Introduction: Abdominal fat, particularly visceral, is associated with a high risk of metabolic complications. The waist-height ratio (WHtR) is used to assess abdominal fat in individuals of all ages.Objective: To determine the ability of the waist-to-height ratio to detect metabolic risk in mexican schoolchildren.Patients and Method: A study was conducted on children between 6 and 12 years. Obesity was diagnosed as a body mass index (BMI) ≥ 85th percentile, and an ICE ≥0.5 was considered abdominal obesity. Blood levels of glucose, cholesterol and triglycerides were measured. The sensitivity, specificity, positive predictive and negative value, area under curve, the positive likelihood ratio and negative likelihood ratio of the WHtR and BMI were calculated in order to identify metabolic alterations. WHtR and BMI were compared to determine which had the best diagnostic efficiency.Results: Of the 223 children included in the study, 51 had hypertriglyceridaemia, 27 with hypercholesterolaemia, and 9 with hyperglycaemia. On comparing the diagnostic efficiency of WHtR with that of BMI, there was a sensitivity of 100% vs. 56% for hyperglycaemia, 93 vs. 70% for cholesterol, and 76 vs. 59% for hypertriglyceridaemia. The specificity, negative predictive value, positive predictive value, positive likelihood ratio, negative likelihood ratio, and area under curve were also higher for WHtR.Conclusions: The WHtR is a more efficient indicator than BMI in identifying metabolic risk in mexican school-age.Introducción: La grasa abdominal, especialmente la visceral, está asociada con un riesgo alto de complicaciones metabólicas. El índice cintura-estatura es usado para evaluar grasa abdominal en individuos de todas las edades.Objetivo: Identificar la capacidad del índice cintura-estatura (ICE) para detectar riesgo metabólico en niños mexicanos de edad escolar.Pacientes y Método: Se estudiaron niños entre 6 y 12 años. Se diagnosticó obesidad con un índice de masa corporal (IMC) ≥ percentil 85, y obesidad abdominal con ICE ≥0,5. Se midieron niveles sanguíneos de glucosa, colesterol y triglicéridos. Se determinó sensibilidad, especificidad, valor predictivo positivo y negativo, área bajo la curva, coeficiente de verosimilitud positivo y negativo de la RCE e IMC para identificar alteraciones metabólicas. Se compararon ICE e IMC para determinar cuál tiene mejor eficiencia diagnóstica.Resultados: Se estudiaron 223 niños, 51 presentaron hipertrigliceridemia, 27 hipercolesterolemia y 9 hiperglucemia. Comparando la eficiencia diagnóstica del ICE contra el IMC se encontró sensibilidad del 100 vs.56% para hiperglucemia, del 93% contra 70% para hipercolesterolemia y del 76% contra 59% para hipertrigliceridemia, especificidad, valor predictivo negativo, valor predictivo positivo, coeficiente de verosimilitud positivo, coeficiente de verosimilitud negativo y área bajo la curva fueron superiores para ICE.Conclusiones: El ICE es un indicador más eficiente que el IMC para identificar riesgo metabólico en niños mexicanos de edad escolar.