Accuracy and capability of tri-ponderal mass index in assessing cardio-metabolic risk factors in Chinese children and adolescents aged 3 to 17 years, compared with body mass index.
10.1097/CM9.0000000000002349
- VernacularTitle:Accuracy and capability of tri-ponderal mass index in assessing cardio-metabolic risk factors in Chinese children and adolescents aged 3 to 17 years, compared with body mass index
- Author:
Rui CHEN
1
;
Lang JI
2
;
Lijuan MA
3
;
Yitong CHEN
4
;
Jiali DUAN
5
;
Mingjing MA
6
;
Ying SUN
5
;
Jun TAI
7
;
Linghui MENG
1
Author Information
1. Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing 100020, China.
2. Central Laboratory, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China.
3. Department of Clinical Laboratory, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China.
4. Infectious Diseases Control and Prevention Division, Daxing Center for Disease Prevention and Control, Beijing 102699, China.
5. Health Promotion Office, Beijing Center for Disease Prevention and Control, Beijing 100013, China.
6. Department of Health Care, Tuanjiehu Community Health Service Center, Chaoyang District, Beijing 100026, China.
7. Department of Otorhinolaryngology, Head and Neck Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Child;
Child, Preschool;
Female;
Humans;
Male;
Body Mass Index;
Dyslipidemias;
East Asian People;
Hypertension;
Obesity, Abdominal;
Pediatric Obesity/diagnosis*;
Cardiometabolic Risk Factors
- From:
Chinese Medical Journal
2023;136(11):1339-1348
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Tri-ponderal mass index (TMI) has been reported to be a more accurate estimate of body fat than body mass index (BMI). This study aims to compare the effectiveness of TMI and BMI in identifying hypertension, dyslipidemia, impaired fasting glucose (IFG), abdominal obesity, and clustered cardio-metabolic risk factors (CMRFs) in 3- to 17-year-old children.
METHODS:A total of 1587 children aged 3 to 17 years were included. Logistic regression was used to evaluate correlations between BMI and TMI. Area under the curves (AUCs) were used to compare discriminative capability among indicators. BMI was converted to BMI- z scores, and accuracy was compared by false-positive rate, false-negative rate, and total misclassification rate.
RESULTS:Among children aged 3 to 17 years, the mean TMI was 13.57 ± 2.50 kg/m 3 for boys and 13.3 ± 2.33 kg/m 3 for girls. Odds ratios (ORs) of TMI for hypertension, dyslipidemia, abdominal obesity, and clustered CMRFs ranged from 1.13 to 3.15, higher than BMI, whose ORs ranged from 1.08 to 2.98. AUCs showed similar ability of TMI (AUC: 0.83) and BMI (AUC: 0.85) in identifying clustered CMRFs. For abdominal obesity and hypertension, the AUC of TMI was 0.92 and 0.64, respectively, which was significantly better than that of BMI, 0.85 and 0.61. AUCs of TMI for dyslipidemia and IFG were 0.58 and 0.49. When 85th and 95th of TMI were set as thresholds, total misclassification rates of TMI for clustered CMRFs ranged from 6.5% to 16.4%, which was not significantly different from that of BMI- z scores standardized according to World Health Organization criteria.
CONCLUSIONS:TMI was found to have equal or even better effectiveness in comparison with BMI in identifying hypertension, abdominal obesity, and clustered CMRFs TMI was more stable than BMI in 3- to 17-year-old children, while it failed to identify dyslipidemia and IFG. It is worth considering the use of TMI for screening CMRFs in children and adolescents.
