Abstract
Background and Objectives: To verify the use of the tri-ponderalmass index (TMI) as a screening tool for risk of central fat accumulation in preschool children. Materials and Methods: An observational, analytical study was carried out on samples from children 2 to 5 years of age. The body mass index (BMI) and the tri-ponderalmass index (TMI: Weight/height3) were calculated. The waist circumference-to-height ratio (WHtR) was used to classify central fat accumulation risk. Preschoolers whose WHtRwas in the upper tertile of the sample were classified as at risk for central fat accumulation. A comparison of the two indicators (BMI and TMI) was made from the area under the receiver operator characteristics (ROC) curve (AUC) in the discrimination of the WHtR. Results: The sample used for analysis was 919 preschoolers. The mean age of the children was 3.9 years (SD = 0.7). The difference in AUC was 5% higher for TMI (p < 0.0001). In the individual analysis of the ROC curve of the TMI, favoring a higher sensitivity, the cutoff point of 14.0 kg/m3 showed a sensitivity of 99.3% (95% CI: 97.6–99.9). Conclusion: Considering WHtR as a marker of possible future metabolic risk among preschool children, TMI proved to be a useful tool, superior to BMI, in screening for risk of central fat accumulation in preschool children.
Highlights
The prevalence of childhood obesity is still considered a significant public health problem because of its alarming progress
The exclusion criteria were children with ages below 2.0 years or above 4.9 years, children with chronic diseases, congenital malformations, or specific growth diseases, children who did not attend daycare centers on the days selected for data collection, and children whose parents did not authorize participation.All other children enrolled in the selected daycare centers were initially included
There is a high correlation between body mass index (BMI) and tri-ponderalmass index (TMI), in the analysis of its accuracy, through the receiver operator characteristics (ROC) curves, the TMI shows a higher capacity for discrimination when used as an indicator of possible future risk of cardiometabolic disease
Summary
The prevalence of childhood obesity is still considered a significant public health problem because of its alarming progress. The body mass index (BMI), after many years of use, has been questioned because it presents limitations in the interpretation of its results as a screening tool [5,6]. Proposed in the mid-1990s, the waist/height ratio (WHtR) has been related to several cardiovascular risk factors [8] and is considered a simple and effective indicator to measure abdominal obesity, indicating possible coronary risk in both adults and children [4]. To verify the use of the tri-ponderalmass index (TMI) as a screening tool for risk of central fat accumulation in preschool children. The waist circumference-to-height ratio (WHtR) was used to classify central fat accumulation risk. Conclusion: Considering WHtR as a marker of possible future metabolic risk among preschool children, TMI proved to be a useful tool, superior to BMI, in screening for risk of central fat accumulation in preschool children
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