title: BMI or BIA: Is Body Mass Index or Body Fat Mass a Better Predictor of Cardiovascular Risk in Overweight or Obese Children and Adolescents? A German/Austrian/Swiss Multicenter APV Analysis of 3,327 Children and Adolescents.
abstract: BACKGROUND
  Body fat (BF) percentiles for German children and adolescents have recently been published. This study aims to evaluate the association between bioelectrical impedance analysis (BIA)-derived BF and cardiovascular risk factors and to investigate whether BF is better suited than BMI in children and adolescents.
  
  
  METHODS
  Data of 3,327 children and adolescents (BMI > 90th percentile) were included. Spearman's correlation and receiver operating characteristics (ROCs) were applied determining the associations between BMI or BF and cardiovascular risk factors (hypertension, dyslipidemia, elevated liver enzymes, abnormal carbohydrate metabolism). Area under the curve (AUC) was calculated to predict cardiovascular risk factors.
  
  
  RESULTS
  A significant association between both obesity indices and hypertension was present (all p < 0.0001), but the correlation with BMI was stronger (r = 0.22) compared to BF (r = 0.13). There were no differences between BMI and BF regarding their correlation with other cardiovascular risk factors. BF significantly predicted hypertension (AUC = 0.61), decreased HDL-cholesterol (AUC = 0.58), elevated LDL-cholesterol (AUC = 0.59), elevated liver enzymes (AUC = 0.61) (all p < 0.0001), and elevated triglycerides (AUC = 0.57, p < 0.05), but not abnormal carbohydrate metabolism (AUC = 0.54, p = 0.15). For the prediction of cardiovascular risk factors, no significant differences between BMI and BF were observed.
  
  
  CONCLUSIONS
  BIA-derived BF was not superior to BMI to predict cardiovascular risk factors in overweight or obese children and adolescents.
authors.affiliation: University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bohn
authors.forename: Manfred James
authors.initials: MJ
authors.lastname: Müller
authors.forename: Gunter
authors.initials: G
authors.lastname: Simic-Schleicher
authors.forename: Wieland
authors.initials: W
authors.lastname: Kiess
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Siegfried
authors.forename: Monika
authors.initials: M
authors.lastname: Oelert
authors.forename: Sabine
authors.initials: S
authors.lastname: Tuschy
authors.forename: Stefan
authors.initials: S
authors.lastname: Berghem
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D050154:Adiposity; D000293:Adolescent; D019540:Area Under Curve; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D002648:Child; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005060:Europe; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000209:etiology; D008055:Lipids / Q000097:blood; D008099:Liver / Q000201:enzymology; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000378:metabolism; D050177:Overweight / Q000097:blood / Q000150:complications; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors
chemical_list: D008055:Lipids