Indexes of adiposity and body composition in the prediction of metabolic syndrome in obese children and adolescents: Which is the best?


Journal

Nutrition, metabolism, and cardiovascular diseases : NMCD
ISSN: 1590-3729
Titre abrégé: Nutr Metab Cardiovasc Dis
Pays: Netherlands
ID NLM: 9111474

Informations de publication

Date de publication:
11 2019
Historique:
received: 05 11 2018
revised: 13 06 2019
accepted: 13 06 2019
pubmed: 6 8 2019
medline: 19 2 2020
entrez: 6 8 2019
Statut: ppublish

Résumé

There is no agreement about which index of adiposity and/or body composition is the most accurate in identifying the metabolic syndrome (METS). The aim of our study was to compare the accuracy of the different indexes in order to recognize the most reliable. We evaluated 1332 obese children and adolescents (778 females and 554 males), aged 14.4 ± 1.8 yrs, Body Mass Index (BMI) standard deviation scores (SDS) 2.99 ± 0.55, followed at the Istituto Auxologico Italiano, a tertiary center for childhood obesity. For each subject the following indexes were assessed: BMI, BMI SDS, Fat-Free Mass Index (FFMI), Fat Mass Index (FMI), Tri-Ponderal Mass Index (TMI), Waist-to-Height ratio (WtHR) and a new one, the Body Mass Fat Index (BMFI), which normalizes the BMI for percentage of body fat and the waist circumference. Thereafter we calculated for each index a threshold value for age and sex, in order to compare their accuracy, sensitivity and specificity in identifying the METS. There was a good correlation among indexes (p < 0.0001 for all). However, when the area under the curve (AUC) was compared, some of them, in particular the BMFI and the BMI, performed better than the other ones, although the differences were small. BMI, which neither considers body composition nor fat distribution, performs as good as other indexes, and should therefore be the preferred one, also because of the easiness of its calculation.

Sections du résumé

BACKGROUND AND AIM
There is no agreement about which index of adiposity and/or body composition is the most accurate in identifying the metabolic syndrome (METS). The aim of our study was to compare the accuracy of the different indexes in order to recognize the most reliable.
METHODS AND RESULTS
We evaluated 1332 obese children and adolescents (778 females and 554 males), aged 14.4 ± 1.8 yrs, Body Mass Index (BMI) standard deviation scores (SDS) 2.99 ± 0.55, followed at the Istituto Auxologico Italiano, a tertiary center for childhood obesity. For each subject the following indexes were assessed: BMI, BMI SDS, Fat-Free Mass Index (FFMI), Fat Mass Index (FMI), Tri-Ponderal Mass Index (TMI), Waist-to-Height ratio (WtHR) and a new one, the Body Mass Fat Index (BMFI), which normalizes the BMI for percentage of body fat and the waist circumference. Thereafter we calculated for each index a threshold value for age and sex, in order to compare their accuracy, sensitivity and specificity in identifying the METS. There was a good correlation among indexes (p < 0.0001 for all). However, when the area under the curve (AUC) was compared, some of them, in particular the BMFI and the BMI, performed better than the other ones, although the differences were small.
CONCLUSIONS
BMI, which neither considers body composition nor fat distribution, performs as good as other indexes, and should therefore be the preferred one, also because of the easiness of its calculation.

Identifiants

pubmed: 31378631
pii: S0939-4753(19)30239-X
doi: 10.1016/j.numecd.2019.06.011
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1189-1196

Informations de copyright

Copyright © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Auteurs

Giorgio Radetti (G)

Marienklinik, Bolzano, Italy. Electronic address: giorgio.radetti@gmail.com.

Antonio Fanolla (A)

Observatory for Health Provincial Government South Tyrol, Italy.

Graziano Grugni (G)

Istituto Auxologico Italiano, Experimental Laboratory for Auxo-endocrinological Research & Division of Auxology, Verbania, Italy.

Fiorenzo Lupi (F)

Department of Pediatrics, Regional Hospital of Bolzano, Italy.

Alessandro Sartorio (A)

Istituto Auxologico Italiano, Experimental Laboratory for Auxo-endocrinological Research & Division of Auxology, Verbania, Italy.

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