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 3 Results of ROC curve analyses that test the proposed relatively optimal WHtR cut-offs of 0.50 and 0.46 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)	No. of subjects	Cut-offs	IDF criteria			NCEP criteria
Country	Age (years)	No. of subjects	Cut-offs	AUC (95% CI)	Sensitivity	Specificity	AUC (95% CI)	Sensitivity	Specificity
Brazil	15–17	441	0.46	0.680 (0.574–0.785)	0.562	0.797	0.565 (0.491–0.640)	0.338	0.793
Brazil	15–17	441	0.50	0.626 (0.534–0.718)	0.312	0.939	0.574 (0.517–0.632)	0.203	0.946
China	6–11	1416	0.46	0.731 (0.655–0.808)	0.880	0.582	0.652 (0.597–0.707)	0.704	0.599
China	6–11	1416	0.50	0.702 (0.597–0.807)	0.640	0.764	0.661 (0.604–0.718)	0.539	0.783
Greece	8–17	439	0.46	0.624 (0.559–0.689)	0.923	0.325	0.624 (0.564–0.683)	0.908	0.340
Greece	8–17	439	0.50	0.626 (0.531–0.722)	0.718	0.535	0.647 (0.569–0.726)	0.738	0.566
Iran	6–18	8171	0.46	0.587 (0.565–0.609)	0.425	0.749	0.578 (0.561–0.595)	0.393	0.763
Iran	6–18	8171	0.50	0.578 (0.560–0.597)	0.261	0.895	0.565 (0.552–0.579)	0.225	0.906
Italy	10–13	570	0.46	0.605 (0.527–0.683)	0.938	0.273	0.595 (0.534–0.657)	0.909	0.281
Italy	10–13	570	0.50	0.663 (0.547–0.780)	0.812	0.514	0.651 (0.567–0.734)	0.773	0.529
Korea	6–18	7769	0.46	0.668 (0.644–0.693)	0.572	0.765	0.653 (0.633–0.673)	0.527	0.778
Korea	6–18	7769	0.50	0.607 (0.585–0.629)	0.317	0.897	0.612 (0.594–0.629)	0.314	0.910
South Africa	10–16	1271	0.46	0.635 (0.575–0.695)	0.514	0.756	0.608 (0.562–0.655)	0.448	0.769
South Africa	10–16	1271	0.50	0.588 (0.534–0.642)	0.305	0.871	0.583 (0.542–0.623)	0.281	0.884
Spain	6–13	631	0.46	0.684 (0.618–0.749)	0.952	0.487	0.665 (0.605–0.724)	0.897	0.433
Spain	6–13	631	0.50	0.730 (0.648–0.813)	0.905	0.556	0.731 (0.669–0.793)	0.879	0.583
UK	10–11	783	0.46	0.801 (0.784–0.818)	1	0.602	0.655 (0.555–0.754)	0.710	0.610
UK	10–11	783	0.50	0.894 (0.880–0.908)	1	0.788	0.664 (0.561–0.768)	0.553	0.795
USA	12–17	3114	0.46	0.658 (0.623–0.694)	0.826	0.491	0.665 (0.635–0.695)	0.826	0.504
USA	12–17	3114	0.50	0.670 (0.629–0.711)	0.662	0.678	0.691 (0.657–0.725)	0.687	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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