{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:33:09Z","timestamp":1790008389679,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T00:00:00Z","timestamp":1562716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Body mass index (BMI) metrics are widely used as a proxy for adiposity in children with severe obesity. The BMI expressed as the percentage of a cut\u2010off percentile for overweight or obesity has been proposed as a better alternative than BMI <jats:italic>z<\/jats:italic>\u2010scores when monitoring children and adolescents with severe obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Annual changes in BMI, BMI <jats:italic>z<\/jats:italic>\u2010score and the percentage above the International Obesity Task Force overweight cut\u2010off (%IOTF\u201025) were compared with dual\u2010energy X\u2010ray absorptiometry (DXA) derived body fat (%BF\u2010DXA) in 59 children and adolescents with severe obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The change in %BF\u2010DXA was correlated with the change in %IOTF\u201025 (r\u00a0=\u00a00.68) and BMI (r\u00a0=\u00a00.70), and somewhat less with the BMI <jats:italic>z<\/jats:italic>\u2010score (r\u00a0=\u00a00.57). Cohen's Kappa statistic to detect an increase or decrease in %BF\u2010DXA was fair for %IOTF\u201025 (\u03ba\u00a0=\u00a00.25; p\u00a0=\u00a00.04) and BMI (\u03ba\u00a0=\u00a00.33; p\u00a0=\u00a00.01), but not for the BMI <jats:italic>z<\/jats:italic>\u2010score (\u03ba\u00a0=\u00a00.08; p\u00a0=\u00a00.5). The change in BMI was positively biased due to a natural increase with age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Changes in the BMI metrics included in the study are associated differently with changes in %BF\u2010DXA. The BMI <jats:italic>z<\/jats:italic>\u2010score is widely used to monitor changes in adiposity in children and adolescents with severe obesity, but the %IOTF\u201025 might be a better alternative.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.14898","type":"journal-article","created":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T07:29:40Z","timestamp":1560497380000},"page":"2261-2266","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Monitoring children and adolescents with severe obesity: body mass index (BMI), BMI <i>z<\/i>\u2010score or percentage above the International Obesity Task Force overweight cut\u2010off?"],"prefix":"10.1111","volume":"108","author":[{"given":"Hanne L.","family":"L\u00f8kling","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Roelants","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care KU Leuven University of Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin G.","family":"Kommedal","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Skj\u00e5k\u00f8deg\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Clinical Science University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen M.","family":"Apalset","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Bergen Group of Epidemiology and Biomarkers in Rheumatic Disease Haukeland University Hospital Bergen 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