[Value and usefulness of modified screening test for detection of overweight and obesity in school-aged children and adolescents].
Overweight and obesity has become an increasing problem in school aged children and adolescents also in Poland. Early detection and treatment of this disorder is crucial. On the basis of height and body mass measurements, the body mass index (BMI) is calculated and is used to assess overweight for maximal correlation with body fat. BMI has been widely used to measure obesity in adults worldwide and it is also used in childhood obesity. The cut-off points of BMI value are the main problem in children and adolescents obesity because BMI varies substantially by age and gender during childhood and adolescence. The aim of the study was a comparison of two methods which were used to assess overweight and obesity in adolescents. A modification of the current screening test for physical development disorders is also proposed.


METHODS
in comparative analysis of overweight and obesity prevalence we used data from our survey in a representative group of over 8000 adolescents aged 13-15 years, in 2005. Different standards have been used to define overweight and obesity: using 85th BMI percentile or 90th BMI percentile for overweight and 95th BMI percentile or 97th BMI percentile for obesity.


RESULTS
the two standards produced consistent estimates of the prevalence of obesity in our sample, but prevalence of overweight produced statistical significant differences. We found underestimation of overweight especially in boys using the standard with 90th BMI percentile references. In case of individual screening test, underestimation of overweight may give a falsely negative result.


CONCLUSIONS
1. Using the Polish standards with 85th percentile references as cut-off point of BMI value instead 90th percentile for overweight increases screening sensitivity. 2. National standards with cut-off points BMI> or =85th percentile for overweight and BMI> or =95th percentile (obesity) are also useful tools for estimation of overweight and obesity prevalence in epidemiological studies and in international comparisons.
Oblacińska
Anna
A
Zakład Ochrony i Promocji Zdrowia, Instytut Matki i Dziecka, Kasprzaka 17a, 014-211 Warszawa. anna.oblacinska@imid.med.pl
Jodkowska
Maria
M
Palczewska
Iwona
I
Tabak
Izabela
I
D000273:Adipose Tissue; D000293:Adolescent; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012680:Sensitivity and Specificity