title: Screening performances of the International Obesity Task Force body mass index cut-off values in adolescents.
abstract: OBJECTIVE
  To try to improve the International Obesity Task Force (IOTF) BMI cut-off values, in terms of prediction of body fat percentage assessed by dual-energy X-ray absorptiometry (DXA), in adolescents.
  
  
  METHODS
  Cross-sectional survey of the adolescents from the city of Zaragoza (Spain). For this analysis we have included 286 adolescents (116 boys and 170 girls) aged 13.0-17.9 years. Body mass index (BMI) was calculated as body weight (kg), divided by height (m) squared. The percentage of body fat (BF%) was estimated by the use of DXA.
  
  
  RESULTS
  We have calculated, new BMI cut-off values (AVENA cut-offs) to predict BF%, for boys and girls in each age group. In male adolescents, sensitivity was higher with the IOTF cut-offs (0.71, 95th C.I.: 0.44, 0.90) than with the AVENA ones (0.53, 95th C.I.: 0.28, 0.77), and specificity was very similar with both cut-off values (0.86 and 0.88, respectively), the differences being not statistically significant. In girls, both sensitivities (0.75 and 0.79, respectively) and specificities (0.90 and 0.92, respectively) were very similar with both cut-off values, and the differences, not significant.
  
  
  CONCLUSIONS
  Optimization of the IOTF BMI cut-off values, in terms of BF%, seems not to be possible in adolescents. The IOTF criteria should be used only for overweight and obesity screening; however, in clinical settings, a more accurate measure of body fat should be recommended.
authors.affiliation: Department of Pediatrics, University School of Health Sciences, University of Zaragoza, Zaragoza, Spain. lmoreno@unizar.es
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.forename: María G
authors.initials: MG
authors.lastname: Blay
authors.forename: Gerardo
authors.initials: G
authors.lastname: Rodríguez
authors.forename: Vicente A
authors.initials: VA
authors.lastname: Blay
authors.forename: María I
authors.initials: MI
authors.lastname: Mesana
authors.forename: José L
authors.initials: JL
authors.lastname: Olivares
authors.forename: Jesús
authors.initials: J
authors.lastname: Fleta
authors.forename: Antonio
authors.initials: A
authors.lastname: Sarría
authors.forename: Manuel
authors.initials: M
authors.lastname: Bueno
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000273:Adipose Tissue / Q000378:metabolism; D000293:Adolescent; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D009765:Obesity / Q000145:classification* / Q000175:diagnosis*; D012015:Reference Standards; D012680:Sensitivity and Specificity; D012737:Sex Factors