Fat and lean BMI reference curves in children and adolescents and their utility in identifying excess adiposity compared with BMI and percentage body fat
Fat and lean BMI reference curves in children and adolescents and their utility in identifying excess adiposity compared with BMI and percentage body fat
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DOI：
10.3945/ajcn.112.053611
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发表时间：
2013-07-01
影响因子：
7.1
通讯作者：
Zemel, Babette S.
中科院分区：
文献类型：
--
作者：
Weber, David R.;Moore, Renee H.;Zemel, Babette S.
背景：身体质量指数（BMI）和体脂百分比（% BF）被广泛用于评估肥胖。这些指标不能解释脂肪质量（FM）和瘦体重（LBM）对体重的独立贡献，它们根据儿童人群的年龄、性别、青春期状态和人口血统而变化。目的：目的是建立儿童脂肪质量指数（FMI）和瘦体重指数（LBMI）的参考曲线，并评估人群血统和LBM对过度肥胖（BMI， %BF和FMI）测量的影响。设计：根据NHANES的双能x射线吸收仪测量的横断面身体成分数据，生成8-20岁儿童和青少年相对于年龄的性别特异性FMI和LBMI参考曲线。结果：黑人（男性：0.26，女性：0.45）的平均LBMI z评分高于白人（男性：-0.07，女性：-0.09）和墨西哥裔美国人（男性：0.05，女性：-0.09）。在黑人（男性：35.9%，女性：30.3%）中，BMI超重对FMI定义的过度肥胖的阳性预测值低于白人（男性：65.4%，女性：52.2%）和墨西哥裔美国人（男性：73.3%，女性：68.3%）。被FMI分类为过度肥胖但按百分比BF分类为正常肥胖的参与者，其BMI、LBMI和身高z得分明显高于按百分比BF分类为过度肥胖但按百分比BF分类为正常肥胖的参与者。结论：相对于FMI，黑人中过度肥胖的患病率被BMI高估，而在高LBM个体中被BF %低估。FMI和LBMI的使用通过允许对FM和LBM进行独立评估，提高了%BF和BMI的使用。
Background: Body mass index (BMI) and percentage body fat (% BF) are widely used to assess adiposity. These indexes fail to account for independent contributions of fat mass (FM) and lean body mass (LBM) to body weight, which vary according to age, sex, pubertal status, and population ancestry in the pediatric population.Objective: The objective was to develop pediatric reference curves for fat mass index (FMI) and lean body mass index (LBMI) and evaluate the effects of population ancestry and LBM on measures of excess adiposity (BMI, %BF, and FMI).Design: Sex-specific FMI and LBMI reference curves relative to age for children and adolescents aged 8-20 y were generated from cross-sectional body-composition data measured by dual-energy Xray absorptiometry from NHANES.Results: The mean LBMI z score was higher in blacks (males: 0.26; females: 0.45) than in whites (males: -0.07; females: -0.09) and Mexican Americans (males: 0.05; females: -0.09). The positive predictive value of overweight by BMI to identify excess adiposity defined by FMI was lower in blacks (males: 35.9%; females: 30.3%) than in whites (males: 65.4%; females: 52.2%) and Mexican Americans (males: 73.3%; females: 68.3%). Participants classified as having excess adiposity by FMI but normal adiposity by %BF had significantly higher BMI, LBMI, and height z scores than did those classified as having excess adiposity by %BF but normal adiposity by FMI.Conclusions: Relative to FMI, the prevalence of excess adiposity is overestimated by BMI in blacks and underestimated by %BF in individuals with high LBM. The use of FMI and LBMI improves on the use of %BF and BMI by allowing for the independent assessment of FM and LBM.