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Cited by 179Obesity, Physical Activity, DietBody Composition Measurement TechniquesDiabetes, Cardiovascular Risks, and Lipoproteins

Waist circumference, waist-to-hip ratio and waist-to-height ratio reference percentiles for abdominal obesity among Greek adolescents

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Bacopoulou, Flora, Efthymiou, Vasiliki, Landis, Georgios, Rentoumis, Anastasios, Chrousos, George P·2015·BMC Pediatrics
DOI 10.1186/s12887-015-0366-zPMC PMC4446827
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Abstract

BACKGROUND: Indices predictive of adolescent central obesity include waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). Such reference data are lacking for Greek adolescents. The aim of this study was to develop age- and gender-specific WC, WHR and WHtR smoothed reference percentiles for abdominal obesity among Greek adolescents aged 12-17 years, to investigate possible obesity cut-offs of WHR and WHtR and to compare WC percentiles to other adolescent populations. METHODS: A representative sample of 1610 high school adolescents (42.2% boys, 57.8% girls; mean age ± sd 14.4 ± 1.72 years) participated in this cross-sectional study in Attica, Greece, in 2013. Weight, height, body mass index (BMI), WC, hip circumference (HC), WHR and WHtR were measured and percentiles were calculated using the LMS method. The relation between WHR, WHtR and general obesity, as defined by the International Obesity Task Force, was investigated with receiver operating characteristic (ROC) analysis. The discriminating power of WHR and WHtR was expressed as area under the curve (AUC). Greek adolescents' WC measurements at the 50th and 90th percentile were compared with their counterparts' smoothed percentiles from Norway, Turkey, Poland, South India, Germany and Kuwait. RESULTS: Boys had significantly higher mean in all measures than girls, except for BMI where there was no statistical difference in terms of gender. BMI, WC and HC showed an increasing trend with age. WC leveled off in both genders at the age of 17 years. WHR and WHtR showed a continuous decrease with advancing age. WHtR was a better predictor for general obesity in both boys and girls (AUC 95% CI 0.945-0.992) than the WHR (AUC 95% CI 0.758-0.870); the WHtR cut-off of 0.5 had sensitivity 91% and specificity 95% for both genders and all age groups combined. International comparisons showed that Greek adolescents had relatively high levels of abdominal obesity in early-middle adolescence but this did not persist at the age of 17 years. CONCLUSIONS: These reference percentile curves could be used provisionally for early detection of abdominal obesity in Greek adolescents aged 12-17 years; WHtR of 0.5 could also be used as a threshold for obesity in this age group.

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Authors
Bacopoulou, F., Efthymiou, V., Landis, G., Rentoumis, A., & Chrousos, G. P.
Affiliations
National and Kapodistrian University of Athens (GR)
Corresponding author
Bacopoulou, Flora
ORCID
Venue
BMC Pediatrics
Publisher
Springer Science and Business Media LLC
Published
2015-05-04
Volume
15
Issue
1
Pages
50-50
ISSN
1471-2431 (ISSN-L)
DOI
10.1186/s12887-015-0366-z
PMC
PMC4446827
OpenAlex
W1986292226
Cited by
179
References
40
Citations by year
2026: 11 · 2025: 9 · 2024: 13 · 2023: 17 · 2022: 16 · 2021: 22 · 2020: 18 · 2019: 27 · 2018: 20 · 2017: 10 · 2016: 13 · 2015: 3
FWCI
16.44
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Pediatrics (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
waist circumference, waist-to-hip ratio, waist-to-height ratio, abdominal obesity, adolescents, reference percentiles, Greek adolescents, sex differences, age differences, body mass index, hip circumference, obesity screening, LMS algorithm, receiver operating characteristic, sensitivity and specificity, early detection of obesity, South India
MeSH terms
Adolescent, Body Height, Female, Greece, Hip, Humans, Male, ROC Curve, Body Mass Index, Waist-Hip Ratio, Waist Circumference, Obesity, Abdominal

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