Evaluation of anthropometric measurements of central obesity as screening tools in children: multi receiver operating characteristic analysis

Background: Obesity in children is often expressed by indicators like Body Mass Index, Waist Circumference, Waist-to-Hip ratio etc. Each of these has its own merits and demerits. Among these, BMI is commonly used to assess overweight/obesity but the central obesity is more important than the body mass as it has shown strong association with risk for coronary heart disease, adverse lipid profile and hyper insulinaemia in children. The objectives were to assess the validity of waist-hip ratio, waist-to-height ratio, conicity index as indicators of central obesity in children as measured by waist circumference.Methods: This is a cross sectional study conducted on 4663 students who were enrolled in 8th to 10th standard of government and private schools of Mandya city. Weight, height, waist and hip circumference are measured following WHO guidelines. The data was analyzed using mean, standard deviation, proportion, cut off, sensitivity, and specificity. ROC curves were drawn to assess the validity of the anthropometric measurements.Results: Using the WC percentiles given by Kuriyan R, the prevalence of overweight/obesity was found to be 7.59% with 8.85% in girls and 6.03% in boys. Waist-to-Height ratio performed significantly better than waist-to-hip ratio and conicity index in identifying central obesity in both girls and boys as indicated by the AUCs.Conclusions: The age and sex specific cut off points for waist-to-hip ratio, waist-to-height ratio and conicity index can be used to detect overweight/obesity in Indian Children aged 11-16 years.