Open Access, Peer-reviewed
pISSN 2234-8646
eISSN 2234-8840
    Korean J Pediatr Gastroenterol Nutr. 2010 Sep;13(2):180-192. Korean.
    Published online Sep 30, 2010.
    https://doi.org/10.5223/kjpgn.2010.13.2.180
    Copyright © 2010 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
    Original Article

    Usefulness of the Waist Circumference-to-Height Ratio in Screening for Obesity in Korean Children and Adolescents

    Joo Hyun Gil, M.D., Mi Na Lee, M.D., Hye Ah Lee,* Hyesook Park, M.D.,* and Jeong Wan Seo, M.D.
      • Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
      • *Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
    • Corresponding author (Email: jwseo@ewha.ac.kr )
    Received August 13, 2010; Revised August 17, 2010; Accepted September 03, 2010.

    Abstract

    Purpose

    To evaluate the feasibility and usefulness of the waist circumference-to-height ratio (WHTR) in screening for obesity in Korean children and adolescents.

    Methods

    Data, including body mass index (BMI), waist circumference (WC), and height, were obtained from the national growth surveys for children and adolescents in 2005. The WHTR was calculated dividing WC by height in subjects 2~18 years of age. Overweight and obese were defined by BMI percentiles for age and gender. The receiver operating characteristic (ROC) analysis was performed to find out the optimal cutoff values of WHTR that matched BMI-determined overweight and obesity using the STATA program. The area under the curve (AUC), a measure of diagnostic power, of WHTR was compared to WC. The influence of age on WHTR was analyzed by the SAS program.

    Results

    The WHTR significantly decreased with age, and had less correlation with age in the 6~18-year-old age group than the 2~5-year-old age group. Furthermore, the WHTR also had less correlation with age than WC in the 6~18-year-old age group. The AUC of WHTR in identifying overweight and obesity was significantly higher than the AUC of WC in the 6~18-year-old age group. The optimal cutoff values were 0.51 in boys and 0.49 in girls for obesity, and 0.48 in boys and 0.47 in girls for overweight, with all having the AUC>0.9. The optimal cutoff values of WHTR had a higher sensitivity for diagnosing obesity than WC≥90th percentiles.

    Conclusion

    The WHTR is an easy, accurate, and less age-dependent index with high applicability in screening for obesity in children and adolescents.

    Keywords
    Waist circumference to height ratio; Children; Adolescents; Overweight; Obesity; Body mass index; Cutoff values

    Figures

    Fig. 1
    Percentile curves of waist circumference-to-height ratio for Korean children and adolescents 2~18 years of age (A) Boys, (B) Girls. Dashed line shows universal cutoff value of 0.5 for adults. Age: completed age, e.g., 6 years= 6~<7 years etc.

    Fig. 2
    The area under curves of waist circumference-to-height ratio for diagnosing overweight and obesity were significantly higher than that of waist circumference in both sexes aged 6 to 18 years (A) Obese boys, (B) Obese girls, (C) Overweight and obese boys, (D) Overweight and obese girls.

    Tables

    Table 1
    Sample Size before and after Excluding Outliers

    Table 2
    Correlation between Variables in Children and Adolescents

    Table 3
    Waist Circumference-to-Height Ratio in the Normal, Overweight, and Obesity Groups 6~18 Years of Age

    Table 4
    Waist Circumference in the Normal, Overweight, and Obesity Groups 6~18 Years of Age

    Table 5
    The Optimal Cutoff Values of Waist Circumference-to-Height Ratio in Screening for Body Mass Index-determined Overweight and Obesity in Children and Adolescents 6~18 Years of Age

    Table 6
    Comparison of Diagnostic Accuracy of Waist Circumference≥90th Percentiles and Optimal Cutoff Values of the Waist Circumference-to-Height Ratio in Screening for Body Mass Index-determined Obesity in Children and Adolescents 6~18 Years of Age

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    MeSH Terms
    Adolescent
    Area Under Curve
    Body Mass Index
    Child
    Humans
    Mass Screening
    Obesity
    Overweight
    Phenothiazines
    ROC Curve
    Waist Circumference
    Metrics
    Share
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