Session: SAT 677-696-Obesity Physiology & Epidemiology
Poster Board SAT-687
Design: Data sources were MEDLINE, EMBASE, Cochrane, Database of Systematic Reviews, Cochrane CENTRAL, Web of Science, and SCOPUS. To be included, studies must have assessed the performance of BMI to measure body adiposity in children and teenagers up to the age of 19 years, provided standard values of diagnostic performance, and used a body composition technique as the reference standard for body fat percent (BF%) measurement. We obtained pooled summary statistics for sensitivity, specificity, positive and negative likelihood ratios (LRs), and diagnostic odds ratio (DOR). The inconsistency statistic (I2) assessed potential heterogeneity.
Results: The search strategy yielded 1412 potentially relevant abstracts, and 37 articles met our predefined inclusion criteria. The studies evaluated a total of 53,521 patients, with a mean age ranging from 4 to 18 years old. Gender-specific data were present in 34 of the 37 studies, which include 18,429 males and 22,781 females. Commonly used BMI cutoffs to diagnose obesity showed a pooled sensitivity to detect high adiposity of 0.70 (95% confidence interval (CI) 0.69 – 0.71) and a pooled specificity of 0.93 (CI 0.93 – 0.93). LR+ was 11.14 (CI 9.25 – 13.41), I2 96.6%; LR- was 0.26 (CI 0.21-0.31), I2 97.6%; and DOR 54.61 (CI 42.41 – 70.32), I2 87.3%. In males, BMI showed a pooled sensitivity of 0.71 (CI0.69 – 0.73), and a pooled specificity of 0.95 (CI 0.95 – 0.96). LR + was 13.53 (10.74 – 17.05), I2 84.5%; LR- was 0.33 (CI 0.25 – 0.44), I2 96.5%; and DOR was 53.18 (36.64 – 77.21), I2 78.4%. As for females, BMI showed a pooled sensitivity of 0.64 (CI 0.62 – 0.68), a pooled specificity of 0.95 (CI 0.94 – 0.95), LR + of 14.74 (CI 10.77 – 20.16), I2 95.1%; LR- of 0.28 (CI 0.22 – 0.35), I2 97.6%; and a DOR of 68.19 (48.8 – 95.30), I2 76.2%.
Cutoff values and regional origin of the studies can only partially explain the heterogeneity seen in pooled DOR estimates.
Conclusion: Commonly used BMI cutoff values to diagnose obesity have high specificity, but low sensitivity to identify adiposity, as they fail to identify over a quarter of children with excess BF%.
Nothing to Disclose: AJ, MJ, DO, SK, FL
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