<p><b>Background:</b> The increase in obesity, especially the increase of visceral fat, has been directly associated with health risk. Additionally, a waist-to-height ratio (WHtR) (0.5) has been proposed as an indicator of early health risk.</p> <p><b>Aims:</b> To test the association between anthropometric measurements and inflammatory mRNA expression and to evaluate the effectiveness of WHtR to predict inflammatory risk in children.</p> <p><b>Subjects and methods:</b> Anthropometric measurements and fasting blood samples were collected in 94 Brazilian children (46 boys) aged 9–11 years. Children were identified as being at inflammatory risk based on cytokine mRNA expression levels at and above the 75th percentile. Inflammatory cytokine mRNA expression levels were determined through buff-coat using real-time polymerase chain reaction.</p> <p><b>Results:</b> Body mass index (BMI), waist circumference (WC) and WHtR showed moderate-to-strong association with inflammatory cytokine mRNA gene expression. WHtR = 0.51 was the most accurate cut-off point in distinguishing children at inflammatory risk. Compared with children with WHtR <0.51, children with a WHtR ≥0.51 presented an odds ratio of 2.643 (95% CI = 1.749–3.994) for both diagnosed IL-6 and MCP-1 above the 75th percentile and 2.796 (95% CI = 1.802–4.338) for TNF-<i>α</i> above the 75th percentile. WHtR = 0.50 presented the same values of sensitivity and odds ratio and ∼7% lower specificity compared to WHtR = 0.51.</p> <p><b>Conclusion:</b> Anthropometric measurements have shown a moderate-to-strong association with the mRNA expression of inflammatory genes and a WHtR of 0.5 could serve as a cut-off point, suggesting increased risk of inflammatory responses.</p
