International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years-Reference-Cited by-同舟云学术

International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years

Published:2019-11-14 Issue:4 Volume:105 Page:e1569-e1583
ISSN:0021-972X
Container-title:The Journal of Clinical Endocrinology & Metabolism
language:en
Short-container-title:

Author:

Xi Bo¹^ORCID,Zong Xin’nan²,Kelishadi Roya³,Litwin Mieczysław⁴,Hong Young Mi⁵,Poh Bee Koon⁶,Steffen Lyn M⁷,Galcheva Sonya V⁸,Herter-Aeberli Isabelle⁹^ORCID,Nawarycz Tadeusz¹⁰,Krzywińska-Wiewiorowska Małgorzata¹¹,Khadilkar Anuradha¹²,Schmidt Michael D¹³,Neuhauser Hannelore¹⁴,Schienkiewitz Anja¹⁵,Kułaga Zbigniew¹⁶,Kim Hae Soon⁵,Stawińska-Witoszyńska Barbara¹¹,Motlagh Mohammad Esmaeil¹⁷,Ruzita Abd Talib⁶,Iotova Violeta M⁸,Grajda Aneta¹⁶,Ismail Mohd Noor¹⁸,Krzyżaniak Alicja¹¹,Heshmat Ramin¹⁹,Stratev Velin²⁰,Różdżyńska-Świątkowska Agnieszka²¹,Ardalan Gelayol³,Qorbani Mostafa²²,Świąder-Leśniak Anna²¹,Ostrowska-Nawarycz Lidia¹⁰,Yotov Yoto²³,Ekbote Veena¹²,Khadilkar Vaman¹²,Venn Alison J²⁴,Dwyer Terence²⁴²⁵,Zhao Min²⁶,Magnussen Costan G²⁴²⁷,Bovet Pascal²⁸

Affiliation:

1. Department of Epidemiology, School of Public Health, Shandong University, Jinan, China

2. Department of Growth and Development, Capital Institute of Pediatrics, Beijing, China

3. Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

4. Department of Nephrology and Arterial Hypertension, The Children’s Memorial Health Institute, Warsaw, Poland

5. Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea

6. Nutritional Sciences Programme and Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

7. Division of Epidemiology and Community Health, University of Minnesotas School of Public Health, Minneapolis, USA

8. Department of Pediatrics, Varna Medical University, Varna, Bulgaria

9. Institute of Food, Nutrition and Health, Human Nutrition Laboratory, ETH Zurich, Zürich, Switzerland

10. Department of Biophysics, Chair of Experimental and Clinical Physiology, Medical University of Lodz, Lodz, Poland

11. Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, Poznan, Poland

12. Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India

13. Department of Kinesiology, University of Georgia, Athens, Georgia, USA

14. Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany and DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany

15. Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany

16. Department of Public Health, The Children’s Memorial Health Institute, Warsaw, Poland

17. Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

18. Faculty of Social Sciences and Leisure Management, Taylor’s University, Subang Jaya, Selangor, Malaysia

19. Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

20. Department of Internal Medicine, Varna Medical University, Varna, Bulgaria

21. Department of Anthropometry, The Children’s Memorial Health Institute, Warsaw, Poland

22. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran

23. Department of cardiology, Medical University Varna, Varna, Bulgaria

24. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia

25. George Institute for Global Health, Oxford Martin School and Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, UK

26. Departments of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China

27. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland

28. Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland

Abstract

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.

Funder

National Natural Science Foundation of China

National Institutes of Health

Swiss Federal Office of Public Health

Isfahan University of Medical Sciences

Ministry of Science, Technology and Innovation ScienceFund research

Nestle Products (Malaysia) Sdn. Bhd.

European Economic Area

National Centre for Research and Development in Poland

Publisher

The Endocrine Society

Subject