Evidence map›Paper›PMID 37667334›Full record

ArticleCardiovascular diabetology2023

BMI-based obesity classification misses children and adolescents with raised cardiometabolic risk due to increased adiposity.

J Karina Zapata, M Cristina Azcona-Sanjulian, Victoria Catalán, Beatriz Ramírez, Camilo Silva, Amaia Rodríguez, Javier Escalada, Gema Frühbeck, Javier Gómez-Ambrosi

Open access · goldAbstract read
In one paragraph

Article in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
10.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Pooled it
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  6. Childhood obesity: The threatening apprentice of the adiposity empire.Reviews in endocrine & metabolic disorders · 2025
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  10. The evolution of the understanding of obesity over the last 100 years.International journal of obesity (2005) · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

J Karina ZapataDepartment of Endocrinology and Nutrition, Clínica Universidad de Navarra, Avda. Pío XII 36, Pamplona, 31008, Spain.
M Cristina Azcona-SanjulianPaediatric Endocrinology Unit, Department of Paediatrics, Clínica Universidad de Navarra, Pamplona, Spain.
Victoria CatalánInstituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
Beatriz RamírezInstituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
Camilo SilvaDepartment of Endocrinology and Nutrition, Clínica Universidad de Navarra, Avda. Pío XII 36, Pamplona, 31008, Spain.
Amaia RodríguezInstituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
Javier EscaladaDepartment of Endocrinology and Nutrition, Clínica Universidad de Navarra, Avda. Pío XII 36, Pamplona, 31008, Spain.
Gema FrühbeckDepartment of Endocrinology and Nutrition, Clínica Universidad de Navarra, Avda. Pío XII 36, Pamplona, 31008, Spain. gfruhbeck@unav.es.
Javier Gómez-AmbrosiInstituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain. jagomez@unav.es.
Navarre Institute of Health Research · ESInstituto de Salud Carlos III · ESCentro de Investigación Biomédica en Red · ESClinica Universidad de Navarra · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess how inaccurately the body mass index (BMI) is used to diagnose obesity compared to body fat percentage (BF%) measurement and to compare the cardiometabolic risk in children and adolescents with or without obesity according to BMI but with a similar BF%.

methodsA retrospective cross-sectional investigation was conducted including 553 (378 females/175 males) white children and adolescents aged 6-17 years, 197 with normal weight (NW), 144 with overweight (OW) and 212 with obesity (OB) according to BMI. In addition to BMI, BF% measured by air displacement plethysmography, as well as markers of cardiometabolic risk had been determined in the existing cohort.

resultsWe found that 7% of subjects considered as NW and 62% of children and adolescents classified as OW according to BMI presented a BF% within the obesity range. Children and adolescents without obesity by the BMI criterion but with obesity by BF% exhibited higher blood pressure and C-reactive protein (CRP) in boys, and higher blood pressure, glucose, uric acid, CRP and white blood cells count, as well as reduced HDL-cholesterol, in girls, similar to those with obesity by BMI and BF%. Importantly, both groups of subjects with obesity by BF% showed a similarly altered glucose homeostasis after an OGTT as compared to their NW counterparts.

conclusionsResults from the present study suggest increased cardiometabolic risk factors in children and adolescents without obesity according to BMI but with obesity based on BF%. Being aware of the difficulty in determining body composition in everyday clinical practice, our data show that its inclusion could yield clinically useful information both for the diagnosis and treatment of overweight and obesity.

Indexed as

AdiposityHypertensionAdolescentBody Mass IndexChildC-Reactive ProteinCross-Sectional StudiesFemaleGlucoseHumansMaleObesityOverweightRetrospective StudiesC-Reactive ProteinGlucoseAdiposityAdolescentsBMICardiometabolic riskChildrenDiagnosisObesity

Identifiers

PMID37667334
PMCPMC10476300
OpenAlexW4386408505

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.