Comparison of various anthropometric indices in predicting abdominal obesity in Chinese children: a cross-sectional study

BACKGROUND: Former evidence regarding reference values of abdominal fat percentage (AFP) and optimal anthropometric indicators in predicting abdominal obesity measured by dual-energy X-ray absorptiometry (DXA) scan in Chinese children were scarce. METHODS: A total of 452 Chinese children aged 6-9 years were included in this cross-sectional study. Abdominal fat and lean mass were measured by a DXA scan, and AFP were calculated. Anthropometric indicators including body mass index (BMI), chest circumference (CC), waist circumference (WC) and hip circumference (HC) were measured, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) was also calculated. RESULTS: By defining abdominal obesity as those with an AFP ≥ 85th percentile, the cutoffs values are 24.80, 30.29, 31.58, 31.86% in boys, and 25.02, 30.32, 31.66, 31.79% in girls, for children aged 6, 7, 8, and 9 years old, respectively. All anthropometric indicators were independently and positively associated with AFP (P all < 0.01). In girls, BMI was found to be the optimal predictors of childhood abdominal obesity. The values of area under curves (AUCs) were significantly higher (P all < 0.05) than other anthropometric indicators, except for WHtR (AUCs value: 0.886). However, in boys, WHtR instead of BMI, provided the largest AUCs value (0.922) in predicting abdominal obesity, followed by BMI ((AUCs value: 0.913). CONCLUSION: This study provides reference values of AFP measured by DXA in Chinese children aged 6-9 years. BMI and WHtR tend to be the optimal anthropometric indicators in predicting abdominal obesity in Chinese girls and boys, respectively.