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Adjusting for Pubertal Status Reduces Overweight and Obesity Prevalence in the United States - 22/03/21

Doi : 10.1016/j.jpeds.2020.12.038 
Eric Morris Bomberg, MD, MAS 1, 2, , Oppong Yaw Addo, PhD 3, Kyriakie Sarafoglou, MD 2, 4, Bradley Scott Miller, MD, PhD 2
1 Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 
2 Division of Endocrinology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 
3 Department of Global Health, Rollins School of Emory University, Atlanta, GA 
4 Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN 

Reprint requests: Eric Morris Bomberg, MD, MAS, Center for Pediatric Obesity Medicine, 717 Delaware Street SE, Room 370, Minneapolis, MN 55414Center for Pediatric Obesity Medicine717 Delaware Street SERoom 370MinneapolisMN55414

Abstract

Objective

To compare pediatric overweight and obesity prevalence among non-Hispanic white, Mexican American, and non-Hispanic black US youths before and after adjusting body mass index (BMI) for pubertal status, as assessed by Tanner stage.

Study design

We analyzed cross-sectional anthropometric and pubertal data from non-Hispanic white, Mexican American, and non-Hispanic black youths in the National Health and Nutrition Examination Survey (NHANES) III. We developed specialized Tanner stage and chronological age-adjusted models to establish Tanner-stage adjusted BMI z-scores, which were then used to determine adjusted overweight/obesity prevalence. We compared pediatric overweight/obesity prevalence before and after pubertal status adjustment.

Results

Among 3206 youths aged 8-18 years (50% male; 26% non-Hispanic white, 35% Mexican American, 39% non-Hispanic black), adjusting BMI for Tanner stage significantly reduced overweight (males, from 29% to 21%; females, from 29% to 17%) and obesity (males, from 14% to 7%; females, from 11% to 5%) prevalence across all races/ethnicities. The obesity prevalence reduction was more pronounced in Mexican Americans (males, 11% reduction; females, 9% reduction) and non-Hispanic blacks (males and females, 10% reduction) compared with non-Hispanic whites (males, 6% reduction; females, 5% reduction). Similar patterns were seen in overweight prevalence.

Conclusions

Adjusting for pubertal status reduced the prevalence of overweight/obesity in non-Hispanic white, Mexican American, and non-Hispanic black youth. This suggests that adjusting for puberty incorporates changes otherwise not captured when only considering the age of a child. Adjusting BMI for pubertal status may be important when interpreting a youth's weight status and consideration for obesity management, as well as when interpreting pediatric overweight/obesity prevalence data.

El texto completo de este artículo está disponible en PDF.

Key words : pediatric obesity, puberty, growth charts, body mass index, ethnic groups, health care surveys, epidemiologic methods

Abbreviations : BMI, CA-BMI, CDC, NHANES, TSA-BMI


Esquema


 E.B. is a site principal investigator for Novo Nordisk. Research reported in this publication was supported by the National Institute of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health under Award Number K23DK125668. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. B.M. is a consultant for Abbvie, Ascendis, BioMarin, Bluebird Bio, Endo Pharmaceuticals, Novo Nordisk, Pfizer, Sandoz, Sanofi Genzyme, Tolmar, and Vertice and has received research support from Alexion, Abbvie, Amgen, Ascendis, BioMarin, Novo Nordisk, OPKO, Protalix, Sandoz, Sangamo, Sanofi Genzyme, and Takeda. K.S. receives research support from the Food and Drug Administration, National Cancer Institute, National Science Foundation, Spruce Biosciences, Alexion, and Neurocrine. O.A. declares no conflicts of interest.
 Portions of this study were presented at the 10th International Meeting of Pediatric Endocrinology, September 16, 2017, Washington, DC.


© 2020  Elsevier Inc. Reservados todos los derechos.
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Vol 231

P. 200 - avril 2021 Regresar al número
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