Table 4.

Performance of proposed WHtR cut-offs of 0.50/0.46 in external independent test pediatric populations aged 6–18 years from six countries

	Brazil (0.46)	China (0.46)	Germany (0.50)	Italy (0.50)	Korea (0.46)	USA (0.50)	Total
Survey year	2014–2016	2009	2000–2007	2008–2010	2011–2012	2015–2018	2000–2018
Sample size	824	749	6810	724	152	360	9619
Boys (%)	463 (56.2)	411 (54.9)	3578 (52.5)	395 (54.6)	105 (69.1)	179 (49.7)	5131 (53.3)
Age (years)	6–18	7–17	6–18	6–18	12–15	12–18	6–18
Cardiometabolic risk factors clustering based on IDF criteria, OR (95% CI)
≥ 2	3.49 (0.99–12.30)	4.02 (2.15–7.51)	3.20 (2.47–4.14)	5.19 (2.06–13.08)	5.09 (2.05–12.64)	3.34 (1.74–6.42)	3.70 (3.09–4.43)
≥ 3	3.39 (0.21–54.52)	2.33 (0.39–14.07)	4.04 (1.97–8.29)	5.42 (0.71–41.52)	2.62 (0.31–22.52)	7.83 (0.90–67.81)	5.40 (3.34–8.74)
Cardiometabolic risk factors clustering based on NCEP criteria, OR (95% CI)
≥ 2	3.23 (1.89–5.55)	2.12 (1.30–2.46)	2.99 (2.39–3.74)	3.46 (2.08–5.76)	4.78 (1.86–12.28)	3.28 (1.60–6.74)	4.03 (3.48–4.66)
≥ 3	7.16 (1.77–28.94)	2.08 (0.49–8.80)	6.18 (3.86–9.90)	9.13 (2.19–38.15)	5.73 (0.70–46.64)	6.06 (0.67–54.86)	8.23 (5.87–11.55)

Abbreviations CI Confidence interval, IDF International Diabetes Federation, NCEP National Cholesterol Education Program, OR Odds ratio, WHtR Waist-to-height ratio. OR (95%CI) was calculated using < 2 cardiometabolic risk factors clustering as the reference group

Mutivariate logistic regression models were adjusted for sex and age in each population, and additionally adjusted for survey year in total population