title: Waist circumference and waist-to-height ratio in Norwegian children 4-18 years of age: reference values and cut-off levels.
abstract: OBJECTIVE
  To establish reference values for waist circumference and waist-to-height ratio of Norwegian children.
  
  
  METHODS
  Data were collected in 2003-2006 as part of a cross-sectional study, including 5725 children 4-18 years of age. Reference curves were fitted with the LMS method; appropriate cut-offs were selected using receiver operating characteristic analysis.
  
  
  RESULTS
  Reference values for waist circumference and waist-to-height ratio are presented. Mean waist circumference increased with age for both genders. Boys had a higher waist circumference at almost all ages. Mean waist-to-height ratio decreased until early adolescence and thereafter increased slightly towards adult age. There was a strong positive correlation between waist circumference and BMI (r = 0.907, p < 0.01) and a moderate positive correlation between waist-to-height ratio and BMI (r = 0.397 p < 0.01). A waist circumference cut-off value of 1.0 SDS (85th percentile) gave a sensitivity of 79% and a specificity of 94% to detect overweight. A cut-off value of 1.6 SDS (95th percentile) gave a sensitivity of 94% and a specificity of 96% to detect obesity.
  
  
  CONCLUSIONS
  This study presents the first reference values of waist circumference and waist-to-height ratio for Norwegian children 4-18 years, which also represent the first reference in Scandinavian schoolchildren. The 85th and 95th percentiles of waist circumference are proposed as appropriate cut-offs for central overweight and obesity.
authors.affiliation: Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway. elbb@sus.no
authors.forename: B
authors.initials: B
authors.lastname: Brannsether
authors.forename: M
authors.initials: M
authors.lastname: Roelants
authors.forename: R
authors.initials: R
authors.lastname: Bjerknes
authors.forename: P B
authors.initials: PB
authors.lastname: Júlíusson
mesh_terms: D000293:Adolescent; D001827:Body Height; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D009765:Obesity / Q000175:diagnosis*; D012372:ROC Curve; D012016:Reference Values; D012737:Sex Factors; D055105:Waist Circumference