Evidence map›Paper›PMID 37968681›Full record

ArticleBMC medicine2023

Establishing international optimal cut-offs of waist-to-height ratio for predicting cardiometabolic risk in children and adolescents aged 6-18 years.

Xin'nan Zong, Roya Kelishadi, Young Mi Hong, Peter Schwandt, Tandi E Matsha, Jose G Mill, Peter H Whincup, Lucia Pacifico, Abel López-Bermejo, Carmelo Antonio Caserta and 17 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 1 pooled it
14.2field-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

45 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.

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  7. Emotional eating behaviour and obesity in adolescents: a cross-sectional survey in Taizhou, China.Archives of public health = Archives belges de sante publique · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors at 16 institutions in 12 countries.

Xin'nan Zong *Department of Epidemiology, School of Public Health, Shandong University, Jinan, China.
Roya Kelishadi *Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Young Mi Hong *Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
Peter Schwandt *Atherosclerosis Prevention Institute, Munich-Nuremberg, Munich, Germany.
Tandi E Matsha *Department of Biomedical Sciences, Faculty of Health & Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.
Jose G Mill *Department of Physiological Sciences, Center of Health Sciences, Federal University of Espírito Santo, Vitória, Brazil.
Peter H Whincup *Population Health Research Institute, St George's, University of London, London, UK.
Lucia Pacifico *Department of Maternal and Child Health, Sapienza University of Rome, Rome, Italy.
Abel López-Bermejo *Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain.
Carmelo Antonio Caserta *Associazione Calabrese Di Epatologia - Medicina Solidale - A.C.E. ETS, Reggio Calabria, Italy.
Carla Campos Muniz Medeiros *Department of Public Health, State University of Paraiba, Campina Grande, Brazil.
Anastasios Kollias *Hypertension Center STRIDE-7, School of Medicine, Third Department of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece.
Mostafa QorbaniNon Communicable Research Center, Alborz University, Karaj, Iran.
Fariborz Sharifian JaziSchool of Science and Technology, University of Georgia, Tbilisi, Georgia.
Gerda-Maria HaasAtherosclerosis Prevention Institute, Munich-Nuremberg, Munich, Germany.
Rafael de Oliveira AlvimDepartment of Public Health, Federal University of Espirito Santo, Vitória, ES, Brazil.
Divanei ZaniqueliDepartment of Physiological Sciences, Center of Health Sciences, Federal University of Espírito Santo, Vitória, Brazil.
Claudio ChiesaInstitute of Translational Pharmacology, National Research Council, Rome, Italy.
Judit BassolsMaternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), Salt, Spain.
Elisabetta Lucia RomeoAssociazione Calabrese Di Epatologia - Medicina Solidale - A.C.E. ETS, Reggio Calabria, Italy.
Danielle Franklin de CarvalhoDepartment of Public Health, State University of Paraiba, Campina Grande, Brazil.
Mônica Oliveira da Silva SimõesDepartment of Public Health, State University of Paraiba, Campina Grande, Brazil.
George S StergiouHypertension Center STRIDE-7, School of Medicine, Third Department of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece.
Evangelos GrammatikosHealth Center of Samos, Vathi, Samos, Greece.
Min ZhaoDepartment of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China.
Costan G MagnussenBaker Heart and Diabetes Institute, Melbourne, VIC, Australia.
Bo XiDepartment of Epidemiology, School of Public Health, Shandong University, Jinan, China. xibo2007@126.com.ORCID 0000-0003-0491-5585
Shandong University · CNUniversidade Estadual da Paraíba · BRUniversidade Federal do Espírito Santo · BRAssociazione Calabrese di Epatologia · ITNational and Kapodistrian University of Athens · GRBaker Heart and Diabetes Institute · AUCape Peninsula University of Technology · ZAEwha Womans University · KRInstitut d'Investigació Biomèdica de Girona · ESIsfahan University of Medical Sciences · IRIstituto di Farmacologia Traslazionale · ITKaraj Payam Noor University · IRSapienza University of Rome · ITSt George's, University of London · GBUniversitat de Girona · ESUniversity of Georgia · GE

Funding

National Key Research and Development Plan: Real-Time Intelligent Active Intervention on Integration of Ten Important Chronic Diseases 2020YFC2003504-2Youth Team of Humanistic and Social Science, and the Innovation Team of "Climbing" Programme, Shandong University 20820IFYT1902
6 · The paper itself

Abstract

backgroundWaist-to-height ratio (WHtR) has been proposed as a simple and effective screening tool for assessing central obesity and cardiometabolic risk in both adult and pediatric populations. However, evidence suggests that the use of a uniform WHtR cut-off of 0.50 may not be universally optimal for pediatric populations globally. We aimed to determine the optimal cut-offs of WHtR in children and adolescents with increased cardiometabolic risk across different countries worldwide.

methodsWe used ten population-based cross-sectional data on 24,605 children and adolescents aged 6-18 years from Brazil, China, Greece, Iran, Italy, Korea, South Africa, Spain, the UK, and the USA for establishing optimal WHtR cut-offs. We performed an external independent test (9,619 children and adolescents aged 6-18 years who came from other six countries) to validate the optimal WHtR cut-offs based on the predicting performance for at least two or three cardiometabolic risk factors.

resultsBased on receiver operator characteristic curve analyses of various WHtR cut-offs to discriminate those with ≥ 2 cardiometabolic risk factors, the relatively optimal percentile cut-offs of WHtR in the normal weight subsample population in each country did not always coincide with a single fixed percentile, but varied from the 75

conclusionsThe proposed international WHtR cut-offs are easy and useful to identify central obesity and cardiometabolic risk in children and adolescents globally, thus allowing international comparison across populations.

Indexed as

Cardiovascular DiseasesMetabolic SyndromeAdolescentAdultBody Mass IndexChildCross-Sectional StudiesHumansObesityObesity, AbdominalRisk FactorsWaist CircumferenceWaist-Height RatioAdolescentCardiovascular risk factorsCentral obesityChildWaist-to-height ratio

Identifiers

PMID37968681
PMCPMC10647138
OpenAlexW4388699722

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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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.