title: Waist-to-Height Ratio: a simple, effective and practical screening tool for childhood obesity and metabolic syndrome.
abstract: OBJECTIVE
  This study aimed to evaluate the diagnostic value of Waist-to-Height Ratio in early detection of obesity and metabolic syndrome in Chinese children and adolescents.
  
  
  METHODS
  A cross-sectional study was conducted in six cities in China in 2010 with 16,914 children and adolescents aged 7-17 years. Participants were randomly divided into the training and testing sets. Diagnostic values were estimated using sensitivity, specificity and areas under receiver operating characteristic curves.
  
  
  RESULTS
  The coefficients of variation of Waist-to-Height Ratio among age groups were lower than that of body mass index and waist circumstance. The area under receiver operating characteristic curve of Waist-to-Height Ratio was 0.968 in boys and 0.949 in girls for general obesity evaluation, and 0.983 in boys and 0.984 in girls for central obesity. The optimal cut-offs of Waist-to-Height Ratio were 0.47 in boys and 0.45 in girls in the training set and validated in the testing set. For metabolic syndrome evaluation, the sensitivity and specificity were 0.858 and 0.825 in boys, 0.864 and 0.812 in girls under the suggested cut-offs.
  
  
  CONCLUSIONS
  Waist-to-Height Ratio was a simple, effective and practical tool for mass screening childhood obesity and metabolic syndrome in China. It will have potential values in public health practice.
authors: Department of Epidemiology & Biostatistics, Zhejiang University School of Public Health, Hangzhou 310058, China.
authors: Dan
authors: D
authors: Zhou
authors: Department of Nutrition and Food Safety, Zhejiang University School of Public Health, Hangzhou 310058, China.
authors: Min
authors: M
authors: Yang
authors: Department of Epidemiology & Biostatistics, Zhejiang University School of Public Health, Hangzhou 310058, China.
authors: Zhe-Ping
authors: ZP
authors: Yuan
authors: Department of Pathology, Zhejiang University School of Medicine, Hangzhou 310058, China.
authors: Dan-Dan
authors: DD
authors: Zhang
authors: Department of Pediatrics, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou 310003, China.
authors: Li
authors: L
authors: Liang
authors: Department of Pediatrics, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou 310003, China.
authors: Chun-Lin
authors: CL
authors: Wang
authors: Department of Pathology, Zhejiang University School of Medicine, Hangzhou 310058, China.
authors: Shuai
authors: S
authors: Zhang
authors: Department of Public Health, College of Health and Human Services, Western Kentucky University, Bowling Green, KY, USA.
authors: Hong-Hong
authors: HH
authors: Zhu
authors: Department of Pathology, Zhejiang University School of Medicine, Hangzhou 310058, China.
authors: Mao-De
authors: MD
authors: Lai
authors: Department of Epidemiology & Biostatistics, Zhejiang University School of Public Health, Hangzhou 310058, China. Electronic address: zhuym@zju.edu.cn.
authors: Yi-Min
authors: YM
authors: Zhu
mesh_terms: D000293:Adolescent; D002648:Child; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D024821:Metabolic Syndrome / Q000175:diagnosis*; D056128:Obesity, Abdominal / Q000175:diagnosis; D063766:Pediatric Obesity / Q000175:diagnosis*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D065927:Waist-Height Ratio
keywords: Children and adolescents; Diagnostic value; Mass screening tool; Metabolic syndrome; Obesity; Waist-to-Height Ratio (WHtR)