The predictive value of anthropometric indices for cardiometabolic risk factors in Chinese children and adolescents: A national multicenter school-based study

Autoři: Yamei Li aff001;  Zhiyong Zou aff002;  Jiayou Luo aff001;  Jun Ma aff002;  Yinghua Ma aff002;  Jin Jing aff003;  Xin Zhang aff004;  Chunyan Luo aff005;  Hong Wang aff006;  Haiping Zhao aff007;  Dehong Pan aff008;  Peng Jia aff009
Působiště autorů: Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China aff001;  Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China aff002;  Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China aff003;  School of Public Health, Tianjin Medical University, Tianjin, China aff004;  Department of School Health, Shanghai Municipal Center for Disease Control and Prevention & Shanghai Institutes of Preventive Medicine, Shanghai, China aff005;  School of Public Health and Management, Chongqing Medical University, Chongqing, China aff006;  School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China aff007;  Liaoning Health Supervision Bureau, Shenyang, Liaoning Province, China aff008;  Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, The Netherlands aff009;  International Initiative on Spatial Lifecourse Epidemiology (ISLE), Enschede, The Netherlands aff010
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227954



This study aimed to assess the accuracy of body mass index (BMI) percentile, waist circumference (WC) percentile, waist-height ratio, and waist-hip ratio for identifying cardiometabolic risk factors in Chinese children and adolescents stratified by sex and BMI categories.


We measured anthropometric indices, fasting plasma glucose, lipid profile and blood pressure for 15698 participants aged 6–17 in a national survey between September and December 2013. The predictive accuracy of anthropometric indices for cardiometabolic risk factors was examined using receiver operating characteristic (ROC) analyses. The DeLong test and Z test were used for the comparisons of areas under ROC curves (AUCs).


The prevalence of impaired fasting glucose, dyslipidemia, hypertension and cluster of risk factors were 2.9%, 27.3%, 10.5% and 5.7% respectively. The four anthropometric indices showed poor to fair discriminatory ability for cardiometabolic risk factors with the AUCs ranging from 0.53–0.72. Each index performed significantly better AUCs for dyslipidemia (0.59–0.63 vs. 0.56–0.59), hypertension (0.62–0.70 vs. 0.55–0.65) and clustered risk factors (0.70–0.73 vs. 0.60–0.64) in boys than that in girls. BMI percentile performed the best accuracy for hypertension in both sexes; WC percentile had the highest AUC for dyslipidemia and BMI percentile and waist-height ratio performed similarly the best AUCs for clustered risk factors in boys while BMI percentile, WC percentile and waist-height ratio performed similar and better AUCs for dyslipidemia and clustered risk factors in girls; whereas waist-hip ratio was consistently the poorest predictor for them regardless of sex. Though the anthropometric indices were more predictive of dyslipidemia, hypertension and clustered risk factors in overweight/obese group compared to their normal BMI peers, the AUCs in overweight/obese group remained in the poor range below 0.70.


Anthropometric indices are not effective screening tools for pediatric cardiometabolic risk factors, even in overweight/obese children.

Klíčová slova:

Adolescents – Anthropometry – Blood pressure – Body mass index – Dyslipidemia – Hypertension – Children – Medical risk factors


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