Validity of body mass index and waist circumference to detect excess fat mass in children aged 7–14 years

Background/Objectives: To evaluate the screening performance of body mass index (BMI) and waist circumference (WC) for excess adiposity. In addition, the diagnostic accuracy of cutoffs from different international and national reference systems based on BMI and WC was investigated. Subjects/Methods:...

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Bibliographic Details
Published in:European journal of clinical nutrition 2011-02, Vol.65 (2), p.151-159
Main Authors: Glasser, N, Zellner, K, Kromeyer-Hauschild, K
Format: Article
Language:English
Subjects:
Adipose tissue
Adipose Tissue - metabolism
Adipose Tissue - pathology
Adiposity
Adolescent
Anthropometry - methods
Biological and medical sciences
Body Composition - physiology
Body fat
Body mass
Body Mass Index
Body size
Child
Children
Children & youth
Classification systems
Cross-Sectional Studies
Epidemiology
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
Girls
Health aspects
Humans
Male
Mass Screening
Measurement techniques
Medical sciences
Metabolic diseases
Obesity
Obesity - classification
Obesity - diagnosis
Overweight - classification
Overweight - diagnosis
Predictive Value of Tests
Reference systems
Reference Values
ROC Curve
Screening
Sensitivity
Sensitivity and Specificity
Sex Factors
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Waist Circumference
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Summary:Background/Objectives: To evaluate the screening performance of body mass index (BMI) and waist circumference (WC) for excess adiposity. In addition, the diagnostic accuracy of cutoffs from different international and national reference systems based on BMI and WC was investigated. Subjects/Methods: Data from 2132 Jena children aged 7–14 years conducted in 2005/2006 were analyzed. Receiver operating characteristic (ROC) curves were constructed to assess BMI and WC, as screening measures for excess adiposity (derived from skinfolds). Sensitivity, specificity and positive predictive values (PPVs) were calculated for two BMI-based classification systems (IOTF and German reference) and sample-based WC cutoffs. Results: The BMI as well as the WC performed well in detecting excess fat mass, indicated by areas under the ROC curve (AUC) close to 1.0, with slightly greater AUCs for BMI than for WC in both sexes. The specificity of all reference systems was high for both sexes (95 to 98%). However, their sensitivities were low (53–67% in boys; 51–67% in girls). PPV were higher for the German reference and the sample-based WC cutoffs than for the IOTF reference, and higher in girls than in boys. Conclusions: The setting in which the reference system should be used is important for the selection of the reference system. The results support the use of the BMI-based references for monitoring in epidemiological studies. The sample-based cutoffs for WC should be refined for clinical use on national level.
ISSN:0954-3007
1476-5640
DOI:10.1038/ejcn.2010.245