title: Anthropometric indices are not satisfactory predictors of metabolic comorbidities in obese children and adolescents.
abstract: OBJECTIVE
  To assess the accuracy of body mass index (BMI), Z score of the BMI, waist circumference, and waist-to-height ratio in selecting obese children with fasting metabolic impairments or impaired glucose tolerance.
  
  
  METHODS
  In a cohort of 883 obese children and adolescents (age 8-18 years), we assessed the associations of anthropometric indices with traditional metabolic complications of obesity (impaired fasting glucose, impaired glucose tolerance, hypertension, high triglycerides, low high-density lipoprotein-cholesterol). The accuracy of anthropometric indices as markers of metabolic impairment was assessed by receiver operating characteristic analysis and the areas under the receiver operating characteristics curves (AUROCs) of anthropometric indices were compared with each other by the DeLong test.
  
  
  RESULTS
  BMI, Z score of the BMI, waist circumference, and waist-to-height ratio were associated with metabolic impairments but showed low to moderate accuracy in discriminating both single and clustered metabolic impairments. The AUROCs ranged from 0.55-0.70. The 4 anthropometric indices did not show significantly different AUROCs as predictors of clustered metabolic risk factors (all P values of DeLong tests: >.05).
  
  
  CONCLUSIONS
  Commonly used anthropometric indices are not satisfactory markers of metabolic comorbidity among obese children and adolescents and should not be adopted as screening tools for the metabolic assessment of this category of patients.
authors.affiliation: Center for Pediatric Diabetes, Clinical Nutrition and Obesity, University of Verona, Verona, Italy. Electronic address: anita.morandi@univr.it.
authors.forename: Anita
authors.initials: A
authors.lastname: Morandi
authors.affiliation: Department of Pediatrics, 'F. Fede' Seconda Università degli Studi di Napoli, Naples, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Miraglia Del Giudice
authors.affiliation: Department of Pediatrics, "La Sapienza" University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Martino
authors.affiliation: Department of Pediatrics, "La Sapienza" University, Rome, Italy.
authors.forename: Eliana
authors.initials: E
authors.lastname: Martino
authors.affiliation: Internal Medicine and Therapeutics Department, University of Pavia, Pavia, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Bozzola
authors.affiliation: Center for Pediatric Diabetes, Clinical Nutrition and Obesity, University of Verona, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Maffeis
mesh_terms: D000293:Adolescent; D002648:Child; D015897:Comorbidity; D006801:Humans; D024821:Metabolic Syndrome / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D012372:ROC Curve; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D065927:Waist-Height Ratio
chemical_list: D014280:Triglycerides