The present study showed that the 75th percentile of visceral fat area in boys and girls is the optimal cutoff for screening cardiometabolic risk and its clustering, but the 80th percentile is the optimal cutoff for hyperglycemia screening in girls. The investigators proposed simplified cutoffs of 37.19 cm2 and 31.09 cm2 aged 6 to 8 years, 56.76 cm2 and 39.51 cm2 aged 9 to 11 years, 57.03 cm2 and 38.33 cm2 aged 12 to 15 years, and 58.32 cm2 and 53.91 cm2 aged 16 to 18 years for boys and girls, respectively. Both the optimal and simplified methods were verified in a 2-year longitudinal cohort. An improved understanding of the importance of visceral fat to cardiometabolic risk and its clustering in children may yield insight into the risks associated with child obesity and the initial phases of cardiovascular disease development, especially in normal-weight boys.

Inclusion Criteria:

Healthy children and adolescents aged 6-18 years

Exclusion Criteria:

Heart disease Kidney disease Thyroid disease Individuals who take hormone medication Missing data for anthropometry

A total of 8133 participants (mean age =11.8 years, SD =3.3 years) from the China Child and Adolescent Cardiovascular Health completed the visceral fat area assessment by dual-energy X-ray absorptiometry, and 10805 participants from the school-based cardiovascular and bone health program (mean age =11.0 years, SD =3.3 years).