Childhood obesity classification systems and cardiometabolic risk factors

Giuliana Valerio, Antonio Balsamo, Marco Giorgio Baroni, Claudia Brufani, Claudia Forziato, Graziano Grugni, Maria Rosaria Licenziati, Claudio Maffeis, Emanuele Miraglia Del Giudice, Anita Morandi, Lucia Pacifico, Alessandro Sartorio, Melania Manco

Research output: Contribution to journalArticle

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Abstract

Background: Body Mass Index Italian reference data are available for clinical and/or epidemiological use, but no study compared the ability of this system to classify overweight and obesity and detect subjects with clustered cardiometabolic risk factors with international standards. Therefore our aim was to assess 1) the agreement among the Italian Society for Pediatric Endocrinology and Diabetology (ISPED), the World Health Organisation (WHO) and the International Obesity Task Force (IOTF) Body Mass Index cut-offs in estimating overweight or obesity in children and adolescents; 2) the ability of each above-mentioned set of cut-points to detect subjects with cardiometabolic risk factors. Methods: Data of 6070 Italian subjects aged 5-17 years were collected. Prevalence of normal-weight, overweight and obesity was determined using three classification systems: ISPED, WHO and IOTF. High blood pressure, hypertriglyceridemia, low high density lipoprotein-cholesterol and impaired fasting glucose were considered as cardiometabolic risk factors. Results: ISPED and IOTF classified more subjects as normal-weight or overweight and less subjects as obese as compared to WHO (p 0.900), while it differed for obesity definition, ranging from the highest agreement between ISPED and IOTF (k 0.875) to the lowest between ISPED and WHO (k 0.664). WHO had the highest sensitivity, while ISPED and IOTF systems had the highest specificity, in identifying obese subjects with clustered cardiometabolic risk factors. Analogous results were found in subjects stratified by gender or age. Conclusions: ISPED and IOTF systems performed similarly in assessing overweight and obesity, and were more specific in identifying obese children/adolescents with clustered cardiometabolic risk factors; on the contrary, the WHO system was more sensitive. Given the seriousness of the obesity epidemic, we wonder whether the WHO system should be preferable to the national standards for clinical practice and/or obesity screening.
Original languageEnglish
JournalItalian Journal of Pediatrics
Volume43
DOIs
Publication statusPublished - Feb 4 2017

Fingerprint

Pediatric Obesity
Obesity
Endocrinology
Advisory Committees
Pediatrics
Aptitude
Body Mass Index
Weights and Measures
Hypertriglyceridemia
LDL Cholesterol
HDL Cholesterol
Fasting

Keywords

  • Adolescents
  • Body mass index
  • Cardiometabolic risk factors
  • Children
  • Classification
  • Cut-offs
  • Obesity
  • Overweight

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Childhood obesity classification systems and cardiometabolic risk factors. / Valerio, Giuliana; Balsamo, Antonio; Baroni, Marco Giorgio; Brufani, Claudia; Forziato, Claudia; Grugni, Graziano; Licenziati, Maria Rosaria; Maffeis, Claudio; Miraglia Del Giudice, Emanuele; Morandi, Anita; Pacifico, Lucia; Sartorio, Alessandro; Manco, Melania.

In: Italian Journal of Pediatrics, Vol. 43, 04.02.2017.

Research output: Contribution to journalArticle

Valerio, G, Balsamo, A, Baroni, MG, Brufani, C, Forziato, C, Grugni, G, Licenziati, MR, Maffeis, C, Miraglia Del Giudice, E, Morandi, A, Pacifico, L, Sartorio, A & Manco, M 2017, 'Childhood obesity classification systems and cardiometabolic risk factors', Italian Journal of Pediatrics, vol. 43. https://doi.org/10.1186/s13052-017-0338-z
Valerio, Giuliana ; Balsamo, Antonio ; Baroni, Marco Giorgio ; Brufani, Claudia ; Forziato, Claudia ; Grugni, Graziano ; Licenziati, Maria Rosaria ; Maffeis, Claudio ; Miraglia Del Giudice, Emanuele ; Morandi, Anita ; Pacifico, Lucia ; Sartorio, Alessandro ; Manco, Melania. / Childhood obesity classification systems and cardiometabolic risk factors. In: Italian Journal of Pediatrics. 2017 ; Vol. 43.
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AU - Licenziati, Maria Rosaria

AU - Maffeis, Claudio

AU - Miraglia Del Giudice, Emanuele

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AB - Background: Body Mass Index Italian reference data are available for clinical and/or epidemiological use, but no study compared the ability of this system to classify overweight and obesity and detect subjects with clustered cardiometabolic risk factors with international standards. Therefore our aim was to assess 1) the agreement among the Italian Society for Pediatric Endocrinology and Diabetology (ISPED), the World Health Organisation (WHO) and the International Obesity Task Force (IOTF) Body Mass Index cut-offs in estimating overweight or obesity in children and adolescents; 2) the ability of each above-mentioned set of cut-points to detect subjects with cardiometabolic risk factors. Methods: Data of 6070 Italian subjects aged 5-17 years were collected. Prevalence of normal-weight, overweight and obesity was determined using three classification systems: ISPED, WHO and IOTF. High blood pressure, hypertriglyceridemia, low high density lipoprotein-cholesterol and impaired fasting glucose were considered as cardiometabolic risk factors. Results: ISPED and IOTF classified more subjects as normal-weight or overweight and less subjects as obese as compared to WHO (p 0.900), while it differed for obesity definition, ranging from the highest agreement between ISPED and IOTF (k 0.875) to the lowest between ISPED and WHO (k 0.664). WHO had the highest sensitivity, while ISPED and IOTF systems had the highest specificity, in identifying obese subjects with clustered cardiometabolic risk factors. Analogous results were found in subjects stratified by gender or age. Conclusions: ISPED and IOTF systems performed similarly in assessing overweight and obesity, and were more specific in identifying obese children/adolescents with clustered cardiometabolic risk factors; on the contrary, the WHO system was more sensitive. Given the seriousness of the obesity epidemic, we wonder whether the WHO system should be preferable to the national standards for clinical practice and/or obesity screening.

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