Abstract
Context
Waist-to-height ratio (WHtR) is a controversial evaluation index of cardiovascular risk factors (CVRFs) in children and adolescents.
Objective
To assess the accuracy of WHtR as a measure to screen for clusters of at least one CVRF (CVRF1), two CVRFs (CVRF2), and three CVRFs (CVRF3) in different ages, sexes, regions and cut-offs.
Methods
The PubMed, Web of Science, EBSCOhost, Springer, Taylor & Francis Online, Wiley Online Library, Wanfang, and CNKI databases were searched for eligible publications up to June 2021. The QUADAS-2 checklist was used to assess the methodology of the included studies.
Results
Twenty-two studies that evaluated 85281 children and adolescents aged 5–19 years were included in the meta-analysis. The AUSROC values were 0.56 (95% CI: 0.54–0.57), 0.82 (95% CI: 0.81–0.83), and 0.89 (95% CI: 0.89–0.90) for CVRF1, CVRF2, and CVRF3, respectively. Higher AUSROC values were found for adolescents (12–19 years), that is, 0.91 (95% CI: 0.88–0.93), 0.90 (95% CI: 0.87–0.92) for males, and 0.91 (95% CI: 0.90–0.91) for a cut-off of ≥ 0.51 in the identification of CVRF3.
Conclusion
WHtR can be used as an accurate screening tool for CVRF3 and CVRF2 in children and adolescents, and it is recommended to select different cut-offs according to different ages, sexes, and regions.
Acknowledgements
The authors thank the National Social Science Foundation of China for the financial support.
Disclosure statement
No potential conflict of interest was reported by the author(s).