Tri-ponderal mass index as a screening tool for obesity prediction in children aged 6-9 years

Yang Niu; Yajie Zhang; Jinye Sheng; Wenyi Lu; Ji Li; Xiaomeng Mao; Wei Cai; Qingya Tang; Xiuhua Shen; Yi Feng

doi:10.3389/fendo.2023.1277125

Tri-ponderal mass index as a screening tool for obesity prediction in children aged 6-9 years

Front Endocrinol (Lausanne). 2023 Nov 9:14:1277125. doi: 10.3389/fendo.2023.1277125. eCollection 2023.

Authors

Yang Niu^#^{1

2}, Yajie Zhang^#^{1

3

4}, Jinye Sheng¹, Wenyi Lu¹, Ji Li¹, Xiaomeng Mao¹, Wei Cai^{1

3

4}, Qingya Tang^{1

3

4}, Xiuhua Shen^{1

2}, Yi Feng^{1

2}

Affiliations

¹ Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China.
² Department of Clinical Nutrition, College of Health Science and Technology, Shanghai JiaoTong University School of Medicine, Shanghai, China.
³ Shanghai Institute for Pediatric Research, Shanghai, China.
⁴ Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.

^# Contributed equally.

Abstract

Objective: This study aimed to evaluate the efficiency of tri-ponderal mass index (TMI) in determining obesity in Chinese children aged 6-9 years, using the criteria of percentage of body fat (PBF) and body mass index z-scores (BMI-Z).

Methods: The cross-sectional study included 5365 children, aged 6-9 years, who participated in the project survey "Group prevention and treatment of obesity among students and school health promotion in Shanghai" from September 2007 to September 2009. Height, weight, waist circumference, body mass index (BMI), TMI, waist-to-height ratio (WHtR), and PBF were recorded. Statistical analyses including Kolmogorov-Smirnov test, chi-square test, receiver operating characteristics curve, and kappa chi-square test were performed.

Results: TMI for both sexes was relatively constant with increasing age, and statistically significant differences were not observed at some ages (P > 0.05 at 6, 7, 8, and 9 years). WHtR showed subtle changes, while BMI and PBF increased significantly with age in boys and girls (P < 0.01). Using BMI-Z criteria as the measure of general obesity, the results indicated that TMI cutoff values for 6-9 years were 14.60 kg/m³ for boys and 14.84 kg/m³ for girls (P < 0.001). Analysis of the agreement between TMI and BMI-Z showed that the kappa statistic was 0.826 in boys and 0.709 in girls (P < 0.001).

Conclusion: TMI, as a constant tool, holds great potential as an alternative screening method for identifying children aged 6-9 years who may be at risk of obesity at an early stage.

Keywords: body mass index; children; obesity; percentage of body fat; tri-ponderal mass index.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Body Mass Index
Child
China
Cross-Sectional Studies
Female
Humans
Male
Pediatric Obesity* / diagnosis
Pediatric Obesity* / epidemiology
ROC Curve

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the 2023 Shanghai Municipal Health Commission Health Industry Clinical Research Special Project (No. 293) and 2023 Shanghai youth work research project (No. 2023QYKTLX2-5).