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J Pediatr. 2016 Oct;177:255-261.e2. doi: 10.1016/j.jpeds.2016.06.059. Epub 2016 Aug 2.

Utility of Body Mass Index in Identifying Excess Adiposity in Youth Across the Obesity Spectrum.

Author information

1
Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN.
2
Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN.
3
Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.
4
Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN; Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.

Abstract

OBJECTIVES:

To determine the proportion of youth within a given body mass index (BMI) obesity category with excess adiposity using dual energy x-ray absorptiometry (DXA). Furthermore, to examine whether mean differences in cardiometabolic risk factors based upon various excess adiposity cutpoints were present.

STUDY DESIGN:

DXA data from the National Health and Nutrition Examination Survey 1999-2006 (n = 10 465; 8-20 years of age) were used for this analysis. Obesity categories were defined using Centers for Disease Control and prevention definitions for age and sex. Excess adiposity was defined using cohort-specific cutpoints at 75th, 85th, and 90th percentiles of DXA body fat (%) by age and sex using quantile regression models. Additionally, we examined differences in cardiometabolic risk factors among youth (BMI percentile >85th) above and below various excess adiposity cutpoints.

RESULTS:

Nearly all youth with class 3 obesity (100% male, 100% female; 97% male, 99% female; and 95% male, 96% female; using the 75th, 85th, and 90th DXA percentiles, respectively) and a high proportion of those with class 2 obesity (98% male, 99% female; 92% male, 91% female; and 76% male, 76% female) had excess adiposity. Significant discordance was observed between BMI categorization and DXA-derived excess adiposity among youth with class 1 obesity or overweight. Elevated cardiometabolic risk factors were present in youth with excess adiposity, regardless of the cutpoint used.

CONCLUSIONS:

BMI correctly identifies excess adiposity in most youth with class 2 and 3 obesity but a relatively high degree of discordance was observed in youth with obesity and overweight. Cardiometabolic risk factors are increased in the presence of excess adiposity, regardless of the cutpoint used.

KEYWORDS:

NHANES; adiposity; children; dual energy x-ray absorptiometry; obesity

PMID:
27496270
DOI:
10.1016/j.jpeds.2016.06.059
[Indexed for MEDLINE]
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