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Degree of Accuracy of the BMI Z-Score to Determine Excess Fat Mass Using DXA in Children and Adolescents

Author

Listed:
  • David Monasor-Ortolá

    (Department of Nursing, University of Alicante, 03690 Alicante, Spain)

  • Jose Antonio Quesada-Rico

    (Department of Clinical Medicine, Miguel Hernández University of Elche, 03550 Elche, Spain)

  • Ana Pilar Nso-Roca

    (Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, 03550 Elche, Spain
    Department of Pediatrics, General University Hospital San Juan de Alicante, 03550 Alicante, Spain)

  • Mercedes Rizo-Baeza

    (Department of Nursing, University of Alicante, 03690 Alicante, Spain)

  • Ernesto Cortés-Castell

    (Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, 03550 Elche, Spain)

  • Asier Martínez-Segura

    (Department of Nursing, University of Alicante, 03690 Alicante, Spain)

  • Francisco Sánchez-Ferrer

    (Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, 03550 Elche, Spain
    Department of Pediatrics, General University Hospital San Juan de Alicante, 03550 Alicante, Spain)

Abstract

Obesity is caused by fat accumulation. BMI Z-score is used to classify the different degrees of weight status in children and adolescents. However, this parameter does not always express the true percentage of body fat. Our objective was to determine the degree of agreement between the fat mass percentage measured by DXA and the stratification of weight according to BMI Z-score in the pediatric age group. We designed a descriptive cross-sectional study. The patients were classified as underweight/normal weight with Z-scores between −2 and +0.99, overweight from 1 to 1.99, obese from 2 to 2.99, and very obese ≥3. We included 551 patients (47% girls), with a mean age of 11.5 ± 2.8 years (3.7–18 years). Higher BMI Z-scores were associated with a higher percentage of total fat ( p < 0.001). However, there were important overlaps between both parameters, such that the BMI Z-score classified patients with the same percentage of total fat mass as having a different nutritional status classification. In conclusion, the stratification of weight status according to BMI Z-score revealed that 46.7% of patients had a fat percentage that did not correspond to their classification. For a more accurate weight assessment in clinical practice, we recommend combining anthropometric indices with diagnostic tools that better correlate with DXA, such as electrical bioimpedance.

Suggested Citation

  • David Monasor-Ortolá & Jose Antonio Quesada-Rico & Ana Pilar Nso-Roca & Mercedes Rizo-Baeza & Ernesto Cortés-Castell & Asier Martínez-Segura & Francisco Sánchez-Ferrer, 2021. "Degree of Accuracy of the BMI Z-Score to Determine Excess Fat Mass Using DXA in Children and Adolescents," IJERPH, MDPI, vol. 18(22), pages 1-9, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:22:p:12114-:d:682139
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    References listed on IDEAS

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    1. Williams, D.P. & Going, S.B. & Lohman, T.G. & Harsha, D.W. & Srinivasan, S.R. & Webber, L.S. & Berenson, G.S., 1992. "Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents," American Journal of Public Health, American Public Health Association, vol. 82(3), pages 358-363.
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