Abstract

MACIAS-TOMEI, Coromoto et al. Capacity of Body Mass Index to predict a comprehensive diagnosis in Venezuelan prepubertal and pubertal boys and girls. Arch Venez Puer Ped [online]. 2012, vol.75, n.2, pp.38-44. ISSN 0004-0649.

Background: New World Health Organization (WHO) Growth Standards motivated countries to analyze its application in local public health programs as well as in clinical assistance. Objective: To compare the predictive capacity of the Body Mass Index (BMI) according to three anthropometric references with regard to the comprehensive clinical diagnosis (CCD). Methods: BMI was analyzed by Estudio Nacional de Crecimiento y Desarrollo Humanos (ENCDH), Estudio Transversal de Caracas (ETC) and WHO 2007 in 198 healthy prepubertal and pubertal boys and girls 5-17 years (95 boys, 103 girls). Pubertal development was assessed by Tanner’s stages: Prepubertal (G1/B1), Pubertal (≥ G 2 / ≥ B 2). BMI categories (normal, low, high) were contrasted with CDD: Concordance (Kappavalues), Sensitivity, Specificity and Predictive Value were calculated with significance for p< 0.05. Results: Thinness was underestimated by the three references with regard to the CCD in both sexes, especially in girls. Overweight was overestimated by ENCDH in girls and by WHO in boys and girls. Non parametric ANOVA showed significant differences between BMI categories with the three references. High concordance (Kappa 0.68-0.85) was found in boys, moderate in girls (0.55-0.60) with high percentages of false negatives (64-73% in girls, 31-44% for boys). False negatives were lower for overweight, (boys 4-7%; girls 17-20%). Predictive Values were higher with national references than with WHO standards. Conclusions: BMI discriminated adequately between normality and overweight, but not for underweight, especially in girls. Predictive Values must be analyzed in larger samples and cut offs point for underweight should be redefined.

Keywords : body mass index; reference values; comprehensive clinical diagnosis; puberty; children; adolescents.

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