title: Exploratory Study Examining Clinical Measures of Adiposity Risk for Predicting Obesity in Adolescents with Physical Disabilities.
abstract: OBJECTIVE
  The purposes of this study were to assess the accuracy of clinical measures for predicting adiposity when compared with a criterion standard of body fat percentage measured by dual-energy X-ray absorptiometry and to determine the most appropriate cut points for classifying obesity for each measure in adolescents with physical disability.
  
  
  METHODS
  Body mass index, triceps skinfolds, and waist, arm, and leg circumferences were collected on 29 adolescents aged 14-17 yrs with spinal cord injury, cerebral palsy, or spina bifida. Percentage of body fat was measured using dual-energy X-ray absorptiometry. Multiple linear regression models were used to assess the ability of measures to predict percentage of body fat. Receiver operating characteristic curves were used to identify optimal cut points for each measure.
  
  
  RESULTS
  Although all clinical measures correlated with body fat as measured by dual-energy X-ray absorptiometry, current cut points are not adequate in this group. Using a body mass index of 20 kg/m (boys) and 19 kg/m (girls) was optimal but still misclassified a significant number of participants as nonobese in this group. Using the optimal cut points for waist circumference, which were 83 cm (boys) and 78 cm (girls), was the best predictor.
  
  
  CONCLUSIONS
  Body mass index, triceps skinfolds, and waist, leg, and arm circumferences are valid measures for estimating obesity in adolescents with physical disability, but further research is needed to validate disability-specific cut points.
authors.affiliation: From the Departments of Occupational Therapy (BCW), Physical Therapy (TM), and Biostatistics (PQ), University of Alabama at Birmingham, Birmingham, Alabama; UAB/Lakeshore Research Collaborative, Birmingham, Alabama (BCW, TM, JHR); Shriners Hospital for Children, Chicago, Illinois (LCV); and Rush University, Chicago, Illinois (LCV).
authors.forename: Brooks C
authors.initials: BC
authors.lastname: Wingo
authors.forename: Tapan
authors.initials: T
authors.lastname: Mehta
authors.forename: Peng
authors.initials: P
authors.lastname: Qu
authors.forename: Larry C
authors.initials: LC
authors.lastname: Vogel
authors.forename: James H
authors.initials: JH
authors.lastname: Rimmer
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D050218:Body Fat Distribution; D015992:Body Mass Index; D002547:Cerebral Palsy / Q000150:complications; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000175:diagnosis*; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D012737:Sex Factors; D012885:Skinfold Thickness; D013119:Spinal Cord Injuries / Q000150:complications; D016135:Spinal Dysraphism / Q000150:complications; D055105:Waist Circumference