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Severe Obesity and Cardiometabolic Risk in Children: Comparison from Two International Classification Systems.
- Source :
- PLoS ONE; Dec2013, Vol. 8 Issue 12, p1-8, 8p
- Publication Year :
- 2013
-
Abstract
- Objectives: There is no agreed-upon definition for severe obesity (Sev-OB) in children. We compared estimates of Sev-OB as defined by different cut-points of body mass index (BMI) from the Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO) curves and the ability of each set of cut-points to screen for the presence of cardiometabolic risk factors. Research Design and Methods: Cross-sectional, multicenter study involving 3,340 overweight/obese young subjects. Sev-OB was defined as BMI ≥99<superscript>th</superscript> percentile or ≥1.2 times the 95<superscript>th</superscript> percentile of the CDC or the WHO curves. High blood pressure, hypertriglyceridemia, low High Density Lipoprotein -cholesterol and impaired fasting glucose were considered as cardiometabolic risk factors. Results: The estimated prevalence of Sev-OB varied widely between the two reference systems. Either using the cut-point ≥99<superscript>th</superscript> percentile or ≥1.2 times the 95<superscript>th</superscript> percentile, less children were defined as Sev-OB by CDC than WHO (46.8 vs. 89.5%, and 63.3 vs. 80.4%, respectively p<0.001). The CDC 99<superscript>th</superscript> percentile had lower sensitivity (58.5 vs 94.2), higher specificity (57.6 vs 12.3) and higher positive predictive value (34.4 vs 28.9) than WHO in identifying obese children with ≥2 cardiometabolic risk factors. These differences were mitigated using the 1.2 times the 95<superscript>th</superscript> percentile (sensitivity 73.9 vs. 88.1; specificity 40.7 vs. 22.5; positive predictive value 32.1 vs. 30.1). Substantial agreement between growth curves was found using the 1.2 times the 95<superscript>th</superscript> percentile, in particular in children ≤10 years. Conclusions: Estimates of Sev-OB and cardiometabolic risk as defined by different cut-points of BMI are influenced from the reference systems used. The 1.2 times the 95<superscript>th</superscript> percentile of BMI of either CDC or WHO standard has a discriminatory advantage over the 99<superscript>th</superscript> percentile for identifying severely obese children at increased cardiometabolic risk, particularly under 10 years of age. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 8
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- PLoS ONE
- Publication Type :
- Academic Journal
- Accession number :
- 93397672
- Full Text :
- https://doi.org/10.1371/journal.pone.0083793