Dataset Information

Evaluation of Agreement of Overweight Screening Criteria in Adolescents: Korean National Health and Nutrition Examination Surveys.

ABSTRACT:

Background

The increasing prevalence of overweight children and childhood obesity has led to early development of obesity-related diseases, including diabetes. Screening tests for type 2 diabetes in children indicate overweight as a major risk factor. Three overweight screening criteria have been considered: body mass index (BMI) >85th percentile (overweight 1, OW1), weight for height >85th percentile (OW2), and weight >120% of ideal for height (OW3). This study was conducted to evaluate the agreement in these screening criteria and the impact of increased use of screening methods.

Methods

Data were obtained from 965 Korean adolescents (521 boys and 444 girls). The subjects were classified into overweight and normal weight groups by the three above criteria. The agreement between criteria was evaluated using Cohen's kappa value. Furthermore, we studied the relationships between the criteria and parameters of height, weight, BMI, and z score, based on the 2007 Korean growth chart.

Results

Totals of 188, 139, and 115 adolescents were classified as OW1, OW2, and OW3, respectively. The kappa values were 0.798, 0.710, and 0.891 for OW1 and OW2, OW1 and OW3, and OW2 and OW3, respectively. Weight, weight-z, BMI, and BMI-z were greater among subjects in all overweight groups compared to the normal weight group. However, the heights of the subjects did not differ between the three groups.

Conclusion

Active assessment of overweight status using OW1 could be improved by including more adolescents and focusing on the variability of individual growth and disease risk, even though substantial agreement was observed among the three overweight screening criteria.

SUBMITTER: Han JY

PROVIDER: S-EPMC8526295 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The aims of this study were to assess the diagnostic value of the weight-to-height ratio (WHtR) for the detection of obesity and metabolic syndrome (MS) in Korean children and adolescents, and to determine the advantages of WHtR as a population-based screening tool in comparison with other obesity indicators, such as body mass index (BMI) and waist circumference (WC). We performed a cross-sectional analysis of data from 3057 children and adolescents (1625 boys, 1332 girls) aged 10-19 years who were included in the fifth Korean National Health and Nutrition Examination Survey (KNHANES, 2010-2012) up to the second year of the sixth KNHANES (2013-2014). Receiver operation characteristic (ROC) curves were generated to determine the optimal cutoff value and accuracy of WHtR for predicting individual obesity indicators or more than two non-WC components of MS. The area under the ROC curve (AUC) is a measure of the diagnostic power of a test. A perfect test will have an AUC of 1.0, and an AUC equal to 0.5 means that the test performs no better than chance. The optimal WHtR cutoff for the evaluation of general obesity and central obesity was 0.50 in boys and 0.47-0.48 in girls, and the AUC was 0.9. Regarding the assessment of each MS risk factor, the optimal WHtR cutoff was 0.43-0.50 in boys and 0.43-0.49 in girls, and these cutoffs were statistically significant only for the detection of high triglyceride and low High-density lipoprotein (HDL) cholesterol levels. When a pairwise comparison of the AUCs was conducted between WHtR and BMI/WC percentiles to quantify the differences in power for MS screening, the WHtR AUC values (boys, 0.691; girls, 0.684) were higher than those of other indices; however, these differences were not statistically significant (boys, p = 0.467; girls, p = 0.51). The WHtR cutoff value was 0.44 (sensitivity, 67.7%; specificity, 64.6%) for boys and 0.43 (sensitivity, 66.4%; specificity, 66.9%) for girls. There was no significant difference between the diagnostic power of WHtR and that of BMI/WC when screening for MS. Although the use of WHtR was not superior, WHtR is still useful as a screening tool for metabolic problems related to obesity because of its convenience.