Waist Circumference to Height Ratio in Children and Adolescents

BACKGROUND: Waist circumference (WC) to height ratio (WC/HT) is used as a measure of central obesity. However, the optimum ratio that will separate populations with high from low cardiovascular risk remains controversial. This investigation evaluates an optimum WC/HT value to define central obesity in children. METHODS: The sensitivity and specificity of WC/HT in 649 children (age 2-18 years) without evidence of heart disease were analyzed for WC and for body mass index (BMI). RESULTS: A WC/HT ≥0.5 resulted in sensitivity:specificity of 99%:72% for detecting central obesity and 83%:77% for detecting overweight (BMI ≥85th percentile) subjects. A value of WC/HT ≥0.55 yielded sensitivity:specificity of 80%:96% for detecting central obesity and 75%:94% for detecting subjects with obesity (BMI ≥95th percentile). CONCLUSIONS: The use of WC/HT between ≥0.5 and <0.55 identified subjects at-risk for central obesity and WC/HT ≥0.55 identified central obesity with a high probability.