Waist-to-height ratio cutoffs ≥0.51 showed high diagnostic accuracy for cardiometabolic risk in children (AUSROC 0.87; 95% CI 0.84-0.90), though optimal cutoffs varied significantly by region.
Meta-Analysis (n=138,561)
Yes
What is the accuracy of different waist-to-height ratio cutoffs as a screening tool for cardiometabolic risk in children and adolescents?
A single waist-to-height ratio cutoff of 0.50 may be inappropriate for screening cardiometabolic risk in children and adolescents, as optimal cutoffs vary significantly by geographic region.
Effect estimate: AUSROC 0.87 (95% CI 0.84-0.90)
p-value: p=<0.001
The present systematic review with meta-analysis sought to estimate the accuracy of different waist-to-height ratio (WHtR) cutoff ranges as risk indicators for cardiometabolic health in different populations of children and adolescents. Systematic searches were undertaken to identify studies in apparently healthy participants aged 3-18 years that conducted receiver operating characteristic curve analysis and reported area under the receiver operating characteristic curves for WHtR with any cardiometabolic biomarker. Forty-one cross-sectional studies were included in the meta-analysis, including 138,561 young individuals (50% girls). Higher area under summary receiver operating characteristic (AUSROC) values were observed in cutoffs between 0.46 and 0.50 (AUSROC = 0.83, 95%CI: 0.80-0.86) and ≥0.51 (AUSROC = 0.87, 95%CI: 0.84-0.90) (p < 0.001 in comparison with cutoffs 0.41 to 0.45), with similar results in both sexes. The AUSROC value increased in the East and Southeast Asian regions using a WHtR cutoff of ≥0.46 (AUSROC = 0.90, 95%CI: 0.87 to 0.92). A cutoff of ≥0.54 was optimal for the Latin American region (AUSROC = 0.96, 95%CI: 0.94-0.97). Our meta-analysis identified optimal cutoff values of WHtR for use in children and adolescents from different regions. Despite the widely accepted WHtR cutoff of 0.50, the present study indicated that a single cutoff value of WHtR may be inappropriate.
Ezzatvar et al. (Mon,) conducted a meta-analysis in Cardiometabolic risk (n=138,561). Waist-to-height ratio (WHtR) vs. Different WHtR cutoffs (e.g., 0.41-0.45) was evaluated on Area under summary receiver operating characteristic (AUSROC) for cardiometabolic risk (AUSROC 0.87, 95% CI 0.84-0.90, p=<0.001). Waist-to-height ratio cutoffs ≥0.51 showed high diagnostic accuracy for cardiometabolic risk in children (AUSROC 0.87; 95% CI 0.84-0.90), though optimal cutoffs varied significantly by region.