title: Waist circumference percentiles in 2-18 year old Indian children.
abstract: OBJECTIVE
  To develop reference percentile curves in Indian children for waist circumference (WC), and to provide a cutoff of WC percentile to identify children at risk for metabolic syndrome (MS).
  
  
  METHODS
  A multicenter, cross-sectional study was performed in 5 major Indian cities. Height, weight, and blood pressure (BP) were measured in 10,842 children (6065 boys). Elevated BP was defined as either systolic BP or diastolic BP >95th percentile. WC was measured with the child standing using a stretch-resistant tape. Sex-specific reference percentiles were computed using the LMS method which constructs reference percentiles adjusted for skewness. To determine optimal cutoffs for WC percentiles, a validation sample of 208 children was assessed for MS risk factors (ie, anthropometry, BP, blood lipids), and receiver operating characteristic (ROC) curve analysis was performed.
  
  
  RESULTS
  Age- and sex-specific WC percentiles (5th, 10th, 15th, 25th, 50th, 75th, 85th, 90th, and 95th) are presented. WC values increased with age in both the boys and the girls. The median WC at age >15 years was greater in boys compared with girls. ROC analysis suggested the 70th percentile as a cutoff for MS risk (sensitivity, 0.84 in boys and 0.82 in girls; specificity, 0.85 in both boys and girls; area under the ROC curve, 0.88 in boys and 0.92 in girls).
  
  
  CONCLUSIONS
  Age- and sex-specific reference curves for WC for Indian children and cutoff values of 70th WC percentile for screening for MS risk are provided.
authors.affiliation: Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India. Electronic address: anuradhavkhadilkar@gmail.com.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Khadilkar
authors.affiliation: Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
authors.forename: Veena
authors.initials: V
authors.lastname: Ekbote
authors.affiliation: Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
authors.forename: Shashi
authors.initials: S
authors.lastname: Chiplonkar
authors.affiliation: Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
authors.forename: Vaman
authors.initials: V
authors.lastname: Khadilkar
authors.affiliation: Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
authors.forename: Neha
authors.initials: N
authors.lastname: Kajale
authors.affiliation: Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
authors.forename: Surabhi
authors.initials: S
authors.lastname: Kulkarni
authors.affiliation: Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
authors.forename: Lavanya
authors.initials: L
authors.lastname: Parthasarathy
authors.affiliation: Institute of Child Health, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Archana
authors.initials: A
authors.lastname: Arya
authors.affiliation: Child Development Centre, Apollo Gleneagles Hospital, Kolkata, India.
authors.forename: Anjan
authors.initials: A
authors.lastname: Bhattacharya
authors.affiliation: Ekta Institute of Child Health, Raipur, India.
authors.forename: Sanwar
authors.initials: S
authors.lastname: Agarwal
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001795:Blood Pressure Determination; D001827:Body Height; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000517:prevention & control; D009765:Obesity / Q000175:diagnosis* / Q000517:prevention & control; D011237:Predictive Value of Tests; D012372:ROC Curve; D012015:Reference Standards; D015203:Reproducibility of Results; D018570:Risk Assessment; D012737:Sex Factors; D055105:Waist Circumference