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PubMed Publications| Keyword search (4,164 papers available) |  |
"Paradis G" Authored Publications:
| Title: | Comparison of different severe obesity definitions in predicting future cardiometabolic risk in a longitudinal cohort of children | ||||
| Authors: | Kakinami L, Smyrnova A, Paradis G, Tremblay A, Henderson M | ||||
| Link: | pubmed.ncbi.nlm.nih.gov/35705336/ | ||||
| DOI: | 10.1136/bmjopen-2021-058857 | ||||
| Publication: | BMJ open | ||||
| Keywords: | community child health; epidemiology; paediatrics; public health; statistics and research methods; | ||||
| PMID: | 35705336 | Category: | Date Added: | 2022-06-16 | |
| Dept Affiliation: |
PERFORM
1 PERFORM Centre, Concordia University, Montreal, Québec, Canada lisa.kakinami@concordia.ca. 2 Department of Mathematics and Statistics, Concordia University, Montreal, Québec, Canada. 3 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada. 4 Département de kinésiologie, Université Laval, Quebec City, Quebec, Canada. 5 Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada. 6 Research Center of CHU Sainte Justine, Université de Montréal, Montreal, Quebec, Canada. |
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Description: |
Objectives: Severe 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. Design: Prospective cohort study SETTING: SO definitions were applied at baseline (2005-2008, M<sub>age</sub>=9.6 years, n=548), and outcomes (fasting lipids, glucose, homoeostatic model assessment (HOMA-IR) and blood pressure) were assessed at first follow-up (F1: 2008-2011, M<sub>age</sub>=11.6 years) and second follow-up (2015-2017, M<sub>age</sub>=16.8 years) of the Quebec Adipose and Lifestyle Investigation in Youth cohort in Montreal, Quebec. Participants: Respondents 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 <underline>></underline>1.24 mmol/L. Unfavourable blood pressure was defined as =90th percentile for age-adjusted, sex-adjusted and height-adjusted systolic or diastolic blood pressure. Analysis: Area under the receiver operating characteristic curve (AUC) and McFadden psuedo R<sup>2</sup> for predicting F1 or F2 unfavourable cardiometabolic levels from baseline SO definitions were calculated. Agreement was assessed with kappas. Results: Baseline 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. Conclusion: WHO-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. |
