{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T09:11:51Z","timestamp":1788772311048,"version":"build-2803163510"},"reference-count":77,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["PID2022-140245OA-I00"],"award-info":[{"award-number":["PID2022-140245OA-I00"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"award":["PID2022-140245OA-I00"],"award-info":[{"award-number":["PID2022-140245OA-I00"]}],"id":[{"id":"https:\/\/ror.org\/05r0vyz12","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Uni\u00f3n Europea"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Field-based health screening in adolescents requires accurate, non-invasive, and feasible diagnostic tools. This study evaluated the discriminatory capacity of anthropometric parameters and physical fitness tests for identifying waist-to-height ratio (WHtR)-defined surrogate cardiometabolic risk across sex and biological maturity status, determining exploratory cut-off thresholds. Methods: A cross-sectional study was conducted with 2944 Spanish adolescents (1459 males, 1485 females; age: 13.35 \u00b1 1.20 years). Anthropometric variables (BMI, skinfolds, fat\/muscle mass) and physical fitness tests (20-m shuttle run, handgrip, CMJ, SBJ, 20-m sprint, curl-up; evaluated in raw and body-mass-normalized formats) were assessed. Biological maturation was estimated via Age at Peak Height Velocity (APHV) using Mirwald equations and categorized into early, on-time, and late maturers relative to the sample mean. Surrogate risk was operationalized strictly as WHtR \u2265 0.50, without direct assessment of biochemical or hemodynamic parameters. Receiver operating characteristic (ROC) curves, optimal Youden-derived cut-offs, and internal bootstrap validation (1000 resamples) were performed. Results: Anthropometric parameters demonstrated high discriminatory performance for detecting WHtR-defined surrogate risk across all sex and maturation cohorts (AUC = 0.88\u20130.98). Unadjusted physical fitness tests showed poor overall classification performance. However, normalizing fitness metrics for body mass (particularly relative CMJ and cardiorespiratory fitness) substantially improved discriminatory capacity. Optimal cut-off values for anthropometric indicators displayed an observed descending pattern across progressively later-maturing cohorts. Conclusions: Anthropometric parameters represent highly accurate field proxies for WHtR-defined surrogate risk screening in adolescents. While unadjusted fitness metrics have limited utility for this anthropometric outcome, body-mass-normalized fitness parameters substantially recover classification capacity. Biological maturation timing should be carefully considered when future research derives and externally validates adolescent screening thresholds, as current cut-offs remain exploratory and sample-derived.<\/jats:p>","DOI":"10.3390\/children13091201","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T08:07:06Z","timestamp":1788768426000},"page":"1201","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Discriminatory Capacity of Anthropometric Indicators and Physical Fitness Tests for Identifying Waist-to-Height Ratio-Defined Cardiometabolic Risk in Adolescents According to Sex and Biological Maturity"],"prefix":"10.3390","volume":"13","author":[{"given":"Victoria","family":"L\u00f3pez-Lomb\u00f3","sequence":"first","affiliation":[{"name":"Research Group Movement Sciences and Sport (MS&SPORT), Department of Physical Activity and Sport Sciences, Faculty of Sport Sciences, University of Murcia, 30720 San Javier, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8111-8358","authenticated-orcid":false,"given":"Adri\u00e1n","family":"Mateo-Orcajada","sequence":"additional","affiliation":[{"name":"Research Group Movement Sciences and Sport (MS&SPORT), Department of Physical Activity and Sport Sciences, Faculty of Sport Sciences, University of Murcia, 30720 San Javier, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9583-737X","authenticated-orcid":false,"given":"Luc\u00eda","family":"Abenza-Cano","sequence":"additional","affiliation":[{"name":"Facultad de Deporte, UCAM Universidad Cat\u00f3lica San Antonio de Murcia, 30107 Guadalupe, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4527-3865","authenticated-orcid":false,"given":"J. Arturo","family":"Abraldes","sequence":"additional","affiliation":[{"name":"Research Group Movement Sciences and Sport (MS&SPORT), Department of Physical Activity and Sport Sciences, Faculty of Sport Sciences, University of Murcia, 30720 San Javier, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0234-7756","authenticated-orcid":false,"given":"Mario","family":"Albaladejo-Saura","sequence":"additional","affiliation":[{"name":"Facultad de Deporte, UCAM Universidad Cat\u00f3lica San Antonio de Murcia, 30107 Guadalupe, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2708-4817","authenticated-orcid":false,"given":"Raquel","family":"Vaquero-Crist\u00f3bal","sequence":"additional","affiliation":[{"name":"Research Group Movement Sciences and Sport (MS&SPORT), Department of Physical Activity and Sport Sciences, Faculty of Sport Sciences, University of Murcia, 30720 San Javier, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","article-title":"Worldwide Trends in Underweight and Obesity from 1990 to 2022: A Pooled Analysis of 3663 Population-Representative Studies with 222 Million Children, Adolescents, and Adults","volume":"403","author":"Phelps","year":"2024","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S0140-6736(25)00397-6","article-title":"Global, Regional, and National Prevalence of Child and Adolescent Overweight and Obesity, 1990\u20132021, with Forecasts to 2050: A Forecasting Study for the Global Burden of Disease Study 2021","volume":"405","author":"Kerr","year":"2025","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s13679-021-00439-9","article-title":"Adolescent and Childhood Obesity and Excess Morbidity and Mortality in Young Adulthood\u2014A Systematic Review","volume":"10","author":"Horesh","year":"2021","journal-title":"Curr. 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