Anita Morandi1, Emanuele Miraglia Del Giudice2, Francesco Martino3, Eliana Martino3, Mauro Bozzola4, Claudio Maffeis5. 1. Center for Pediatric Diabetes, Clinical Nutrition and Obesity, University of Verona, Verona, Italy. Electronic address: anita.morandi@univr.it. 2. Department of Pediatrics, 'F. Fede' Seconda Università degli Studi di Napoli, Naples, Italy. 3. Department of Pediatrics, "La Sapienza" University, Rome, Italy. 4. Internal Medicine and Therapeutics Department, University of Pavia, Pavia, Italy. 5. Center for Pediatric Diabetes, Clinical Nutrition and Obesity, University of Verona, Verona, Italy.
Abstract
OBJECTIVE: To assess the accuracy of body mass index (BMI), Z score of the BMI, waist circumference, and waist-to-height ratio in selecting obese children with fasting metabolic impairments or impaired glucose tolerance. STUDY DESIGN: In a cohort of 883 obese children and adolescents (age 8-18 years), we assessed the associations of anthropometric indices with traditional metabolic complications of obesity (impaired fasting glucose, impaired glucose tolerance, hypertension, high triglycerides, low high-density lipoprotein-cholesterol). The accuracy of anthropometric indices as markers of metabolic impairment was assessed by receiver operating characteristic analysis and the areas under the receiver operating characteristics curves (AUROCs) of anthropometric indices were compared with each other by the DeLong test. RESULTS: BMI, Z score of the BMI, waist circumference, and waist-to-height ratio were associated with metabolic impairments but showed low to moderate accuracy in discriminating both single and clustered metabolic impairments. The AUROCs ranged from 0.55-0.70. The 4 anthropometric indices did not show significantly different AUROCs as predictors of clustered metabolic risk factors (all P values of DeLong tests: >.05). CONCLUSIONS: Commonly used anthropometric indices are not satisfactory markers of metabolic comorbidity among obese children and adolescents and should not be adopted as screening tools for the metabolic assessment of this category of patients.
OBJECTIVE: To assess the accuracy of body mass index (BMI), Z score of the BMI, waist circumference, and waist-to-height ratio in selecting obesechildren with fasting metabolic impairments or impaired glucose tolerance. STUDY DESIGN: In a cohort of 883 obesechildren and adolescents (age 8-18 years), we assessed the associations of anthropometric indices with traditional metabolic complications of obesity (impaired fasting glucose, impaired glucose tolerance, hypertension, high triglycerides, low high-density lipoprotein-cholesterol). The accuracy of anthropometric indices as markers of metabolic impairment was assessed by receiver operating characteristic analysis and the areas under the receiver operating characteristics curves (AUROCs) of anthropometric indices were compared with each other by the DeLong test. RESULTS: BMI, Z score of the BMI, waist circumference, and waist-to-height ratio were associated with metabolic impairments but showed low to moderate accuracy in discriminating both single and clustered metabolic impairments. The AUROCs ranged from 0.55-0.70. The 4 anthropometric indices did not show significantly different AUROCs as predictors of clustered metabolic risk factors (all P values of DeLong tests: >.05). CONCLUSIONS: Commonly used anthropometric indices are not satisfactory markers of metabolic comorbidity among obesechildren and adolescents and should not be adopted as screening tools for the metabolic assessment of this category of patients.
Authors: Gert-Jan van der Heijden; Zhiyue J Wang; Zili D Chu; Morey Haymond; Pieter J J Sauer; Agneta L Sunehag Journal: Children (Basel) Date: 2018-06-15