Abstract
Background and objective To characterize the use of pediatric body mass index (BMI) to predict obesity, overweight, and diseases in middle age. Methods A longitudinal study of people born in a week in 1958 ( n = 12,327). The main outcome measures are obesity (BMI ≥ 30) and overweight (BMI ≥ 25) at age 33 and disease history self-reported at age 42. Receiver operating characteristic (ROC) analysis was performed using BMI measured at ages 7, 11, and 16 years as predictors. Results BMI values measured at age 11 could predict obesity at age 33 with areas under ROC curve (AUC) of 0.78 for males and 0.80 for females (each P < .001). BMI values at age 11 predicted overweight with slightly smaller AUC (each P < .001). They could also predict history of diabetes and hypertension (AUC = 0.60 and 0.56, respectively, each P < .01), both sexes pooled. Prediction based on BMI at age 7 was less satisfactory; that at 16 gave limited improvement. Cutoff points based on ROC curves, the international reference, and the 85th and 95th percentiles gave very different profiles of diagnostic features. Conclusion Pediatric BMI may predict adult obesity and overweight with a reasonable profile of sensitivity and specificity.
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