title: Body mass index for predicting hyperglycemia and serum lipid changes in Brazilian adolescents.
abstract: OBJECTIVE
  To determine the best cut-offs of body mass index for identifying alterations of blood lipids and glucose in adolescents.
  
  
  METHODS
  A probabilistic sample including 577 adolescent students aged 12-19 years in 2003 (210 males and 367 females) from state public schools in the city of Niterói, Southeastern Brazil, was studied. The Receiver Operating Characteristic curve was used to identify the best age-adjusted BMI cut-off for predicting high levels of serum total cholesterol (> or =150 mg/dL), LDL-C (> or =100 mg/dL), serum triglycerides (> or =100 mg/dL), plasma glucose (> 100 mg/dL) and low levels of HDL-C (< 45 mg/dL). Four references were used to calculate sensitivity and specificity of BMI cut-offs: one Brazilian, one international and two American.
  
  
  RESULTS
  The most prevalent metabolic alterations (>50%) were: high total cholesterol and low HDL-C. BMI predicted high levels of triglycerides in males, high LDL-C in females, and high total cholesterol and the occurrence of three or more metabolic alterations in both males and females (areas under the curve range: 0.59 to 0.67), with low sensitivity (57%-66%) and low specificity (58%-66%). The best BMI cut-offs for this sample (20.3 kg/m(2) to 21.0 kg/m(2)) were lower than those proposed in the references studied.
  
  
  CONCLUSIONS
  Although BMI values lower than the International cut-offs were better predictor of some metabolic abnormalities in Brazilian adolescents, overall BMI is not a good predictor of these abnormalities in this population.
authors.affiliation: Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil. carolreiff@gmail.com
authors.forename: Ana Carolina R
authors.initials: AC
authors.lastname: Vieira
authors.forename: Marlene M
authors.initials: MM
authors.lastname: Alvarez
authors.forename: Salim
authors.initials: S
authors.lastname: Kanaan
authors.forename: Rosely
authors.initials: R
authors.lastname: Sichieri
authors.forename: Gloria V
authors.initials: GV
authors.lastname: Veiga
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002784:Cholesterol / Q000097:blood; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D050177:Overweight / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012016:Reference Values; D017678:Sex Distribution; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol