Diagnostic test accuracy of waist-to-height ratio as a screening tool for cardiovascular risk in children and adolescents: a meta-analysis

References

• Ahmed J, Laghari A, Naseer M, Mehraj V. 2013. Prevalence of and factors associated with obesity among Pakistani schoolchildren: a school-based, cross-sectional study. East Mediterr Health J. 19(03):242–247.
   PubMed Web of Science ®Google Scholar
• Akobeng AK. 2007. Understanding diagnostic tests 1: sensitivity, specificity and predictive values. Acta Paediatri. 96(3):338–341.
   PubMed Web of Science ®Google Scholar
• Aristizabal JC, Estrada-Restrepo A, Barona J. 2019. Waist-to-height ratio may be an alternative tool to the body mass index for identifying Colombian adolescents with cardiometabolic risk factors. Nutr Hosp. 36(1):96–102.
   PubMed Web of Science ®Google Scholar
• Ashwell M, Lejeune S, McPherson K. 1996. Ratio of waist circumference to height may be better indicator of need for weight management. BMJ. 312(7027):377.
   PubMed Web of Science ®Google Scholar
• Bauer KW, Marcus MD, El Ghormli L, Ogden CL, Foster GD. 2015. Cardio-metabolic risk screening among adolescents: understanding the utility of body mass index, waist circumference and waist to height ratio. Pediatr Obes. 10(5):329–337.
   PubMed Web of Science ®Google Scholar
• Benmohammed K, Valensi P, Benlatreche M, Nguyen MT, Benmohammed F, Paries J, Khensal S, et al. 2015. Anthropometric markers for detection of the metabolic syndrome in adolescents. Diabetes Metab. 41(2):138–144.
   PubMed Web of Science ®Google Scholar
• Browning LM, Hsieh SD, Ashwell M. 2010. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr Res Rev. 23(2):247–269.
   PubMed Web of Science ®Google Scholar
• Chhatwal J, Verma M, Riar SK. 2004. Obesity among pre-adolescent and adolescents of a developing country (India). Asia Pac J Clin Nutr. 13(3):231–235.
   PubMed Web of Science ®Google Scholar
• Dai Y, Fu J, Liang L, Gong C, Xiong F, Liu G, Luo F, Chen S. 2014. [A proposal for the cutoff point of waist-to-height for the diagnosis of metabolic syndrome in children and adolescents in six areas of China]. Zhonghua Liu Xing Bing Xue Za Zhi. 35(8):882–885. Chinese.
   PubMedGoogle Scholar
• Deeks JJ, Macaskill P, Irwig L. 2005. The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol. 58(9):882–893.
   PubMed Web of Science ®Google Scholar
• Devillé WL, Buntinx F, Bouter LM, Montori VM, de Vet HC, van der Windt DA, Bezemer PD. 2002. Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Med Res Methodol. 2:9.
   PubMedGoogle Scholar
• Di Cesare M, Soric M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA, Laxmaiah A, et al. 2019. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med. 17(1):212.
   PubMed Web of Science ®Google Scholar
• Dou Y, Jiang Y, Yan Y, Chen H, Zhang Y, Chen X, Wang Y, et al. 2020. Waist-to-height ratio as a screening tool for cardiometabolic risk in children and adolescents: a nationwide cross-sectional study in China. BMJ Open. 10(6):e037040.
   PubMed Web of Science ®Google Scholar
• Drozdz D, Alvarez-Pitti J, Wojcik M, Borghi C, Gabbianelli R, Mazur A, Herceg-Cavrak V, et al. 2021. Obesity and Cardiometabolic Risk Factors: From Childhood to Adulthood. Nutrients. 13(11):4176.
   PubMed Web of Science ®Google Scholar
• Elizondo-Montemayor L, Serrano-Gonzalez M, Ugalde-Casas PA, Bustamante-Careaga H, Cuello-Garcia C. 2011. Waist-to-height: cutoff matters in predicting metabolic syndrome in Mexican children. Metab Syndr Relat Disord. 9(3):183–190.
   PubMed Web of Science ®Google Scholar
• Ezzatvar Y, Izquierdo M, Ramirez-Velez R, Del Pozo Cruz B, Garcia-Hermoso A. 2022. Accuracy of different cutoffs of the waist-to-height ratio as a screening tool for cardiometabolic risk in children and adolescents: A systematic review and meta-analysis of diagnostic test accuracy studies. Obes Rev. 23(2):e13375.
   PubMed Web of Science ®Google Scholar
• Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM. 2012. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. BMJ. 345:e4759.
   PubMed Web of Science ®Google Scholar
• Goulding A, Taylor RW, Grant AM, Parnell WR, Wilson NC, Williams SM. 2010. Waist-to-height ratios in relation to BMI z-scores in three ethnic groups from a representative sample of New Zealand children aged 5-14 years. Int J Obes. 34(7):1188–1190.
   Web of Science ®Google Scholar
• Grassi G, Arenare F, Dell’oro R, Quarti-Trevano F, Brambilla G, Carugo S, Smith M, Mancia G. 2009. Prevalence of cardiovascular risk factors in an unselected italian population. Results of the Cardiolab Project 2004-2008. Acta Cardiol. 64(6):771–778.
   PubMed Web of Science ®Google Scholar
• Graves L, Garnett SP, Cowell CT, Baur LA, Ness A, Sattar N, Lawlor DA. 2014. Waist-to-height ratio and cardiometabolic risk factors in adolescence: findings from a prospective birth cohort. Pediatr Obes. 9(5):327–338.
   PubMed Web of Science ®Google Scholar
• Guo X, Zheng L, Li Y, Zhang X, Yu S, Yang H, Zhang X, et al. 2013. Prevalence and risk factors of being overweight or obese among children and adolescents in northeast China. Pediatr Res. 74(4):443–449.
   PubMed Web of Science ®Google Scholar
• Gupta DK, Shah P, Misra A, Bharadwaj S, Gulati S, Gupta N, Sharma R, et al. 2011. Secular trends in prevalence of overweight and obesity from 2006 to 2009 in urban asian Indian adolescents aged 14-17 years. PLoS One. 6(2):e17221.
   PubMed Web of Science ®Google Scholar
• Heymsfield SB, Scherzer R, Pietrobelli A, Lewis CE, Grunfeld C. 2009. Body mass index as a phenotypic expression of adiposity: quantitative contribution of muscularity in a population-based sample. Int J Obes. 33(12):1363–1373.
   Web of Science ®Google Scholar
• Higgins JP, Thompson SG. 2002. Quantifying heterogeneity in a meta-analysis. Stat Med. 21(11):1539–1558.
   PubMed Web of Science ®Google Scholar
• Higgins JP, Thompson SG, Deeks JJ, Altman DG. 2003. Measuring inconsistency in meta-analyses. BMJ. 327(7414):557–560.
   PubMed Web of Science ®Google Scholar
• Hou YP, Yang L, Xi B. 2018. [Comparison of the performance of waist circumference, waist-height ratio,and body mass index in predicting metabolic disorders among children and adolescents]. Chinese Journal of Child Health Care. 26(3):239–242,257. Chinese.
   Google Scholar
• Hsieh SD, Yoshinaga H. 1995. Abdominal fat distribution and coronary heart disease risk factors in men-waist/height ratio as a simple and useful predictor. Int J Obes Relat Metab Disord. 19(8):585–589.
   PubMed Web of Science ®Google Scholar
• Hsieh SD, Yoshinaga H. 1999. Do people with similar waist circumference share similar health risks irrespective of height? Tohoku J Exp Med. 188(1):55–60.
   PubMed Web of Science ®Google Scholar
• Hubert HB, Feinleib M, McNamara PM, Castelli WP. 1983. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 67(5):968–977.
   PubMed Web of Science ®Google Scholar
• Jiang Y, Dou Y, Chen H, Zhang Y, Chen X, Wang Y, Rodrigues M, Yan W. 2021. Performance of waist-to-height ratio as a screening tool for identifying cardiometabolic risk in children: a meta-analysis. Diabetol Metab Syndr. 13(1):66.
   PubMed Web of Science ®Google Scholar
• Jiang Y, Dou YL, Xiong F, Zhang L, Zhu GH, Wu T, Zhang Y, Yan WL. 2018. Waist-to-height ratio remains an accurate and practical way of identifying cardiometabolic risks in children and adolescents. Acta Paediatr. 107(9):1629–1634.
   Web of Science ®Google Scholar
• Khoury M, Manlhiot C, McCrindle BW. 2013. Role of the waist/height ratio in the cardiometabolic risk assessment of children classified by body mass index. J Am Coll Cardiol. 62(8):742–751.
   PubMed Web of Science ®Google Scholar
• Kruger HS, Faber M, Schutte AE, Ellis SM. 2013. A proposed cutoff point of waist-to-height ratio for metabolic risk in African township adolescents. Nutrition. 29(3):502–507.
   PubMed Web of Science ®Google Scholar
• Lee CM, Huxley RR, Wildman RP, Woodward M. 2008. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol. 61(7):646–653.
   PubMed Web of Science ®Google Scholar
• Lee EY, Yoon KH. 2018. Epidemic obesity in children and adolescents: risk factors and prevention. Front Med. 12(6):658–666.
   PubMed Web of Science ®Google Scholar
• Leeflang MM, Deeks JJ, Gatsonis C, Bossuyt PM, Cochrane Diagnostic Test Accuracy Working G, Cochrane Diagnostic Test Accuracy Working Group 2008. Systematic reviews of diagnostic test accuracy. Ann Intern Med. 149(12):889–897.
   PubMed Web of Science ®Google Scholar
• Li Y, Zou Z, Luo J, Ma J, Ma Y, Jing J, Zhang X, et al. 2020. The predictive value of anthropometric indices for cardiometabolic risk factors in Chinese children and adolescents: A national multicenter school-based study. PLoS One. 15(1):e0227954.
   PubMed Web of Science ®Google Scholar
• Liu B, Jiang R, Li P, Liu C, Li L. 2017. [Cutoff Waist-to-height and Waist-to-hip Ratios for Metabolic Syndrome in Chinese Children and Adolescents]. Journal of China Medical University. 46(5):434–438, 443. Chinese.
   Google Scholar
• Liu Z, Yao Z, Li C, Liu X, Chen H, Gao C. 2013. A step-by-step guide to the systematic review and meta-analysis of diagnostic and prognostic test accuracy evaluations. Br J Cancer. 108(11):2299–2303.
   PubMed Web of Science ®Google Scholar
• Lo K, Wong M, Khalechelvam P, Tam W. 2016. Waist-to-height ratio, body mass index and waist circumference for screening paediatric cardio-metabolic risk factors: a meta-analysis. Obes Rev. 17(12):1258–1275.
   PubMed Web of Science ®Google Scholar
• Mai TMT, Gallegos D, Jones L, Tran QC, Tran TMH, van der Pols JC. 2020. The utility of anthopometric indicators to identify cardiovascular risk factors in Vietnamese children. Br J Nutr. 123(9):1043–1055.
   PubMed Web of Science ®Google Scholar
• McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, and, Clifford T, Cohen JF, the P-DTAG, et al. 2018. Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: The PRISMA-DTA Statement. JAMA. 319(4):388–396.
   PubMed Web of Science ®Google Scholar
• Mokha JS, Srinivasan SR, DasMahapatra P, Fernandez C, Chen W, Xu J, Berenson GS. 2010. Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: The Bogalusa Heart Study. BMC Pediatr. 10(1):73.
   PubMed Web of Science ®Google Scholar
• Musa-Veloso K, Fallah S, O’Shea M, Chu Y. 2016. Assessment of intakes and patterns of cooked oatmeal consumption in the U.S. using data from the national health and nutrition examination surveys. Nutrients. 8(8):503.
   PubMed Web of Science ®Google Scholar
• Nawarycz T, So HK, Choi KC, Sung RY, Li AM, Nelson EA, Gazicki-Lipman M, Ostrowska-Nawarycz L. 2016. Waist-to-height ratio as a measure of abdominal obesity in southern Chinese and European children and adolescents. Int J Obes. 40(7):1109–1118.
   Web of Science ®Google Scholar
• Ochoa Sangrador C, Ochoa-Brezmes J. 2018. Waist-to-height ratio as a risk marker for metabolic syndrome in childhood. A meta-analysis. Pediatr Obes. 13(7):421–432.
   PubMed Web of Science ®Google Scholar
• Perona JS, Schmidt-RioValle J, Rueda-Medina B, Correa-Rodriguez M, Gonzalez-Jimenez E. 2017. Waist circumference shows the highest predictive value for metabolic syndrome, and waist-to-hip ratio for its components, in Spanish adolescents. Nutr Res. 45:38–45.
   PubMed Web of Science ®Google Scholar
• Piryani S, Baral KP, Pradhan B, Poudyal AK, Piryani RM. 2016. Overweight and its associated risk factors among urban school adolescents in Nepal: a cross-sectional study. BMJ Open. 6(5):e010335.
   PubMed Web of Science ®Google Scholar
• Prentice AM, Jebb SA. 2001. Beyond body mass index. Obes Rev. 2(3):141–147.
   PubMedGoogle Scholar
• Reitsma JB, Glas AS, Rutjes AW, Scholten RJ, Bossuyt PM, Zwinderman AH. 2005. Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews. J Clin Epidemiol. 58(10):982–990.
   PubMed Web of Science ®Google Scholar
• Rodea-Montero ER, Evia-Viscarra ML, Apolinar JE. 2014. Waist-to-height ratio is a better anthropometric index than waist circumference and BMI in predicting metabolic syndrome among obese mexican adolescents. Int J Endocrinol. 2014:1–9.
   Web of Science ®Google Scholar
• Sardinha LB, Santos DA, Silva AM, Grontved A, Andersen LB, Ekelund U. 2016. A comparison between BMI, waist circumference, and waist-to-height ratio for identifying cardio-metabolic risk in children and adolescents. PLoS One. 11(2):e0149351.
   PubMed Web of Science ®Google Scholar
• Saydah S, Bullard KM, Imperatore G, Geiss L, Gregg EW. 2013. Cardiometabolic risk factors among US adolescents and young adults and risk of early mortality. Pediatrics. 131(3):e679-686–e686.
   Web of Science ®Google Scholar
• Seo JY, Kim JH. 2017. Validation of surrogate markers for metabolic syndrome and cardiometabolic risk factor clustering in children and adolescents: A nationwide population-based study. PLoS One. 12(10):e0186050.
   PubMed Web of Science ®Google Scholar
• Šimundić A-M. 2009. Measures of diagnostic accuracy: basic definitions. EJIFCC. 19(4):203–211.
   PubMedGoogle Scholar
• Smith SC. Jr. 2007. Multiple risk factors for cardiovascular disease and diabetes mellitus. Am J Med. 120(3 Suppl 1):S3–S11.
   PubMed Web of Science ®Google Scholar
• Swets JA. 1988. Measuring the accuracy of diagnostic systems. Science. 240(4857):1285–1293.
   PubMed Web of Science ®Google Scholar
• Taylor AE, Ebrahim S, Ben-Shlomo Y, Martin RM, Whincup PH, Yarnell JW, Wannamethee SG, Lawlor DA. 2010. Comparison of the associations of body mass index and measures of central adiposity and fat mass with coronary heart disease, diabetes, and all-cause mortality: a study using data from 4 UK cohorts. Am J Clin Nutr. 91(3):547–556.
   PubMed Web of Science ®Google Scholar
• Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E, Ben-Ami Shor D, et al. 2016. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med. 374(25):2430–2440.
   PubMed Web of Science ®Google Scholar
• Tzotzas T, Kapantais E, Tziomalos K, Ioannidis I, Mortoglou A, Bakatselos S, Kaklamanou M, et al. 2011. Prevalence of overweight and abdominal obesity in Greek children 6-12 years old: Results from the National Epidemiological Survey. Hippokratia. 15(1):48–53.
   PubMed Web of Science ®Google Scholar
• Vasquez F, Correa-Burrows P, Blanco E, Gahagan S, Burrows R. 2019. A waist-to-height ratio of 0.54 is a good predictor of metabolic syndrome in 16-year-old male and female adolescents. Pediatr Res. 85(3):269–274.
   PubMed Web of Science ®Google Scholar
• Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MM, QUADAS-2 Group, et al. 2011. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 155(8):529–536.
   PubMed Web of Science ®Google Scholar
• World Health Organization. 2016. Consideration of the evidence on childhood obesity for the Commission on Ending Childhood Obesity: report of the ad hoc working group on science and evidence for ending childhood obesity, Geneva, Switzerland. Geneva: World Health Organization.
   Google Scholar
• Xi B, Hu Y. 2020. [Establishing longitudinal cohort studies based on domestic and foreign experiences and promoting the prevention and control of cardiovascular diseases in childhood]. Chin J Prev Med. 54(12):1305–1309. Chinese.
   Google Scholar
• Yang Y, Miao Q, Zhu X, Qin L, Gong W, Zhang S, Zhang Q, et al. 2020. Sleeping time, BMI, and body fat in chinese freshmen and their interrelation. Obes Facts. 13(2):179–190.
   PubMed Web of Science ®Google Scholar
• Zhang T, Li S, Bazzano L, He J, Whelton P, Chen W. 2018. Trajectories of childhood blood pressure and adult left ventricular hypertrophy: the Bogalusa Heart Study. Hypertension. 72(1):93–101.
   PubMed Web of Science ®Google Scholar
• Zhang T, Xu J, Li S, Bazzano LA, He J, Whelton PK, Chen W. 2019. Trajectories of childhood BMI and adult diabetes: the Bogalusa Heart Study. Diabetologia. 62(1):70–77.
   PubMed Web of Science ®Google Scholar
• Zhang Y, Hu J, Li Z, Li T, Chen M, Wu L, Liu W, et al. 2019. A novel indicator of lipid accumulation product associated with metabolic syndrome in Chinese children and adolescents. Diabetes Metab Syndr Obes. 12:2075–2083.
   PubMed Web of Science ®Google Scholar
• Zhao M, Bovet P, Ma C, Xi B. 2017. Performance of different adiposity measures for predicting cardiovascular risk in adolescents. Sci Rep. 7:43686.
   PubMed Web of Science ®Google Scholar
• Zheng W, Zhao A, Xue Y, Zheng Y, Chen Y, Mu Z, Wang P, Zhang Y. 2016. Gender and urban-rural difference in anthropometric indices predicting dyslipidemia in Chinese primary school children: a cross-sectional study. Lipids Health Dis. 15:87.
   PubMed Web of Science ®Google Scholar
• Zhou D, Yang M, Yuan ZP, Zhang DD, Liang L, Wang CL, Zhang S, et al. 2014. Waist-to-Height Ratio: a simple, effective and practical screening tool for childhood obesity and metabolic syndrome. Prev Med. 67:35–40.
   PubMed Web of Science ®Google Scholar