title: 2000 CDC or 2007 WHO - what is the most sensitive anthropometric reference for determination of overweight and cardio-metabolic risk in children aged 6-10 years?
abstract: OBJECTIVE
  To compare the two anthropometric standards for screening of overweight and cardio-metabolic risk in 6-10-year-old children.
  
  
  METHODS
  This cross-sectional study included 175 subjects attending the Referral Center for the Treatment of Children and Adolescents in Campos, Rio de Janeiro. They were classified according to CDC and WHO BMI z scores as normal-weight (z-score > -1 and < 1), overweight (z-score ≥ 1 and < 2) or obese (z-score ≥ 2). Sensitivities and specificities in predicting systolic (SBP), diastolic (DBP) blood pressure and homeostatic model assessment insulin resistance index (HOMA-IR) alterations were calculated.
  
  
  RESULTS
  There was a major difference in 11 children who rated overweight by the CDC but were reclassified as obese by the WHO. Their mean z-scores for SBP (1.71 ± 1.54), DBP (2.64 ± 1.83) and HOMA-IR (1.84 ± 0.98) were higher than those classified as overweight by both references (SBP = 0.49 ± 1.34, p < 0.023, DBP = 1.45 ± 0.97, p < 0.04 and HOMA = 1.24 ± 0.67, p < 0.04), but were similar to those classified as obese by both criteria (SBP = 1.25 ± 2.04, p = 0.60, DBP = 1.94 ± 1.19, p = 0.50 and HOMA = 2.09 ± 1.12, p = 0.76).
  
  
  CONCLUSIONS
  The 2007 WHO reference was the most sensitive in screening for overweight and alterations in blood pressure and HOMA-IR in 6-10-year-old children.
authors.affiliation: Referral Center for the Treatment of Children and Adolescents, Rio de Janeiro, RJ, Brazil.
authors.forename: Valesca Mansur
authors.initials: VM
authors.lastname: Kuba
authors.affiliation: Department of Maternal and Child Health, School of Public Health, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Claudio
authors.initials: C
authors.lastname: Leone
authors.affiliation: Instituto da Criança, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Durval
authors.initials: D
authors.lastname: Damiani
mesh_terms: D000293:Adolescent; D000886:Anthropometry / Q000379:methods*; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000209:etiology; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000209:etiology; D050177:Overweight / Q000145:classification / Q000150:complications / Q000175:diagnosis*; D012016:Reference Values; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014481:United States; D014944:World Health Organization