Severe Obesity Defined by Percentiles of WHO and Cardiometabolic Risk in Youth with Obesity
<b>Background/Objectives:</b> The pediatric definition of severe obesity (OB) depends on the body mass index (BMI) references. We evaluated different BMI-derived metrics of the World Health Organization (WHO) system to define which cut-off is associated with the highest cardiometabolic r...
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MDPI AG
2024-11-01
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| author | Giuliana Valerio Procolo Di Bonito Anna Di Sessa Giada Ballarin Valeria Calcaterra Domenico Corica Maria Felicia Faienza Francesca Franco Maria Rosaria Licenziati Claudio Maffeis Giulio Maltoni Emanuele Miraglia del Giudice Anita Morandi Enza Mozzillo Malgorzata Wasniewska |
| author_facet | Giuliana Valerio Procolo Di Bonito Anna Di Sessa Giada Ballarin Valeria Calcaterra Domenico Corica Maria Felicia Faienza Francesca Franco Maria Rosaria Licenziati Claudio Maffeis Giulio Maltoni Emanuele Miraglia del Giudice Anita Morandi Enza Mozzillo Malgorzata Wasniewska |
| author_sort | Giuliana Valerio |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> The pediatric definition of severe obesity (OB) depends on the body mass index (BMI) references. We evaluated different BMI-derived metrics of the World Health Organization (WHO) system to define which cut-off is associated with the highest cardiometabolic risk (CMR); <b>Methods:</b> In this multicentric study, data were retrieved for 3727 youths (1937 boys; 2225 children, 1502 adolescents). OB was defined as BMI > 97th percentile (BMI<sub>97th</sub>), severe OB was defined as BMI > 99th percentile (BMI<sub>99th</sub>), BMI ≥ 120% of the 97th percentile (120% BMI<sub>97th</sub>), or BMI Z-score > 3 (WHO tables), or BMI ≥ the International Obesity Task Force (IOTF) value crossing a BMI of 35 kg/m<sup>2</sup> at the age of 18 (IOTF<sub>35</sub>). The continuous CMR Z-score (sum of residual standardized for age and sex of waist-to-height ratio, systolic and diastolic blood pressure, triglycerides, and HDL-cholesterol x −1) and the cluster of at least two CMR factors (hypertension, high triglycerides, low HDL-cholesterol, and high waist-to-height ratio) were calculated. <b>Results:</b> Continuous CMR Z-score was significantly higher both in children or adolescents with severe OB defined by 120% BMI<sub>97th</sub> compared to BMI<sub>99th</sub> (<i>p</i> < 0.0001), while it was lower only in adolescents with severe OB defined by 120% BMI<sub>97th</sub> compared to BMI Z-score >3 (<i>p</i> < 0.0001). Compared to 120% BMI<sub>97th</sub>, BMI Z-score > 3 and IOTF<sub>35</sub> had higher specificity, but lower sensitivity in identifying children and adolescents with clustered CMR factors. <b>Conclusions:</b> The definition of severe OB based on 120% BMI<sub>97th</sub> is superior to BMI<sub>99th</sub> but it is inferior to BMI Z score > 3 as far as the association between severe OB and CMR factors is concerned. Pediatricians should take into consideration the implication of the use of different BMI metrics in those countries that recommend the WHO system. WHO BMI Z-score > 3 and IOTF<sub>35</sub> can be used interchangeably to predict cardiometabolic risk. |
| format | Article |
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| institution | Kabale University |
| issn | 2227-9067 |
| language | English |
| publishDate | 2024-11-01 |
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| spelling | doaj-art-7259825750ff4ad4b5e48b32c76dfdb62024-11-26T17:57:32ZengMDPI AGChildren2227-90672024-11-011111134510.3390/children11111345Severe Obesity Defined by Percentiles of WHO and Cardiometabolic Risk in Youth with ObesityGiuliana Valerio0Procolo Di Bonito1Anna Di Sessa2Giada Ballarin3Valeria Calcaterra4Domenico Corica5Maria Felicia Faienza6Francesca Franco7Maria Rosaria Licenziati8Claudio Maffeis9Giulio Maltoni10Emanuele Miraglia del Giudice11Anita Morandi12Enza Mozzillo13Malgorzata Wasniewska14Department of Medical, Movement Sciences and Wellbeing, University of Napoli “Parthenope”, 80133 Napoli, ItalyDepartment of Internal Medicine, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, ItalyDepartment of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, ItalyDepartment of Medical, Movement Sciences and Wellbeing, University of Napoli “Parthenope”, 80133 Napoli, ItalyDepartment of Internal Medicine, University of Pavia, 27100 Pavia, ItalyDepartment of Human Pathology in Adulthood and Childhood, University of Messina, 98122 Messina, ItalyPediatric Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, 70124 Bari, ItalyPediatric Department, Azienda Sanitaria Universitaria Friuli Centrale, Hospital of Udine, 33100 Udine, ItalyNeuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Napoli, ItalyDepartment of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, ItalyPediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDepartment of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, ItalyDepartment of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, ItalySection of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetes, University of Naples “Federico II”, 80131 Napoli, ItalyDepartment of Human Pathology in Adulthood and Childhood, University of Messina, 98122 Messina, Italy<b>Background/Objectives:</b> The pediatric definition of severe obesity (OB) depends on the body mass index (BMI) references. We evaluated different BMI-derived metrics of the World Health Organization (WHO) system to define which cut-off is associated with the highest cardiometabolic risk (CMR); <b>Methods:</b> In this multicentric study, data were retrieved for 3727 youths (1937 boys; 2225 children, 1502 adolescents). OB was defined as BMI > 97th percentile (BMI<sub>97th</sub>), severe OB was defined as BMI > 99th percentile (BMI<sub>99th</sub>), BMI ≥ 120% of the 97th percentile (120% BMI<sub>97th</sub>), or BMI Z-score > 3 (WHO tables), or BMI ≥ the International Obesity Task Force (IOTF) value crossing a BMI of 35 kg/m<sup>2</sup> at the age of 18 (IOTF<sub>35</sub>). The continuous CMR Z-score (sum of residual standardized for age and sex of waist-to-height ratio, systolic and diastolic blood pressure, triglycerides, and HDL-cholesterol x −1) and the cluster of at least two CMR factors (hypertension, high triglycerides, low HDL-cholesterol, and high waist-to-height ratio) were calculated. <b>Results:</b> Continuous CMR Z-score was significantly higher both in children or adolescents with severe OB defined by 120% BMI<sub>97th</sub> compared to BMI<sub>99th</sub> (<i>p</i> < 0.0001), while it was lower only in adolescents with severe OB defined by 120% BMI<sub>97th</sub> compared to BMI Z-score >3 (<i>p</i> < 0.0001). Compared to 120% BMI<sub>97th</sub>, BMI Z-score > 3 and IOTF<sub>35</sub> had higher specificity, but lower sensitivity in identifying children and adolescents with clustered CMR factors. <b>Conclusions:</b> The definition of severe OB based on 120% BMI<sub>97th</sub> is superior to BMI<sub>99th</sub> but it is inferior to BMI Z score > 3 as far as the association between severe OB and CMR factors is concerned. Pediatricians should take into consideration the implication of the use of different BMI metrics in those countries that recommend the WHO system. WHO BMI Z-score > 3 and IOTF<sub>35</sub> can be used interchangeably to predict cardiometabolic risk.https://www.mdpi.com/2227-9067/11/11/1345body mass index z-scorecardiometabolic risksevere obesityinternational obesity task forceworld health organization |
| spellingShingle | Giuliana Valerio Procolo Di Bonito Anna Di Sessa Giada Ballarin Valeria Calcaterra Domenico Corica Maria Felicia Faienza Francesca Franco Maria Rosaria Licenziati Claudio Maffeis Giulio Maltoni Emanuele Miraglia del Giudice Anita Morandi Enza Mozzillo Malgorzata Wasniewska Severe Obesity Defined by Percentiles of WHO and Cardiometabolic Risk in Youth with Obesity Children body mass index z-score cardiometabolic risk severe obesity international obesity task force world health organization |
| title | Severe Obesity Defined by Percentiles of WHO and Cardiometabolic Risk in Youth with Obesity |
| title_full | Severe Obesity Defined by Percentiles of WHO and Cardiometabolic Risk in Youth with Obesity |
| title_fullStr | Severe Obesity Defined by Percentiles of WHO and Cardiometabolic Risk in Youth with Obesity |
| title_full_unstemmed | Severe Obesity Defined by Percentiles of WHO and Cardiometabolic Risk in Youth with Obesity |
| title_short | Severe Obesity Defined by Percentiles of WHO and Cardiometabolic Risk in Youth with Obesity |
| title_sort | severe obesity defined by percentiles of who and cardiometabolic risk in youth with obesity |
| topic | body mass index z-score cardiometabolic risk severe obesity international obesity task force world health organization |
| url | https://www.mdpi.com/2227-9067/11/11/1345 |
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