title: Diagnostic performance of skinfold method to identify obesity as measured by air displacement plethysmography in cardiac rehabilitation.
abstract: OBJECTIVE
  To assess the diagnostic performance of the skinfold (SKF) method to detect obesity in patients enrolled in an outpatient cardiac rehabilitation (CR) program.
  
  
  METHODS
  This study involves outpatients attending a phase II CR program who underwent air displacement plethysmography (ADP) to assess body composition. We measured body fat percentage (BF%), using a 3-site SKF method calculated through the Jackson-Pollock equation utilizing a Harpenden caliper. Air displacement plethysmography calculated BF% using a bicompartmental model, deriving the body composition after the direct calculation of body density (BD), using the Siri equation [(BF% = 495/BD) - 450]. We calculated the diagnostic performance of SKF to detect obesity, utilizing a BF% cutoff of ≥35% for women and ≥25% for men determined by SKF and ADP to define obesity.
  
  
  RESULTS
  Our sample (n = 310) was 80% men, 60.2 ± 11 years of age, had a mean weight of 89.88 ± 17.96 kg, height 173.38 ± 8.68 cm, body mass index (BMI) 29.78 ± 5.01 kg/m, waist circumference 100.55 ± 14.38 cm, and waist-to-hip ratio of 0.96 ± 0.09. The evaluation of the diagnostic performance of SKF to detect obesity showed a sensitivity of 57%, specificity of 93%, a positive predictive value of 97%, and a negative predictive value of 33%. These values were not different from the diagnostic performance of BMI to detect obesity as defined by BF%. SKF and BMI misclassified 43% and 49% of obese patients as nonobese, respectively.
  
  
  CONCLUSIONS
  Our findings underscore the limitation of using SKF to assess body fatness in the CR setting.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota (Drs Rodriguez-Escudero, Pack, Somers, Thomas, Squires, Sochor, Allison, and Lopez-Jimenez); and Department of Cardiovascular Diseases, International Clinic Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic (Dr Sochor).
authors.forename: Juan P
authors.initials: JP
authors.lastname: Rodriguez-Escudero
authors.forename: Quinn R
authors.initials: QR
authors.lastname: Pack
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
authors.forename: Randal J
authors.initials: RJ
authors.lastname: Thomas
authors.forename: Ray W
authors.initials: RW
authors.lastname: Squires
authors.forename: Ondrej
authors.initials: O
authors.lastname: Sochor
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Allison
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis*; D015588:Observer Variation; D010991:Plethysmography / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012885:Skinfold Thickness