Excess weight and its association with cardiometabolic risk in adolescents: comparative analysis of national and international classifications.
4 affiliations
- 1Universidade Estadual do Ceará, Centro de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Fortaleza, CE, Brazil.
- 2Universidade Estadual do Ceará, Health Sciences Center, Centro de Ciências da Saúde, Programa de Pós-Graduação em Nutrição e Saúde, Fortaleza, CE, Brazil.
- 3Universidade de São Paulo, Faculdade de Medicine, Instituto do Coração, Programa de Pós-Graduação em Cardiologia, São Paulo, SP, Brazil.
- 4Universidade Estadual do Ceará, Centro de Ciências da Saúde, Fortaleza, CE, Brazil.
Abstract
Objective
To evaluate the agreement between the overweight and obesity classifications of the World Health Organization (WHO), the International Obesity Task Force (IOTF), and the Brazilian Reference (BR) proposed by Conde and Monteiro in adolescents, and to verify the association of these classifications with cardiometabolic risk (CMR).Methods
A cross-sectional study was conducted with 823 adolescents (aged 10-19 years) from municipal schools in Fortaleza, Ceará. Nutritional status was classified according to three body mass index references. CMR was defined by the simultaneous presence of insulin resistance, identified by the waist-to-height ratio, and dyslipidemia, assessed by biochemical tests (total cholesterol, HDL-c, LDL-c, and triglycerides). Agreement between classifications was assessed using the Kappa (κ) statistic, and the association with CMR was analyzed using Poisson regression.Results
All classifications showed excellent agreement, with weighted κ values ranging from 0.85 to 0.95. The highest agreement was between WHO and IOTF references (κ=0.95; 95%CI 0.93-0.97), while the lowest was between WHO and BR (κ=0.85; 95%CI 0.82-0.88). Despite the lower agreement, the diagnosis of obesity according to the BR reference demonstrated strong clinical relevance, being associated with an 8.51-fold higher prevalence of CMR in adolescents (95%CI 6.38-11.35).Conclusions
BR showed a stronger association with CMR. The inclusion of this classification may optimize the early detection of CMR in Brazilian health services, helping to prevent cardiometabolic disorders in this population.
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BibTeX
@article{nogueira2026excess,
title = {{Excess weight and its association with cardiometabolic risk in adolescents: comparative analysis of national and international classifications.}},
author = {Maria Dinara de Araújo Nogueira and Luis Felipe Nunes de Oliveira and Géssica de Souza Martins and Ribanna Aparecida Marques Braga and Eric Wenda Ribeiro Lourenço and Ilana Nogueira Bezerra and Carla Soraya Costa Maia},
journal = {Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo},
year = {2026},
month = oct,
doi = {10.1590/1984-0462/2026/44/2025342},
url = {https://europepmc.org/article/MED/42912062},
note = {CC BY},
}
RIS
TY - JOUR
TI - Excess weight and its association with cardiometabolic risk in adolescents: comparative analysis of national and international classifications.
AU - Maria Dinara de Araújo Nogueira
AU - Luis Felipe Nunes de Oliveira
AU - Géssica de Souza Martins
AU - Ribanna Aparecida Marques Braga
AU - Eric Wenda Ribeiro Lourenço
AU - Ilana Nogueira Bezerra
AU - Carla Soraya Costa Maia
PY - 2026
DA - 2026/10/19
JO - Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo
DO - 10.1590/1984-0462/2026/44/2025342
UR - https://europepmc.org/article/MED/42912062
AB - Objective To evaluate the agreement between the overweight and obesity classifications of the World Health Organization (WHO), the International Obesity Task Force (IOTF), and the Brazilian Reference (BR) proposed by Conde and Monteiro in adolescents, and to verify the association of these classifications with cardiometabolic risk (CMR).Methods A cross-sectional study was conducted with 823 adolescents (aged 10-19 years) from municipal schools in Fortaleza, Ceará. Nutritional status was classified according to three body mass index references. CMR was defined by the simultaneous presence of insulin resistance, identified by the waist-to-height ratio, and dyslipidemia, assessed by biochemical tests (total cholesterol, HDL-c, LDL-c, and triglycerides). Agreement between classifications was assessed using the Kappa (κ) statistic, and the association with CMR was analyzed using Poisson regression.Results All classifications showed excellent agreement, with weighted κ values ranging from 0.85 to 0.95. The highest agreement was between WHO and IOTF references (κ=0.95; 95%CI 0.93-0.97), while the lowest was between WHO and BR (κ=0.85; 95%CI 0.82-0.88). Despite the lower agreement, the diagnosis of obesity according to the BR reference demonstrated strong clinical relevance, being associated with an 8.51-fold higher prevalence of CMR in adolescents (95%CI 6.38-11.35).Conclusions BR showed a stronger association with CMR. The inclusion of this classification may optimize the early detection of CMR in Brazilian health services, helping to prevent cardiometabolic disorders in this population.
SN - 0103-0582
SN - 1984-0462
ER -