Validation of a BMI cut-off point to predict an adverse cardiometabolic profile with adiposity measurements by dual-energy X-ray absorptiometry in Guatemalan children

Public Health Nutr. 2015 Apr;18(6):951-8. doi: 10.1017/S1368980014001207. Epub 2014 Jun 23.

Abstract

Objective: To identify a body fat percentage (%BF) threshold related to an adverse cardiometabolic profile and its surrogate BMI cut-off point.

Design: Cross-sectional study.

Setting: Two public schools in poor urban areas on the outskirts of Guatemala City.

Subjects: A convenience sample of ninety-three healthy, prepubertal, Ladino children (aged 7-12 years).

Results: Spearman correlations of cardiometabolic parameters were higher with %BF than with BMI-for-age Z-score. BMI-for-age Z-score and %BF were highly correlated (r=0·84). The %BF threshold that maximized sensitivity and specificity for predicting an adverse cardiometabolic profile (elevated homeostasis model assessment-insulin resistance index and/or total cholesterol:HDL-cholesterol ratio) according to receiver operating characteristic curve analysis was 36 %. The BMI-for-age Z-score cut-off point that maximized the prediction of BF ≥ 36 % by the same procedure was 1·5. The area under the curve (AUC) for %BF and for BMI data showed excellent accuracy to predict an adverse cardiometabolic profile (AUC 0·93 (sd 0·04)) and excess adiposity (AUC 0·95 (sd 0·02)).

Conclusions: Since BMI standards have limitations in screening for adiposity, specific cut-off points based on ethnic-/sex- and age-specific %BF thresholds are needed to better predict an adverse cardiometabolic profile.

Keywords: Guatemala.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Absorptiometry, Photon
  • Adiposity*
  • Body Mass Index
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / metabolism
  • Child
  • Child Development
  • Child Nutritional Physiological Phenomena*
  • Cross-Sectional Studies
  • Female
  • Guatemala / epidemiology
  • Humans
  • Insulin Resistance*
  • Male
  • Overweight / physiopathology*
  • Poverty Areas
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors
  • Sensitivity and Specificity
  • Suburban Health*