title: Development of waist circumference percentiles for Japanese children and an examination of their screening utility for childhood metabolic syndrome: a population-based cross-sectional study.
abstract: BACKGROUND
  In Japan, waist circumference (WC) percentiles to screen for childhood metabolic syndrome (MetS) are unavailable. The objectives of this study were to develop WC and WC-to-height ratio (WC/Ht) percentile curves by age and sex for Japanese children, and to test their utility in screening for MetS in children with obesity who are otherwise healthy.
  
  
  METHODS
  The WC and WC/Ht percentiles were developed using the LMS method of summarizing growth standards, which monitors changing skewness (L), medians (M), and coefficients of variation (S) in childhood distributions. A representative dataset was used, which consisted of 3,634 boys and 3,536 girls aged 4.5-12.75 years in Shizuoka prefecture, Japan, between 2010 and 2012. Children who were obese (355 boys and 230 girls) aged 6-12 years from Osaka prefecture, Japan, were screened for childhood MetS using the new percentiles and the International Diabetes Federation's (IDF's) definition of MetS.
  
  
  RESULTS
  The number of participants with certain metabolic abnormalities (high systolic and diastolic blood pressure, and a high level of triglycerides) was significantly higher in boys aged 10-12 years, with a WC ≥ 90th percentile, than among those with a WC < 90th percentile. None of the participants with a WC < 90th percentile exhibited two or more metabolic abnormalities, regardless of their age or sex. Among the participants aged 10-12 years, 11.4 % of boys and 4.4 % of girls with a WC ≥ 90th percentile were diagnosed with MetS.
  
  
  CONCLUSIONS
  The new percentiles may have a certain level of potential to screen Japanese children for childhood MetS in accordance with the IDF definition.
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. rriefuru@yahoo.co.jp.
authors.forename: Rie
authors.initials: R
authors.lastname: Matsushita
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, The University of Tokyo 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. isojimat@aol.com.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Isojima
authors.affiliation: Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan. ped013@poh.osaka-med.ac.jp.
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Takaya
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. satabow@gmail.com.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Satake
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. lrs0701@hama-med.ac.jp.
authors.forename: Rie
authors.initials: R
authors.lastname: Yamaguchi
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. kitta_k@hotmail.com.
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Kitsuda
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. amn_e@hama-med.ac.jp.
authors.forename: Eiko
authors.initials: E
authors.lastname: Nagata
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. sanosin2u@yahoo.co.jp.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Sano
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. toshiki@hama-med.ac.jp.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Nakanishi
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. ynyuichi@kbd.biglobe.ne.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Department of Nursing, Kyoritsu Women's University and Junior College, 3-27 Kanda Jimbocho, Chiyoda-ku, Tokyo, 101-0051, Japan. tohzeki@kyoritsu-wu.ac.jp.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Ohzeki
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. tomogata@hama-med.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Ogata
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. yasuko@hama-med.ac.jp.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Fujisawa
mesh_terms: D000367:Age Factors; D001794:Blood Pressure; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008403:Mass Screening / Q000379:methods*; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology*; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D065927:Waist-Height Ratio
chemical_list: D014280:Triglycerides