{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:50:12Z","timestamp":1782399012371,"version":"3.54.5"},"reference-count":57,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01MD011686"],"award-info":[{"award-number":["R01MD011686"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01MD011686\u201005S2"],"award-info":[{"award-number":["R01MD011686\u201005S2"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01MD011686\u201005S3"],"award-info":[{"award-number":["R01MD011686\u201005S3"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Science &amp; Practice"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate total body fat percentage (TBFP) percentiles and their association with obesity and cardiometabolic risk biomarkers in the United States adult population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Cross\u2010sectional data for adults (20\u201359\u00a0years) from the 2011\u20132018 National Health and Nutrition Examination Survey (NHANES) were analyzed (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a014,347). TBFP was assessed using dual\u2010energy X\u2010ray absorptiometry. TBFP percentiles were calculated using age\u2010adjusted, weighted quantile regression. Receiver operating characteristic (ROC) analyses assessed the ability of TBFP to predict obesity (body mass index [BMI]\u00a0\u2265\u00a030\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), elevated HbA1c (\u2265\u00a05.7%), and alanine aminotransferase (ALT) thresholds (\u2265\u00a020 and\u00a0\u2265\u00a040\u00a0U\/L); and the ability of BMI to predict elevated TBFP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>TBFP percentiles were similar across groups, but non\u2010Hispanic Black men had significantly lower odds of TBFP\u00a0\u2265\u00a090th percentile compared with non\u2010Hispanic White men. TBFP demonstrated accuracy in predicting BMI\u2010defined obesity (AUC 0.83\u20130.91), and BMI demonstrated accuracy in predicting elevated TBFP (AUC 0.80\u20130.90). TBFP had limited ability to predict elevated HbA1c (AUC 0.52\u20130.65) and ALT (AUC 0.51\u20130.63).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TBFP percentiles are associated with BMI\u2010defined obesity but are insufficient to predict cardiometabolic risk independently. These findings support the continued use of BMI as a screening tool and suggest that TBFP may complement but not replace existing measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/osp4.70158","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:37:08Z","timestamp":1780472228000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Total Body Fat Percentiles, Obesity and Cardiometabolic Health Biomarkers in Adults in the United States"],"prefix":"10.1002","volume":"12","author":[{"given":"Grant","family":"Herrington","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Division of Endocrinology University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luyu","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Health Data Science and Biostatistics Quantitative Biomedical Research Center Peter O'Donnell Jr. School of Public Health University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenglin","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Health Data Science and Biostatistics Quantitative Biomedical Research Center Peter O'Donnell Jr. School of Public Health University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Clark","sequence":"additional","affiliation":[{"name":"Sharp Rees\u2010Stealy Medical Group  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna C.","family":"Rivara","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Science Peter O'Donnell Jr. School of Public Health University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Sunil","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Peter O'Donnell Jr. School of Public Health University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Endocrinology University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepali K.","family":"Ernest","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Peter O'Donnell Jr. School of Public Health University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime P.","family":"Almandoz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Endocrinology University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6685-2175","authenticated-orcid":false,"given":"Sarah E.","family":"Messiah","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Peter O'Donnell Jr. School of Public Health University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Department of Pediatrics University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Children's Health System of Texas  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2018.09.005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.22378"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm517"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010021\u201002188\u2010x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(23)00058\u2010x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900\u2010013\u20109792\u20108"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(21)00088\u20107"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.24129"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(03)15268\u20103"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15102254"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(16)30175\u20101"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(18)30288\u20102"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2010.04.012"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.121.023667"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2024.03.018"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1590\/s0100\u2010879x2012007500059"},{"key":"e_1_2_10_18_1","unstructured":"M.Krugh andM. 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