Evidence map›Paper›PMID 29880034›Full record

Observational studyBMC pediatrics2018

BMI z-score in obese children is a poor predictor of adiposity changes over time.

Cassandra Vanderwall, Jens Eickhoff, R Randall Clark, Aaron L Carrel

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Cassandra VanderwallUniversity of Wisconsin, UW Health- University Hospital, 600 Highland Ave, Madison, WI, 53792, USA. CVanderwall@uwhealth.org.ORCID 0000-0002-0916-4103
Jens EickhoffUniversity of Wisconsin, UW Health- University Hospital, 600 Highland Ave, Madison, WI, 53792, USA.
R Randall ClarkUW Health Department of Sports Medicine, Madison, WI, USA.
Aaron L CarrelUniversity of Wisconsin, UW Health- University Hospital, 600 Highland Ave, Madison, WI, 53792, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe age and sex standardized body mass index (BMIz) is a simple and widely utilized screening tool for obesity in children and adolescents. The purpose of this study was to evaluate the relationship between the BMIz trajectory versus the percent body fat (%FAT) trajectory, and if BMIz could predict significant changes in %FAT in a sample of obese children and adolescents.

methodsIn this longitudinal observational study, body composition was measured by dual energy x-ray absorptiometry (DXA) in obese children within a multidisciplinary pediatric fitness clinic at an academic medical center over a 3-year time period. Regression analyses were conducted to evaluate the association between changes in BMIz and changes in %FAT.

resultsBaseline assessment was obtained from 515 participants. The reduction observed in BMIz (2.20 to 2.08, p < 0.0001) correlated with the reduction in %FAT (38.5 to 35.8%, p < 0.05) in the first two years. The overall correlation between the slope in BMIz reduction versus %FAT reduction was moderate (r = 0.36, p < 0.0001) over the 3-year follow-up period. The sensitivity of BMIz changes for predicting a decrease in %FAT was acceptable (70, 95% CI: 61-78%), however the specificity was poor (42, 95% CI: 31-54%).

conclusionsThese findings advance the understanding of the utility and limitations of BMIz in children and adolescents. While BMIz may be sensitive to changes in adiposity, it is a weak predictor of these changes in total body fat (%FAT) due to the poor specificity. Therefore, clinicians must exercise caution when monitoring changes in a growing child's body composition to avoid misclassifying or missing substantial change when utilizing BMIz alone.

Indexed as

AdiposityBody Mass IndexAbsorptiometry, PhotonAdolescentBody CompositionChildChild, PreschoolFemaleHumansLongitudinal StudiesMalePediatric ObesityBody compositionBody mass index Z-scoreChildhood obesityDual energy X-ray absorptiometry

Identifiers

PMID29880034
PMCPMC5992682

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.