Simplifying the screening of abdominal adiposity in Chinese children with waist‐to‐height ratio

Objectives: The current age‐ and sex‐specific waist circumference (WC) reference for defining abdominal adiposity in Chinese children is quite complex. This study aimed to evaluate the optimal waist‐to‐height ratio (WHtR) thresholds based on the estimated WC references.


Methods: A cross‐sectional analysis of data from 121,025 Chinese children aged 7–18 years collected in 2010 was performed. Optimal WHtR thresholds were selected by Youden's index using receiver operating characteristic (ROC) curve analysis, with the estimated references of WC in Chinese children used as the gold standard.


Results: The optimal cut‐off values for identifying abdominally overweight and obese children were 0.44 and 0.46, respectively. Across the different sex and age groups, the proposed thresholds revealed high negative predictive values and areas under the ROC curve (≥0.857), and moderate to high sensitivity, specificity, and positive predictive values, ranging from 0.48 to 1.00.


Conclusions: The proposed WHtR thresholds reduce the number of cut‐off values from 48 to 2, and have a high discriminatory ability to identify abdominal adiposity in Chinese children.