Vol. 15 No. 1 (2023): Arch Pub Health
Clinical Science

Central obesity: waist circumference, waist-to-hip ratio and waist-to-height ratio in 13-year-old children

Arjeta Raufi
Clinical Hospital in Tetovo, Department for children’s diseases, Republic of North Macedonia
Marina Krstevska-Konstantinova
University Clinic of Children’s Diseases; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
Kostandina Kuzevska-Maneva
University Clinic of Children’s Diseases; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
Sonja Bojadzieva
University Clinic of Children’s Diseases; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
Avdi Murtezani
University Clinic of Children's Diseases; Faculty of Medicine, SS Cyril a Methodius University in Skopje, Republic Of North Macedoniand

Published 2023-06-30


  • childhood obesity,
  • central obesity,
  • waist circumference,
  • waist to hip ratio,
  • waist to height ratio

How to Cite

Raufi A, Krstevska-Konstantinova M, Kuzevska-Maneva K, Bojadzieva S, Murtezani A. Central obesity: waist circumference, waist-to-hip ratio and waist-to-height ratio in 13-year-old children. Arch Pub Health [Internet]. 2023 Jun. 30 [cited 2023 Dec. 6];15(1):63-70. Available from: https://id-press.eu/aph/article/view/6080


Obesity in children is a growing worldwide health problem, with a tenfold increase over just four decades. The aim of this study was to determine the prevalence of obesity and to identify central obesity in children aged 13 years from southwestern part of North Macedonia. Materials and methods: This cross-sectional study included a total of 178 healthy children of both sexes (boys 98, girls 80) aged 13 years living in Tetovo, North Macedonia. Results: The prevalence of categorized BMI according to CDC in all 13-year old children (n=178) was 4.5% underweight, 20.2% overweight and 16.3% obese. Among boys, the total prevalence of underweight, overweight and obese was consistently 4.1% vs. 19.4 %vs. 15.3%, while girls had statistically insignificant higher prevalence of underweight, overweight and obese 5% vs. 21.2% vs. 17.5%. At a comparison of the central obesity parameters like WC,WHR, WHtR showed statistically significant differences between sexes (p<0.003, p<0.0001, p<0.011).In the entire sample, the prevalence of high risk for waist-to-hip ratio (WHR) was 34.3% and the prevalence of high risk for waist-to-height ratio (WHtR) was 31.5%. In boys, the prevalence of high risk for WHR was 51% and for WHtR was 35.7% while in girls for WHR was 13.8 % and for WHtR 26.2%. A significant association of male gender with high risk for WHR (X2=27.161; df=1; p=0.0001) was found while for WHtR (X2 =1.830; p=0.176) there was no statistically significant sssociation. It is important to underline that in boys the risk of central obesity was 6.53 times higher compared to girls of the same age [OR=6.53 (3.08–13.83) 95% CI. Conclusions: In our study girls had a higher BMI prevalence of general overweight and obesity vs. boys, and a significant association of male gender with high risk for WHR was detected. Additionally, healthcare professionals should always consider assessing the measurements and risk of central obesity in obese or overweight children, and seek for the unique risk factors associated with each type of obesity and tailor interventions accordingly.


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