Establishing Waist-to-Height Ratio Standards from Criterion-Referenced BMI Using ROC Curves in Low-Income Children

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Burns, Ryan D.
Brusseau, Timothy A.
Fang, Yi
Fu, You
Hannon, James C.

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2016

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Article

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Abstract

The purpose of this study was to establish health-related waist-to-height ratio(WHtR) cut-points associating with FITNESSGRAM's body mass index (BMI) criterion-referenced standards in low-income children. A secondary aim was to examine the classification agreement between the derived WHtR cut-points and various cardiometabolic blood markers using current recommendations. Participants were 219 children from low-income schools (mean age = 10.5 +/- 0.6 years). Waist circumference, height, weight, and cardiometabolic blood markers were collected in a fasting state before school hours. Receiver operating characteristic (ROC) curves were used to determine WHtR cut-points that associated with a child meeting FITNESSGRAM's age-and sex-specific criterion-referenced standards for BMI. The derived WHtR cut-point was 0.50 (AUC = 0.89, p < 0.001
sensitivity = 0.86, specificity = 0.82, and accuracy = 84.3%). Classification agreement using the derived WHtR cut-point with various blood marker standards was statistically significant but considered weak to fair (kappa 0.14-0.34, agreement = 59%-67%, and p < 0.01). The WHtR cut-point of 0.50 can be used with strong accuracy to distinguish low-income children who met FITNESSGRAM's criterion-referenced standards for body composition
however, the evidence was weaker for its use in distinguishing low-income children meeting specific cardiometabolic blood marker recommendations.

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Burns, R. D., Brusseau, T. A., Fang, Y., Fu, Y., & Hannon, J. C. (2016). Establishing Waist-to-Height Ratio Standards from Criterion-Referenced BMI Using ROC Curves in Low-Income Children. Journal of Obesity, 2016, 1�"7. doi:10.1155/2016/2740538

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Creative Commons Attribution 4.0 International

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2090-0708

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