PLoS ONE (Jan 2013)

Severe obesity and cardiometabolic risk in children: comparison from two international classification systems.

  • Giuliana Valerio,
  • Claudio Maffeis,
  • Antonio Balsamo,
  • Emanuele Miraglia Del Giudice,
  • Claudia Brufani,
  • Graziano Grugni,
  • Maria Rosaria Licenziati,
  • Paolo Brambilla,
  • Melania Manco,
  • Childhood Obesity Group of the Italian Society of Pediatric Endocrinology and Diabetology

DOI
https://doi.org/10.1371/journal.pone.0083793
Journal volume & issue
Vol. 8, no. 12
p. e83793

Abstract

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ObjectivesThere is no agreed-upon definition for severe obesity (Sev-OB) in children. We compared estimates of Sev-OB as defined by different cut-points of body mass index (BMI) from the Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO) curves and the ability of each set of cut-points to screen for the presence of cardiometabolic risk factors.Research design and methodsCross-sectional, multicenter study involving 3,340 overweight/obese young subjects. Sev-OB was defined as BMI ≥ 99(th) percentile or ≥ 1.2 times the 95(th) percentile of the CDC or the WHO curves. High blood pressure, hypertriglyceridemia, low High Density Lipoprotein -cholesterol and impaired fasting glucose were considered as cardiometabolic risk factors.ResultsThe estimated prevalence of Sev-OB varied widely between the two reference systems. Either using the cut-point ≥ 99(th) percentile or ≥ 1.2 times the 95(th) percentile, less children were defined as Sev-OB by CDC than WHO (46.8 vs. 89.5%, and 63.3 vs. 80.4%, respectively pConclusionsEstimates of Sev-OB and cardiometabolic risk as defined by different cut-points of BMI are influenced from the reference systems used. The 1.2 times the 95(th) percentile of BMI of either CDC or WHO standard has a discriminatory advantage over the 99(th) percentile for identifying severely obese children at increased cardiometabolic risk, particularly under 10 years of age.