Evidence map›Paper›PMID 31723976›Full record

ArticleThe Journal of clinical endocrinology and metabolism2020

International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years.

Bo Xi, Xin'nan Zong, Roya Kelishadi, Mieczysław Litwin, Young Mi Hong, Bee Koon Poh, Lyn M Steffen, Sonya V Galcheva, Isabelle Herter-Aeberli, Tadeusz Nawarycz and 29 more

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Article in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 6 pooled it
11.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 6 syntheses or guidelines pooled it, 152 citations in OpenAlex.

  1. Pooled it
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  3. Obesity in South and Southeast Asia-A new consensus on care and management.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2023
    Guideline
  4. Pooled it
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  6. Pooled it
  7. Trial
  8. Effects of obesity on brain health and cognition.Nature reviews. Neurology · 2026
    Review
  9. Toddler diet quality: a factor associated with childhood growth?International journal of obesity (2005) · 2026
    Article
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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

39 authors at 20 institutions in 13 countries.

Bo XiDepartment of Epidemiology, School of Public Health, Shandong University, Jinan, China.
Xin'nan ZongDepartment of Growth and Development, Capital Institute of Pediatrics, Beijing, China.
Roya KelishadiDepartment of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Mieczysław LitwinDepartment of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland.
Young Mi HongDepartment of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
Bee Koon PohNutritional Sciences Programme and Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Lyn M SteffenDivision of Epidemiology and Community Health, University of Minnesotas School of Public Health, Minneapolis, USA.
Sonya V GalchevaDepartment of Pediatrics, Varna Medical University, Varna, Bulgaria.
Isabelle Herter-AeberliInstitute of Food, Nutrition and Health, Human Nutrition Laboratory, ETH Zurich, Zürich, Switzerland.
Tadeusz NawaryczDepartment of Biophysics, Chair of Experimental and Clinical Physiology, Medical University of Lodz, Lodz, Poland.
Małgorzata Krzywińska-WiewiorowskaDepartment of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Anuradha KhadilkarHirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
Michael D SchmidtDepartment of Kinesiology, University of Georgia, Athens, Georgia, USA.
Hannelore NeuhauserDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany and DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany.
Anja SchienkiewitzDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Zbigniew KułagaDepartment of Public Health, The Children's Memorial Health Institute, Warsaw, Poland.
Hae Soon KimDepartment of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
Barbara Stawińska-WitoszyńskaDepartment of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Mohammad Esmaeil MotlaghDepartment of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Abd Talib RuzitaNutritional Sciences Programme and Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Violeta M IotovaDepartment of Pediatrics, Varna Medical University, Varna, Bulgaria.
Aneta GrajdaDepartment of Public Health, The Children's Memorial Health Institute, Warsaw, Poland.
Mohd Noor IsmailFaculty of Social Sciences and Leisure Management, Taylor's University, Subang Jaya, Selangor, Malaysia.
Alicja KrzyżaniakDepartment of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Ramin HeshmatDepartment of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Velin StratevDepartment of Internal Medicine, Varna Medical University, Varna, Bulgaria.
Agnieszka Różdżyńska-ŚwiątkowskaDepartment of Anthropometry, The Children's Memorial Health Institute, Warsaw, Poland.
Gelayol ArdalanDepartment of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Mostafa QorbaniNon-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Anna Świąder-LeśniakDepartment of Anthropometry, The Children's Memorial Health Institute, Warsaw, Poland.
Lidia Ostrowska-NawaryczDepartment of Biophysics, Chair of Experimental and Clinical Physiology, Medical University of Lodz, Lodz, Poland.
Yoto YotovDepartment of cardiology, Medical University Varna, Varna, Bulgaria.
Veena EkboteHirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
Vaman KhadilkarHirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
Alison J VennMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Terence DwyerMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Min ZhaoDepartments of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China.
Costan G MagnussenMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Pascal BovetDepartment of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Children's Memorial Health Institute · PLMedical University of Varna · BGJehangir Hospital · INPoznan University of Medical Sciences · PLUniversity of Tasmania · AUEwha Womans University · KRIsfahan University of Medical Sciences · IRMedical University of Lodz · PLNational University of Malaysia · MYRobert Koch Institute · DEShandong University · CNAhvaz Jundishapur University of Medical Sciences · IRCapital Institute of Pediatrics · CNCentre universitaire de médecine générale et santé publique, Lausanne · CHETH Zurich · CHJahrom University of Medical Sciences · IRTaylor's University · MYTehran University of Medical Sciences · IRUniversity of Georgia · USUniversity of Minnesota · US

Funding

UNIV OF NORTH CAROLINA CLINICAL NUTRITION RESEARCH UNITP30DK056350 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Ian Michael Carroll · 1999 to 2026
$31.6M
MONITORING SOCIAL CHANGE: HEALTH, REPRODUCTION, AGINGR01HD030880 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ADAIR, LINDA S, POPKIN, BARRY M · 1994 to 2024
$27.0M
Carolina Population CenterR24HD050924 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MORGAN, SAMUEL PHILIP · 2005 to 2014
$10.0M
CHILD HEALTH EFFECTS OF RAPID SOCIO-DEMOGRAPHIC CHANGER01HD038700 · NICHD · UNIVERSITY OF NORTH CAROLINA CHAPEL HILL · PI POPKIN, BARRY M · 2000 to 2004
$1.5M
NICHD NIH HHS R01 HD030880NICHD NIH HHS R01 HD038700NICHD NIH HHS R24 HD050924NIDDK NIH HHS P30 DK056350
6 · The paper itself

Abstract

contextNo universal waist circumference (WC) percentile cutoffs used have been proposed for screening central obesity in children and adolescents.

objectiveTo develop international WC percentile cutoffs for children and adolescents with normal weight based on data from 8 countries in different global regions and to examine the relation with cardiovascular risk. DESIGN AND

settingWe used pooled data on WC in 113,453 children and adolescents (males 50.2%) aged 4 to 20 years from 8 countries in different regions (Bulgaria, China, Iran, Korea, Malaysia, Poland, Seychelles, and Switzerland). We calculated WC percentile cutoffs in samples including or excluding children with obesity, overweight, or underweight. WC percentiles were generated using the general additive model for location, scale, and shape (GAMLSS). We also estimated the predictive power of the WC 90th percentile cutoffs to predict cardiovascular risk using receiver operator characteristics curve analysis based on data from 3 countries that had available data (China, Iran, and Korea). We also examined which WC percentiles linked with WC cutoffs for central obesity in adults (at age of 18 years).

main outcome measureWC measured based on recommendation by the World Health Organization.

resultsWe validated the performance of the age- and sex-specific 90th percentile WC cutoffs calculated in children and adolescents (6-18 years of age) with normal weight (excluding youth with obesity, overweight, or underweight) by linking the percentile with cardiovascular risk (area under the curve [AUC]: 0.69 for boys; 0.63 for girls). In addition, WC percentile among normal weight children linked relatively well with established WC cutoffs for central obesity in adults (eg, AUC in US adolescents: 0.71 for boys; 0.68 for girls).

conclusionThe international WC cutoffs developed in this study could be useful to screen central obesity in children and adolescents aged 6 to 18 years and allow direct comparison of WC distributions between populations and over time.

Indexed as

Body HeightBody Mass IndexWaist CircumferenceAdolescentAdultArea Under CurveChildChild, PreschoolCross-Sectional StudiesFemaleFollow-Up StudiesHumansIranMalaysiaMaleObesity, Abdominalcentral obesitychildren and adolescentscutoff pointswaist circumference

Identifiers

PMID31723976
PMCPMC7059990
OpenAlexW2984564756

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.