Identification of the most appropriate existing anthropometric index for home-based obesity screening in children and adolescents

Abstract

ObjectivesHome-based self-screening and monitoring for obesity is particularly valuable for the prevention and control of chronic diseases. This study aimed to identify an anthropometric index suitable for home-based obesity screening in children and adolescents. Study designThe design of this study is a cross-sectional study. MethodsA total of 14,042 students (6–17 years) from the Qibao Community, Minhang District, Shanghai, were studied in 2018. The percentage body fat (PBF), height, weight, waist circumference (WC) and hip circumference were measured. Body mass index (BMI), triponderal mass index (TMI), body adiposity index (BAI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Partial correlation analysis was used to evaluate the relationships between these indices and PBF, and receiver operating characteristic (ROC) curves were used to evaluate their performance for obesity screening. ResultsBMI, TMI, WC and WHtR were found to strongly correlate with PBF (r ≥ 0.830, all P < 0.001). The optimal index for obesity screening in children (6–11 years) was BMI (area under the ROC curve [AUC] = 0.980 for boys and 0.981 for girls) and in adolescents (12–17 years) was TIM (AUC = 0.976 for boys and 0.945 for girls); however, the optimal cut-off values for BMI and TMI differed among the subgroups. The ROC curve analysis showed that WHtR had similar cut-off values in each subgroup (0.45 for boys of 6–11 years and 0.43 for the other subgroups), excellent performance in children (AUC>0.90) and good performance in adolescents (AUC = 0.960 for girls and 0.878 for boys). ConclusionsOwing to its accuracy and stable cut-off value for defining obesity, WHtR should be recommended for home-based obesity screening in children and adolescents.