title: Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents.
abstract: OBJECTIVE
  To explore the optimal threshold values of waist circumference (WC) for detecting cardiovascular (CV) risk factors among Chinese children and adolescents.
  
  
  METHODS
  Association of WC with CV risk factors was studied among 65,898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension (blood pressure above 95 percentile levels), dyslipidemia (with one or more of the following three indexes: TG > or = 1.7 mmol/L, TC > or = 5.18 mmol/L, and HDL-C < or = 1.04 mmol/L) and elevated glucose level (fasting plasma glucose > or = 5.6 mmol/L). Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors.
  
  
  RESULTS
  A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category.
  
  
  CONCLUSIONS
  The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.
authors.affiliation: National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, 100050 China. mags@chinacdc.net.cn
authors.forename: Guan-Sheng
authors.initials: GS
authors.lastname: Ma
authors.forename: Cheng-Ye
authors.initials: CY
authors.lastname: Ji
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.forename: Jie
authors.initials: J
authors.lastname: Mi
authors.forename: Rita
authors.initials: R
authors.lastname: Yt Sung
authors.forename: Feng
authors.initials: F
authors.lastname: Xiong
authors.forename: Wei-Li
authors.initials: WL
authors.lastname: Yan
authors.forename: Xiao-Qi
authors.initials: XQ
authors.lastname: Hu
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Li
authors.forename: Song-Ming
authors.initials: SM
authors.lastname: Du
authors.forename: Hong-Yun
authors.initials: HY
authors.lastname: Fang
authors.forename: Jing-Xiong
authors.initials: JX
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D050177:Overweight / Q000150:complications / Q000453:epidemiology*; D012016:Reference Values; D012307:Risk Factors; D055105:Waist Circumference / Q000502:physiology*