title: Validation of a BMI cut-off point to predict an adverse cardiometabolic profile with adiposity measurements by dual-energy X-ray absorptiometry in Guatemalan children.
abstract: OBJECTIVE
  To identify a body fat percentage (%BF) threshold related to an adverse cardiometabolic profile and its surrogate BMI cut-off point.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Two public schools in poor urban areas on the outskirts of Guatemala City.
  
  
  METHODS
  A convenience sample of ninety-three healthy, prepubertal, Ladino children (aged 7-12 years).
  
  
  RESULTS
  Spearman correlations of cardiometabolic parameters were higher with %BF than with BMI-for-age Z-score. BMI-for-age Z-score and %BF were highly correlated (r=0·84). The %BF threshold that maximized sensitivity and specificity for predicting an adverse cardiometabolic profile (elevated homeostasis model assessment-insulin resistance index and/or total cholesterol:HDL-cholesterol ratio) according to receiver operating characteristic curve analysis was 36 %. The BMI-for-age Z-score cut-off point that maximized the prediction of BF ≥ 36 % by the same procedure was 1·5. The area under the curve (AUC) for %BF and for BMI data showed excellent accuracy to predict an adverse cardiometabolic profile (AUC 0·93 (sd 0·04)) and excess adiposity (AUC 0·95 (sd 0·02)).
  
  
  CONCLUSIONS
  Since BMI standards have limitations in screening for adiposity, specific cut-off points based on ethnic-/sex- and age-specific %BF thresholds are needed to better predict an adverse cardiometabolic profile.
authors: 1Social and Cardiovascular Epidemiology Research Group,School of Medicine,University of Alcalá,Alcalá de Henares,Madrid 28871,Spain.
authors: Olga
authors: O
authors: Redondo
authors: 3Department of Epidemiology,School of Public Health,University of Michigan,Ann Arbor,MI,USA.
authors: Eduardo
authors: E
authors: Villamor
authors: 4Department of Public Health, Medical Faculty,Catholic University of the North,Santiago de Chile,Chile.
authors: Javiera
authors: J
authors: Valdés
authors: 1Social and Cardiovascular Epidemiology Research Group,School of Medicine,University of Alcalá,Alcalá de Henares,Madrid 28871,Spain.
authors: Usama
authors: U
authors: Bilal
authors: 6Center for Human Nutrition,Department of International Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA.
authors: Benjamín
authors: B
authors: Caballero
authors: 7INCAP Comprehensive Center for the Prevention of Chronic Diseases (CIIPEC),Institute of Nutrition of Central America and Panama (INCAP),Guatemala 1188,Central America.
authors: Dina
authors: D
authors: Roche
authors: 7INCAP Comprehensive Center for the Prevention of Chronic Diseases (CIIPEC),Institute of Nutrition of Central America and Panama (INCAP),Guatemala 1188,Central America.
authors: Fernanda
authors: F
authors: Kroker
authors: 7INCAP Comprehensive Center for the Prevention of Chronic Diseases (CIIPEC),Institute of Nutrition of Central America and Panama (INCAP),Guatemala 1188,Central America.
authors: Manuel
authors: M
authors: Ramírez-Zea
authors: 1Social and Cardiovascular Epidemiology Research Group,School of Medicine,University of Alcalá,Alcalá de Henares,Madrid 28871,Spain.
authors: Manuel
authors: M
authors: Franco
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D050177:Overweight / Q000503:physiopathology*; D011204:Poverty Areas; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018881:Suburban Health
keywords: Guatemala