Determining body mass index, waist-to-height ratio, percent body fat, and conicity index cut-off values associated with metabolic abnormalities in Lebanese children and adolescents -

Abstract

Recent studies have proposed ethnic-specific cut-off values for several anthropometric indicators in predicting cardio-metabolic risk factors in the pediatric population. The objective of this study is to determine optimal cut-off values for BMI, percent body fat, waist-to-height ratio, and conicity index to predict increased risk of metabolic abnormalities and their clustering into the metabolic syndrome in Lebanese youth. This cross sectional study included a sample of 490 children and adolescents, aged between 7 and 19 years old. Based on anthropometric measurements (weight, height, waist circumference, and percent body fat), blood pressure measurements (systolic and diastolic) and biochemical analysis data (fasting serum glucose, HDL-C, TG, LDL-C, and T-C), individual metabolic abnormalities and the metabolic syndrome were identified according to the NCEP-ATPIII criteria. BMI and WHtR were found to predict with high accuracy elevated WC (AUC: 0.95, Sensitivity: 94.4percent, Specificity: 80.7percent in males and AUC: 0.89, Sensitivity: 85.4percent, Specificity: 81.2percent in females for BMI; AUC: 0.98, Sensitivity: 98.6percent, Specificity: 87.9percent in males and AUC: 0.93, Sensitivity: 91.1percent, Specificity: 80.9percent in females for WHtR), and TG (AUC: 0.74, Sensitivity: 80.0percent, Specificity: 61.7percent in males and AUC: 0.71, Sensitivity: 70.3percent, Specificity: 60.2percent in females for BMI; AUC: 0.76, Sensitivity: 71.1percent, Specificity: 70.1percent in males and AUC: 0.69, Sensitivity: 71.6percent, Specificity: 60.0percent in females for WHtR); whereas, the four anthropometric indicators (BMI, WHtR, percentBF, and CI) had low accuracy, sensitivity and specificity in predicting low HDL-C and high BP. The optimal cut-off values for predicting MetS in boys and girls were, respectively, BMI Z score above +2.35 and +2.29, percentBF above 32.2percent and 36.45percent, WHtR above 0.58 and 0.54, and CI above 1.58 and 1.45. BMI (AUC: 0.86, Sensitivity: 88.9percent, Specificity: 80.7percent in males; AUC: 0.86, Sensitivity: 81.8percentpercent, Specificity: 78.9percent in females) and WHtR (AUC: 0.87, Sensitivity: 88.0percent, Specificity: 80.2percent