Sensitivity and Specificity of Body Mass Index as a Marker of Obesity in Elderly Patients on Hemodialysis

Sensitivity and Specificity of Body Mass Index as a Marker of Obesity in Elderly Patients on Hemodialysis

Author Rodrigues, Juliana Google Scholar
Santin, Fernanda Google Scholar
Barbosa Brito, Flavia Santos Google Scholar
Carrero, Juan Jesus Google Scholar
Lindholm, Bengt Google Scholar
Cuppari, Lilian Autor UNIFESP Google Scholar
Avesani, Carla Maria Google Scholar
Abstract Objectives: Diagnosing obesity by body mass index (BMI) may not be reliable in elderly individuals due to the changes in body composition. We aimed to analyze the accuracy of BMI thresholds by World Health Organization (WHO) and Nutrition Screening Initiative (NSI) to diagnose obesity in elderly patients on hemodialysis (HD). Design: Multicenter cross-sectional study. Setting: Six dialysis facilities. Subjects: 169 elderly on chronic HD (70.4 +/- 7.1 years; 63.9% men). Main Outcome Variable: Total body fat percentage (BF%) was assessed by the sum of skinfold thicknesses and abdominal fat by waist circumference (WC). Both were used as reference to test the specificity and sensitivity of BMI thresholds (WHO: >= 30 kg/m(2); NSI: >27 kg/m(2)). Results: The prevalence of obesity according to NSI-BMI, WHO-BMI, BF%, and WC thresholds were 31%, 13%, 27%, and 29.6% in men, respectively, and 36%, 15%, 13%, and 75% in women. Compared to BF%, the sensitivity of NSI-BMI was moderate (65.5%) for men and high (100%) for women, whereas that of WHO-BMI was low (31%) for men and high (87.5%) for women. Compared with WC, NSI-BMI had good (75%) sensitivity for men and moderate (47.8%) for women, whereas WHO-BMI had moderate (43.8%) sensitivity for men and low (19.6%) for women. The best agreement with BF% was observed for NSI-BMI in men (kappa = 0.46) and for WHO-BMI in women (kappa = 0.80). For WC, the best agreement was for WHO-BMI for men (kappa = 0.63) and NSI-BMI for women (kappa = 0.31). Conclusions: BMI thresholds do not accurately diagnose adiposity in elderly on HD. Therefore, using BMI may lead to misclassifications in this segment population. (C) 2016 by the National Kidney Foundation, Inc. All rights reserved.
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Sponsor Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ)
Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)
Fundacao de Amparo e Pesquisa do Estado do Rio de Janeiro (FAPERJ)
Baxter Healthcare
Grant number FAPERJ: E-26/111.653/2010
FAPERJ: E-26/103.209/2011
Date 2016
Published in Journal Of Renal Nutrition. Philadelphia, v. 26, n. 2, p. 65-71, 2016.
ISSN 1051-2276 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co-Elsevier Inc
Extent 65-71
Origin http://dx.doi.org/10.1053/j.jrn.2015.09.001
Access rights Closed access
Type Article
Web of Science ID WOS:000372011100003
URI https://repositorio.unifesp.br/handle/11600/57885

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