ArticleBMJ open2020
Waist-to-height ratio as a screening tool for cardiometabolic risk in children and adolescents: a nationwide cross-sectional study in China.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Optimal cut-off value of waist circumference-to-height ratio to predict central obesity in children and adolescents: A systematic review and meta-analysis of diagnostic studies.Frontiers in nutrition · 2022Pooled it
- Prevalence of non-alcoholic fatty liver disease and its association with different combinations of weight status and metabolic abnormalities in children aged 6-18 years.Pediatric investigation · 2026Article
- Body image among bullied obese children: an Egyptian case-control study.BMC public health · 2026Article
- Integrative multi-omics analysis reveals molecular signatures of central obesity in children.Pediatric research · 2025Article
- Auricular Acupressure Versus an Intermittent Low-Carbohydrate Diet in Children With Overweight or Obesity With Gastric-Heat and Dampness-Obstruction Syndrome: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2025Article
- Predictive performance of the waist-to-height ratio and the conicity index for diagnosing excess body fat in children.Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo · 2025Article
- Article
- Factors influencing normal blood pressure maintenance in young adults.Journal of clinical hypertension (Greenwich, Conn.) · 2023Article
- Comparison of adiposity anthropometric indices and their associations with visceral fat levels determined by bioelectrical impedance analysis among diabetic patients.Scientific reports · 2022Article
- Article
- Weight-to-height ratio and body roundness index are superior indicators to assess cardio-metabolic risks in Chinese children and adolescents: compared with body mass index and a body shape index.Translational pediatrics · 2022Article
- The independent and combined effects of single-child status and ideal lifestyle on clustered cardio-metabolic risk factors among Chinese children and adolescents.Frontiers in nutrition · 2022Article
- The Impact of PM2.5 on the Growth Curves of Children's Obesity Indexes: A Prospective Cohort Study.Frontiers in public health · 2022Article
- The relationship of remnant cholesterol and abdominal obesity in children: A cross-sectional study.Frontiers in cardiovascular medicine · 2022Article
- Performance of waist-to-height ratio as a screening tool for identifying cardiometabolic risk in children: a meta-analysis.Diabetology & metabolic syndrome · 2021Article
- Utility of Three Adiposity Indices for Identifying Left Ventricular Hypertrophy and Geometric Remodeling in Chinese Children.Frontiers in endocrinology · 2021Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo demonstrate the accuracy and flexibility of using waist-to-height ratio (WHtR) as a screening tool for identifying children and adolescents with cardiometabolic risk (CMR) across a wide range of prevalence levels among general paediatric populations.
designA nationwide population-based cross-sectional study with all data collected at school settings in six cities of China.
participantsA total of 8130 children and adolescents aged 7-18 years with complete anthropometric and CMR measurements based on blood tests were recruited. OUTCOME MEASURES: Elevated blood pressure, dyslipidaemia, elevated fasting blood glucose and central obesity were measured. The primary outcome, CMRs, was defined as meeting three or more of the above risk factors. The accuracy of WHtR for identifying CMRs was evaluated using areas under the curves (AUCs) with 95% CI of the receiver operating characteristic curve. The predictability of WHtR at given CMRs prevalence levels was estimated by positive predictive value (PPV) and negative predictive value.
resultsOverall, 6.1% of study participants were presented with CMRs. WHtR had high AUCs ranging from 0.84 (95% CI 0.81 to 0.88) to 0.88 (95% CI 0.86 to 0.90) in the total population and age-subgroup and gender-subgroup. The overall optimal WHtR cut-off value was 0.467, with boys having a higher cut-off than girls (0.481 vs 0.456). WHtR achieved an overall sensitivity of 0.89 and PPV of 18.8% at a specificity of 0.75. The screening performance of WHtR remained satisfactory across a wide range of given CMRs prevalence levels (5%, 10% and 20%).
conclusionWHtR as a screening tool could accurately and flexibly identify children affected with the clusters of three or more of CMR factors from the general paediatric population with various CMR prevalence levels. Our findings provide support for policy-making on early CMR identification and management in the high-risk group of children.
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