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  • Original Article
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Waist circumference and body mass index in Chinese children: cutoff values for predicting cardiovascular risk factors

International Journal of Obesity volume 31, pages 550–558 (2007)Cite this article

A Corrigendum to this article was published on 26 February 2007

Abstract

Background:

Body mass index (BMI) and waist circumference (WC) correlate with cardiovascular (CV) risk factors in childhood which track into adulthood. WC provides a measure of central obesity, which has been specifically associated with CV risk factors. Reference standards for WC, and for WC and BMI risk threshold values are not established in Chinese children.

Objectives:

To construct reference percentile charts of WC, establish relationships between WC, BMI and other risk factors, and propose WC and BMI threshold values predictive of CV risk factors in Hong Kong ethnic Chinese children.

Methods:

Weight, height, waist and hip circumference were measured in 2593 (52% boys, 47% girls) randomly sampled Hong Kong school children aged 6–12 years. In 958 of these and 97 additional overweight children (n=1055), the relationships between WC, BMI, waist/hip and waist/height ratio and six age-adjusted CV risk factors (>85% percentile levels of blood pressure (BP), fasting triglycerides, low-density lipoprotein (LDL) cholesterol, glucose and insulin levels, and <15% percentile levels of high-density lipoprotein (HDL) cholesterol) were studied. Receiver-operating characteristic analysis was employed to derive optimal age-adjusted sex-specific WC and BMI thresholds for predicting these measures of risk.

Results:

WC percentiles were constructed. WC correlated slightly more than BMI with CV risk factors and most strongly with insulin and systolic BP, but poorly or not with LDL and glucose. Optimal WC and BMI risk thresholds for predicting four of these six CV risk factors were ca. the 85th percentiles (sensitivities ∼0.8, specificities ∼0.87) with age-specific cutoff values in girls/boys from ∼57/58 to ∼71/76 cm and 17/18 to 22/23 kg/m2.

Conclusion:

These are the first set of WC reference data for Chinese children. WC risk cutoff values are proposed which, despite a smaller waist in Chinese children, are similar to those reported for American children. WC percentiles may reflect population risk.

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Acknowledgements

This study was supported by the Jump Rope for heart project, Hong Kong College of Cardiology and Polar Electro Oy. We are grateful to Professor AH Henderson, Emeritus Professor of Cardiology and Professor RR West, Department of Statistics and Epidemiology, at the University of Wales College of Medicine, for their critical review of the manuscript. Special thanks go to Professor Tony Nelson for his valuable comments.

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Authors and Affiliations

  1. Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China

    R Y T Sung, A M C Li, D Chan, A F C Lo & T F Fok

  2. Institute of Human Performance, The University of Hong Kong, Hong Kong SAR, China

    C C W Yu & A McManus

  3. Centre for Epidemiology and Biostatistics, The Chinese University of Hong Kong, Hong Kong, China

    K C Choi & S L Y Xu

  4. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China

    J C N Chan

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  1. R Y T Sung
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Correspondence to R Y T Sung.

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Sung, R., Yu, C., Choi, K. et al. Waist circumference and body mass index in Chinese children: cutoff values for predicting cardiovascular risk factors. Int J Obes 31, 550–558 (2007). https://doi.org/10.1038/sj.ijo.0803452

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