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. 2023 Jan 4:9:985319.
doi: 10.3389/fnut.2022.985319. eCollection 2022.

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

Maysa Eslami  1 , Farzad Pourghazi  1 , Maryam Khazdouz  2 , Jing Tian  3 , Kumars Pourrostami  4 , Zahra Esmaeili-Abdar  5 , Hanieh-Sadat Ejtahed  6 , Mostafa Qorbani  7   8
Affiliations

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

Maysa Eslami et al. Front Nutr. .

Abstract

Introduction: Waist circumference-to-height ratio (WHtR) is a simple anthropometric index with good screening power and fast interpretation for early detection of childhood abdominal obesity. This systematic review and meta-analysis aims to determine the best cut-off value of WHtR to use in clinical setting.

Methods: Comprehensive searches were conducted in PubMed, Scopus, and Web of Science by the end of March 2021. Observational studies investigated the best WHtR cut-off to detect abdominal obesity in children and adolescents were included. Thirteen articles (n = 180,119) were included in this systematic review and eight documents were included in the meta-analysis.

Results: The overall optimal cut-off was 0.49 with pooled sensitivity, specificity and diagnostic odds ratio (DOR) of 0.93 (95% confidence interval (CI): 0.93-0.96), 0.88 (95% CI: 0.85-0.91) and 102.6 (95% CI: 50.7-207.5), respectively. The optimal WHtR cut-off to predict abdominal obesity in girls and boys were both 0.49.

Discussion: The current study shows that we could use this cut-off as a simple index for predicting abdominal obesity in children and adolescents without the need for any charts in practice.

Keywords: abdominal obesity; adolescents; central obesity; children; waist to height ratio.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart for study identification and selection. Based on PRISMA 2020.
FIGURE 2
FIGURE 2
Diagnostic test accuracy meta-analysis for overall optimal cutoff score of WHtR for detecting central obesity in children and adolescence. (A) Regression lines of accuracy of WHtR for children and adolescence. (B) The optimal cutoff score 0.49 was marked as a cross in the estimated SROC curve.
FIGURE 3
FIGURE 3
Forest plots for the diagnostic accuracy of overall cutoff point.
FIGURE 4
FIGURE 4
Diagnostic test accuracy meta-analysis for optimal cutoff score of WHtR for detecting central obesity in children and adolescence. (A) Regression lines of accuracy of WHtR for boys. (B) The optimal cutoff score 0.48 was marked as a cross in the estimated SROC curve. (C) Regression lines of accuracy of WHtR for girls. (D) The optimal cutoff score 0.49 was marked as a cross in the estimated SROC curve.
See this image and copyright information in PMC

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