Accuracy of obesity diagnosis in Brazilian adolescents: comparison of Cole et al and Must et al criteria with DXA percentage of fat mass
OLIVEIRA FLC, TADDEI JAA, ESCRIVÃO MAM, COBAYASHI F, BARROS ME, VITOLO MR, COLUGNATI FAB, ANCONA-LÓPEZ F
Nutrición Hospitalaria 2006;21(4): 484-490
Resumen del Autor:
Objectives: to assess the accuracy of the two most
used anthropometric criteria: Must and Cole to diagnose
obesity in adolescence comparing with percentage of
fat mass determined by DXA.
Methodology: cross-sectional study with 418 adolescents
(52.4% males) attending a private school in São
Paulo/Brazil. Anthropometric measures of height and
weight were taken and BMI was calculated. Analysis of
body composition was performed using the DXA to detect
percentage of fat mass. Using the method proposed
by Ellis & Wong (ERM) two sex-specific linear regression
models of fat percentage for age in years were fitted.
The comparison between the methods was carried out
through the analyses of specificity and sensitivity with
two residual percentiles as cutoff points (ERM85th and
ERM95th) as standards. A logistic model was fitted to
estimate the probability curves of obesity classification.
Results: the comparison of the two classic criteria for
the diagnosis of obesity with the ERM85th and ERM 95th,
yields for females the same sensitivities of 0.50 and 0.20
for both criteria. For males sensitivities for ERM 85th
were 0.61(Must) and 0.49 (Cole); while for ERM95th the
sensitivities were 0.81 (Must) and 0.64 (Cole). Therefore,
there are high probabilities that those criteria diagnose
adolescents as obese, when actually they are not.
Conclusion: the Must and Cole criteria were similar
and present flaws for the diagnosis of obesity. In clinical
practice and field studies anthropometric criteria should
be evaluated as to the diagnostic accuracy along with other clinical parameters and, when feasible, the analysis
of fatness percentage. However, the anthropometric criteria
evaluated are efficient in the identification of nonobese
adolescent in the two cutoff points considered.
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