Evaluation of BMI-based classification of adolescent overweight and obesity: choice of percentage body fat cutoffs exerts a large influence. The COMPASS study

• Published in: European journal of clinical nutrition 2008-10, Vol.62 (10), p.1201-1207
• Main Authors: Neovius, M, Rasmussen, F
• Format: Article
• Language: English
• Subjects: accuracy; Adipose Tissue - metabolism; Adipose Tissue - pathology; Adipose tissues; Adolescent; Adolescents; Area Under Curve; Biological and medical sciences; body composition; Body Composition - physiology; Body fat; Body Mass Index; Body size; Body weight; boys; Classification; Classification systems; Clinical Nutrition; COMPASS Study; Cross-Sectional Studies; Diagnosis; diagnostic techniques; disease diagnosis; Educational Status; Epidemiology; Evaluation; False Negative Reactions; False Positive Reactions; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; gender differences; girls; height; Humans; Internal Medicine; Male; Measurement; Medical sciences; Medical screening; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Metabolic Diseases; Methods; Obesity; Obesity - classification; Obesity - epidemiology; Obesity in adolescence; original-article; Overweight; Overweight - classification; Overweight - epidemiology; Performance evaluation; Population studies; Predictive Value of Tests; Public Health; Reference Values; ROC Curve; Sensitivity analysis; Sensitivity and Specificity; Sex Factors; Sweden - epidemiology; Teenagers; Test methods; test sensitivity; test specificity; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1602846

Objective: To determine the impact of commonly used body fat percentage (%BF) references when evaluating the sensitivity, specificity and misclassifications of body mass index (BMI) for obesity screening in adolescence. Subjects/Methods: A community-based sample of 3334 adolescents aged 15.2 +/- 0.6 years was studied. Weight, height and %BF were measured. Sensitivity, specificity, predictive values and type and extent of misclassifications were calculated. True-positive subjects for overweight and obesity were defined by recently published paediatric %BF cutoffs, 85th and 95th percentiles from the present study population, and an older %BF reference. Results: Regardless of %BF reference used, specificities were high (>0.98 for obesity and >0.90 for overweight) in both sexes, with values for overweight consistently higher for girls (P