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

Katrin Kromeyer-Hauschild (1) , Nancy Glässer (1) , Konrad Zellner (1)

1 Institute of Human Genetics and Anthropology

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. 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 (PPV) 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 % to 67 % in boys; 51 % to 67 % in girls). PPV were higher for the German reference and the sample-based WC cutoffs than 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. Keywords: body mass index, waist circumference, excess adiposity, ROC analysis, children

Mots clés: body mass index; waist circumference; excess adiposity; ROC analysis; children

Katrin Kromeyer-Hauschild, Nancy Glässer, Konrad Zellner. Validity of body mass index and waist circumference to detect excess fat mass in children aged 7-14 years. European Journal of Clinical Nutrition, 2010, ⟨10.1038/ejcn.2010.245⟩. ⟨hal-00589963⟩