ArticleBMJ open2022
Comparison of different severe obesity definitions in predicting future cardiometabolic risk in a longitudinal cohort of children.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed, 2 citations in OpenAlex.
- The effects of ellagic acid in metabolic dysfunction-associated steatotic liver disease (MASLD) patients: a randomized, add-on, double-blind, controlled trial.Inflammopharmacology · 2025Trial
- Assessment of electronic patient education materials for adolescent bariatric surgery candidates: An environment scan.PEC innovation · 2023Article
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSevere obesity (SO) prevalence varies between reference curve-based definitions (WHO: ≥99th percentile, Centers for Disease Control and Prevention (CDC): >1.2×95th percentile). Whether SO definitions differentially predict cardiometabolic disease risk is critical for proper clinical care and management but is unknown.
designProspective cohort study
settingSO definitions were applied at baseline (2005-2008, M
participantsRespondents were youth who had at least one biological parent with obesity. PRIMARY OUTCOME MEASURES: Unfavourable cardiometabolic levels of fasting blood glucose (≥6.1 mmol/L), insulin resistance (HOMA-IR index ≥2.0), high-density lipoprotein <1.03 mmol/L, low-density lipoprotein ≥2.6 mmol/L and triglycerides ANALYSIS: Area under the receiver operating characteristic curve (AUC) and McFadden psuedo R
resultsBaseline SO prevalence differed (WHO: 18%, CDC: 6.7%). AUCs ranged from 0.52 to 0.77, with fair agreement (kappa=37%-55%). WHO-SO AUCs for detecting unfavourable HOMA-IR (AUC>0.67) and high-density lipoprotein (AUC>0.59) at F1 were statistically superior than CDC-SO (AUC>0.59 and 0.53, respectively; p<0.05). Only HOMA-IR and the presence of more than three risk factors had acceptable model fit. WHO-SO was not more predictive than WHO-obesity, but CDC-SO was statistically inferior to CDC-obesity.
conclusionWHO-SO is statistically superior at predicting cardiometabolic risk than CDC-SO. However, as most AUCs were generally uninformative, and obesity definitions were the same if not better than SO, the improvement may not be clinically meaningful.
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