International waist circumference percentile cutoffs for central obesity in children and adolescents aged 6 to 18 years
AU - Xi, Bo
AU - Zong, Xinnan
AU - Kelishadi, Roya
AU - Litwin, Mieczysław
AU - Hong, Young Mi
AU - Poh, Bee Koon
AU - Steffen, Lyn M.
AU - Galcheva, Sonya V.
AU - Herter-Aeberli, Isabelle
AU - Nawarycz, Tadeusz
AU - Krzywińska-Wiewiorowska, Małgorzata
AU - Khadilkar, Anuradha
AU - Schmidt, Michael D.
AU - Neuhauser, Hannelore
AU - Schienkiewitz, Anja
AU - Kułaga, Zbigniew
AU - Kim, Hae Soon
AU - Stawińska-Witoszyńska, Barbara
AU - Motlagh, Mohammad Esmaeil
AU - Ruzita, Abd Talib
AU - Iotova, Violeta M.
AU - Grajda, Aneta
AU - Ismail, Mohd Noor
AU - Krzyżaniak, Alicja
AU - Heshmat, Ramin
AU - Stratev, Velin
AU - Różdżyńska-Świątkowska, Agnieszka
AU - Ardalan, Gelayol
AU - Qorbani, Mostafa
AU - Świąder-Leśniak, Anna
AU - Ostrowska-Nawarycz, Lidia
AU - Yotov, Yoto
AU - Ekbote, Veena
AU - Khadilkar, Vaman
AU - Venn, Alison J.
AU - Dwyer, Terence
AU - Zhao, Min
AU - Magnussen, Costan G.
AU - Bovet, Pascal
N1 - Publisher Copyright:
© Endocrine Society 2019. All rights reserved.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - 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.
AB - 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.
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U2 - 10.1210/clinem/dgz195
DO - 10.1210/clinem/dgz195
M3 - Article
C2 - 31723976
AN - SCOPUS:85081945868
SN - 0021-972X
VL - 105
SP - E1569-E1583
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 4
ER -
