The team of Prof. Xi Bo from the School of Public Health published a paper titled "Establishing international optimal cut-offs of waist-to-height ratio for predicting cardiometabolic risk in children and adolescents aged 6–18 years" in BMC Medicine recently, which made a new progress in the field of childhood obesity. PhD candidate Zong Xinnan is the first author and Prof. Xi Bo is the corresponding author. Shandong University is the first author unit and the corresponding author unit.

In recent years, with the increase in energy intake and decrease in physical activity, childhood obesity has become a significant global public health issue. Childhood obesity often accompanies cardiometabolic risk factors such as high blood pressure (BP), elevated triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C), and high fasting blood glucose (FBG) and then lead to hypertension, dyslipidemia, and various cardiovascular organ damages. Moreover, childhood obesity often persists into adulthood, thereby increasing the risk of cardiovascular diseases in adulthood. Therefore, early identification and control of childhood obesity are of utmost public health importance in preventing immediate target organ damages and cardiovascular events in adulthood. However, there is no consensus among the academia regarding the optimal cut-offs for waist-to-height ratio (WHtR) in children and adolescents.

Prof. Xi Bo's team has been focusing on the epidemiological studies of childhood obesity and hypertension for a long time. They collaborated with nearly 20 scholars from 10 countries, including China, Iran, South Korea, the United Kingdom, Brazil, Italy, Spain, Greece, South Africa, and the United States, who are also experts in childhood obesity research. Data on WHtR and blood biochemical were collected from over 25,000 children aged 6-18 years old. They proposed that WHtR cut-off of 0.50 might be suitable for defining central obesity in children and adolescents from Europe and the USA, while a lower value of 0.46 might be more appropriate for those from Asia, Africa, and South America. Furthermore, the validation results in external independent test populations with a total of 9,619 children and adolescence from six countries showed that the proposed WHtR international standard of 0.50/0.46 for screening metabolic abnormalities in childhood had good effects and could be used for quick and easy screening of central obesity in children.

Figure 1 Relatively optimal cut-offs of WHtR to discriminate those with and without ≥ 2 cardiometabolic risk factors for the second analysis strategy

The international optimal cut-offs of WHtR established by Prof. Xi Bo's team in children and adolescents can utilized for worldwide comparison of abdominal obesity rates, providing a fast, easyand effective tool for the prevention and treatment of childhood central obesity. Additionally, the standard can be directly applied to clinical evaluations and preventive interventions for childhood central obesity on a global scale, thereby facilitating the direct translation of scientific research findings.

Link to the paper:https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-03169-y