Establishing international optimal cut-offs of waist-to-height ratio for predicting cardiometabolic risk in children and adolescents aged 6–18 years

Zong, Xin’nan; Kelishadi, Roya; Hong, Young Mi; Schwandt, Peter; Matsha, Tandi E.; Mill, Jose G.; Whincup, Peter H.; Pacifico, Lucia; López-Bermejo, Abel; Caserta, Carmelo Antonio; Medeiros, Carla Campos Muniz; Kollias, Anastasios; Qorbani, Mostafa; Jazi, Fariborz Sharifian; Haas, Gerda-Maria; de Oliveira Alvim, Rafael; Zaniqueli, Divanei; Chiesa, Claudio; Bassols, Judit; Romeo, Elisabetta Lucia; de Carvalho, Danielle Franklin; da Silva Simões, Mônica Oliveira; Stergiou, George S.; Grammatikos, Evangelos; Zhao, Min; Magnussen, Costan G.; Xi, Bo

doi:10.1186/s12916-023-03169-y

Table 2 Results of ROC curve analyses to identify relatively optimal percentile cut-offs of WHtR based on age-, sex-, and country-specific percentiles to discriminate those with ≥ 2 cardiometabolic risk factors, stratified by country

From: Establishing international optimal cut-offs of waist-to-height ratio for predicting cardiometabolic risk in children and adolescents aged 6–18 years

Country	Age (years)	Sex	No. of participants	IDF criteria				NCEP criteria
Country	Age (years)	Sex	No. of participants	Cut-offs	AUC (95% CI)	Sensitivity	Specificity	Cut-offs	AUC (95% CI)	Sensitivity	Specificity
Brazil	15–17	Boys	141	P₇₅	0.830 (0.715–0.946)	0.917	0.744	P₈₀	0.631 (0.516–0.745)	0.465	0.796
Brazil	15–17	Girls	300	P₈₀	0.654 (0.520–0.788)	0.600	0.707	P₈₅	0.643 (0.530–0.756)	0.516	0.770
China	6–11	Boys	750	P₈₅	0.725 (0.622–0.827)	0.909	0.540	P₉₀	0.663 (0.588–0.739)	0.724	0.603
China	6–11	Girls	666	P₉₀	0.778 (0.609–0.888)	0.857	0.699	P₉₀	0.655 (0.574–0.737)	0.596	0.714
Greece	8–17	Boys	207	P₉₀	0.609 (0.484–0.734)	0.643	0.575	P₉₅	0.633 (0.523–0.744)	0.650	0.617
Greece	8–17	Girls	232	P₉₀	0.723 (0.562–0.885)	0.727	0.719	P₉₀	0.712 (0.591–0.833)	0.680	0.744
Iran	6–18	Boys	4047	P₇₅	0.582 (0.550–0.615)	0.449	0.716	P₇₅	0.561 (0.537–0.585)	0.395	0.727
Iran	6–18	Girls	4124	P₇₅	0.592 (0.562–0.621)	0.455	0.729	P₇₅	0.588 (0.564–0.613)	0.434	0.743
Italy	10–13	Boys	284	P₉₀	0.635 (0.474–0.796)	0.727	0.542	P₉₀	0.716 (0.621–0.811)	0.857	0.574
Italy	10–13	Girls	286	P₈₅	0.792 (0.763–0.821)	1	0.584	P₈₅	0.605 (0.457–0.753)	0.625	0.585
Korea	6–18	Boys	4111	P₈₀	0.693 (0.662–0.723)	0.753	0.632	P₈₅	0.680 (0.654–0.706)	0.666	0.694
Korea	6–18	Girls	3658	P₈₀	0.656 (0.619–0.693)	0.585	0.728	P₈₀	0.538 (0.605–0.670)	0.542	0.733`
South Africa	10–16	Boys	496	P₈₀	0.682 (0.601–0.763)	0.597	0.767	P₈₀	0.621 (0.552–0.690)	0.471	0.772
South Africa	10–16	Girls	775	P₉₀	0.632 (0.541–0.723)	0.558	0.706	P₉₀	0.606 (0.542–0.670)	0.491	0.721
Spain	6–13	Boys	337	P₉₅	0.695 (0.590–0.801)	0.917	0.474	P₉₅	0.730 (0.666–0.793)	0.963	0.497
Spain	6–13	Girls	294	P₉₅	0.749 (0.720–0.778)	1	0.498	P₉₅	0.680 (0.585–0.775)	0.839	0.521
UK	10–11	Boys	363	P₉₅	0.887 (0.865–0.908)	1	0.773	P₉₅	0.597 (0.436–0.758)	0.417	0.778
UK	10–11	Girls	420	P₉₀	0.853 (0.831–0.875)	1	0.707	P₉₅	0.710 (0.578–0.842)	0.611	0.808
USA	12–17	Boys	1591	P₈₅	0.710 (0.664–0.756)	0.811	0.610	P₉₅	0.722 (0.679–0.764)	0.711	0.733
USA	12–17	Girls	1523	P₈₀	0.671 (0.611–0.731)	0.797	0.545	P₉₅	0.704 (0.649–0.760)	0.714	0.695

Abbreviations AUC Area under the curve, CI Confidence interval, IDF International Diabetes Federation, NCEP National Cholesterol Education Program, P Percentile, ROC Receiver operator characteristic, UK United Kingdom, USA United States of America, WHtR Waist-to-height ratio

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