Predicting cardiometabolic markers in children using tri-ponderal mass index: a cross-sectional study

Author:

Ashley-Martin Jillian,Ensenauer Regina,Maguire Bryan,Kuhle StefanORCID

Abstract

ObjectiveTo model the development of the tri-ponderal mass index (TMI, kg/m3) throughout childhood and adolescence and to compare the utility of the TMI with that of the body mass index (BMI, kg/m2) to predict cardiometabolic risk in a population-based sample of Canadian children and youth.MethodsWe used data from the Canadian Health Measures Survey to model TMI from 6 to 19 years of age. Percentile curves were developed using the LMS method. Logistic regression was used to predict abnormal levels of cardiometabolic markers; predictive accuracy was assessed using the area under the ROC curve (AUC).ResultsMean TMI was relatively stable from ages 6 to 19 years for both sexes, but variability increased with age. There was no notable difference in AUC values for prediction models based on BMI z-score compared with TMI for any of the outcomes. For both BMI z-score and TMI, prediction accuracy was good for homeostasis model assessment insulin resistance and having ≥3 abnormal tests (AUC>0.80), fair for C-reactive protein and poor for the remainder of the outcomes.ConclusionsThe use of a single sex-specific TMI cut-off for overweight or obesity is hampered by the increasing variability of the measure with age. Weight-for-height indices likely have only limited ability to predict cardiometabolic marker levels, and changing the scaling power of height is unlikely to improve predictive accuracy.

Funder

IWK Health Centre Foundation

Publisher

BMJ

Subject

Pediatrics, Perinatology and Child Health

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