Utility of Body Mass Index in Identifying Excess Adiposity in Youth Across the Obesity Spectrum

Justin R. Ryder, Alexander M. Kaizer, Kyle D. Rudser, Stephen R. Daniels, Aaron S. Kelly

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives To determine the proportion of youth within a given body mass index (BMI) obesity category with excess adiposity using dual energy x-ray absorptiometry (DXA). Furthermore, to examine whether mean differences in cardiometabolic risk factors based upon various excess adiposity cutpoints were present. Study design DXA data from the National Health and Nutrition Examination Survey 1999-2006 (n = 10 465; 8-20 years of age) were used for this analysis. Obesity categories were defined using Centers for Disease Control and prevention definitions for age and sex. Excess adiposity was defined using cohort-specific cutpoints at 75th, 85th, and 90th percentiles of DXA body fat (%) by age and sex using quantile regression models. Additionally, we examined differences in cardiometabolic risk factors among youth (BMI percentile >85th) above and below various excess adiposity cutpoints. Results Nearly all youth with class 3 obesity (100% male, 100% female; 97% male, 99% female; and 95% male, 96% female; using the 75th, 85th, and 90th DXA percentiles, respectively) and a high proportion of those with class 2 obesity (98% male, 99% female; 92% male, 91% female; and 76% male, 76% female) had excess adiposity. Significant discordance was observed between BMI categorization and DXA-derived excess adiposity among youth with class 1 obesity or overweight. Elevated cardiometabolic risk factors were present in youth with excess adiposity, regardless of the cutpoint used. Conclusions BMI correctly identifies excess adiposity in most youth with class 2 and 3 obesity but a relatively high degree of discordance was observed in youth with obesity and overweight. Cardiometabolic risk factors are increased in the presence of excess adiposity, regardless of the cutpoint used.

Original languageEnglish (US)
Pages (from-to)255-261.e2
JournalJournal of Pediatrics
Volume177
DOIs
StatePublished - Jan 1 2016

Fingerprint

Adiposity
Body Mass Index
Obesity
X-Rays
Nutrition Surveys
Centers for Disease Control and Prevention (U.S.)
Adipose Tissue

Keywords

  • NHANES
  • adiposity
  • children
  • dual energy x-ray absorptiometry
  • obesity

Cite this

Utility of Body Mass Index in Identifying Excess Adiposity in Youth Across the Obesity Spectrum. / Ryder, Justin R.; Kaizer, Alexander M.; Rudser, Kyle D.; Daniels, Stephen R.; Kelly, Aaron S.

In: Journal of Pediatrics, Vol. 177, 01.01.2016, p. 255-261.e2.

Research output: Contribution to journalArticle

@article{3cbe7c474d6c40b1b57dd4e754ca5e9b,
title = "Utility of Body Mass Index in Identifying Excess Adiposity in Youth Across the Obesity Spectrum",
abstract = "Objectives To determine the proportion of youth within a given body mass index (BMI) obesity category with excess adiposity using dual energy x-ray absorptiometry (DXA). Furthermore, to examine whether mean differences in cardiometabolic risk factors based upon various excess adiposity cutpoints were present. Study design DXA data from the National Health and Nutrition Examination Survey 1999-2006 (n = 10 465; 8-20 years of age) were used for this analysis. Obesity categories were defined using Centers for Disease Control and prevention definitions for age and sex. Excess adiposity was defined using cohort-specific cutpoints at 75th, 85th, and 90th percentiles of DXA body fat ({\%}) by age and sex using quantile regression models. Additionally, we examined differences in cardiometabolic risk factors among youth (BMI percentile >85th) above and below various excess adiposity cutpoints. Results Nearly all youth with class 3 obesity (100{\%} male, 100{\%} female; 97{\%} male, 99{\%} female; and 95{\%} male, 96{\%} female; using the 75th, 85th, and 90th DXA percentiles, respectively) and a high proportion of those with class 2 obesity (98{\%} male, 99{\%} female; 92{\%} male, 91{\%} female; and 76{\%} male, 76{\%} female) had excess adiposity. Significant discordance was observed between BMI categorization and DXA-derived excess adiposity among youth with class 1 obesity or overweight. Elevated cardiometabolic risk factors were present in youth with excess adiposity, regardless of the cutpoint used. Conclusions BMI correctly identifies excess adiposity in most youth with class 2 and 3 obesity but a relatively high degree of discordance was observed in youth with obesity and overweight. Cardiometabolic risk factors are increased in the presence of excess adiposity, regardless of the cutpoint used.",
keywords = "NHANES, adiposity, children, dual energy x-ray absorptiometry, obesity",
author = "Ryder, {Justin R.} and Kaizer, {Alexander M.} and Rudser, {Kyle D.} and Daniels, {Stephen R.} and Kelly, {Aaron S.}",
year = "2016",
month = "1",
day = "1",
doi = "10.1016/j.jpeds.2016.06.059",
language = "English (US)",
volume = "177",
pages = "255--261.e2",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Utility of Body Mass Index in Identifying Excess Adiposity in Youth Across the Obesity Spectrum

AU - Ryder, Justin R.

AU - Kaizer, Alexander M.

AU - Rudser, Kyle D.

AU - Daniels, Stephen R.

AU - Kelly, Aaron S.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objectives To determine the proportion of youth within a given body mass index (BMI) obesity category with excess adiposity using dual energy x-ray absorptiometry (DXA). Furthermore, to examine whether mean differences in cardiometabolic risk factors based upon various excess adiposity cutpoints were present. Study design DXA data from the National Health and Nutrition Examination Survey 1999-2006 (n = 10 465; 8-20 years of age) were used for this analysis. Obesity categories were defined using Centers for Disease Control and prevention definitions for age and sex. Excess adiposity was defined using cohort-specific cutpoints at 75th, 85th, and 90th percentiles of DXA body fat (%) by age and sex using quantile regression models. Additionally, we examined differences in cardiometabolic risk factors among youth (BMI percentile >85th) above and below various excess adiposity cutpoints. Results Nearly all youth with class 3 obesity (100% male, 100% female; 97% male, 99% female; and 95% male, 96% female; using the 75th, 85th, and 90th DXA percentiles, respectively) and a high proportion of those with class 2 obesity (98% male, 99% female; 92% male, 91% female; and 76% male, 76% female) had excess adiposity. Significant discordance was observed between BMI categorization and DXA-derived excess adiposity among youth with class 1 obesity or overweight. Elevated cardiometabolic risk factors were present in youth with excess adiposity, regardless of the cutpoint used. Conclusions BMI correctly identifies excess adiposity in most youth with class 2 and 3 obesity but a relatively high degree of discordance was observed in youth with obesity and overweight. Cardiometabolic risk factors are increased in the presence of excess adiposity, regardless of the cutpoint used.

AB - Objectives To determine the proportion of youth within a given body mass index (BMI) obesity category with excess adiposity using dual energy x-ray absorptiometry (DXA). Furthermore, to examine whether mean differences in cardiometabolic risk factors based upon various excess adiposity cutpoints were present. Study design DXA data from the National Health and Nutrition Examination Survey 1999-2006 (n = 10 465; 8-20 years of age) were used for this analysis. Obesity categories were defined using Centers for Disease Control and prevention definitions for age and sex. Excess adiposity was defined using cohort-specific cutpoints at 75th, 85th, and 90th percentiles of DXA body fat (%) by age and sex using quantile regression models. Additionally, we examined differences in cardiometabolic risk factors among youth (BMI percentile >85th) above and below various excess adiposity cutpoints. Results Nearly all youth with class 3 obesity (100% male, 100% female; 97% male, 99% female; and 95% male, 96% female; using the 75th, 85th, and 90th DXA percentiles, respectively) and a high proportion of those with class 2 obesity (98% male, 99% female; 92% male, 91% female; and 76% male, 76% female) had excess adiposity. Significant discordance was observed between BMI categorization and DXA-derived excess adiposity among youth with class 1 obesity or overweight. Elevated cardiometabolic risk factors were present in youth with excess adiposity, regardless of the cutpoint used. Conclusions BMI correctly identifies excess adiposity in most youth with class 2 and 3 obesity but a relatively high degree of discordance was observed in youth with obesity and overweight. Cardiometabolic risk factors are increased in the presence of excess adiposity, regardless of the cutpoint used.

KW - NHANES

KW - adiposity

KW - children

KW - dual energy x-ray absorptiometry

KW - obesity

UR - http://www.scopus.com/inward/record.url?scp=84997606147&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84997606147&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2016.06.059

DO - 10.1016/j.jpeds.2016.06.059

M3 - Article

VL - 177

SP - 255-261.e2

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

ER -