Body fat percentage is better than indicators of weight status to identify children and adolescents with unfavorable lipid profile.

OBJECTIVE To assess whether the indicators of weight status body mass index and waist-to-height ratio are similar to body fat percentage to identify obese children and adolescents with unfavorable lipid profile. METHODS This was a cross-sectional study involving 840 children and adolescents (6-18 years). The same individuals were classified as non-obese (<P95) or obese (≥P95) according to body fat percentage and indicators of weight status, body mass index, and waist-to-height ratio. Body fat percentage was obtained by multi-frequency bioelectrical impedance. Linear association between obesity and increased lipid fractions was tested by ANCOVA. Normal distribution curves of non-HDL cholesterol were designed for obese and non-obese. To provide the proportion of obese individuals with elevated non-HDL-c across all indicators, Z-score was calculated. RESULTS Obese boys presented higher non-HDL cholesterol when compared with those non-obese, classified by body mass index (107±28 vs. 94±25mg/dL, p=0.001), waist-to-height ratio (115±29 vs. 94±25mg/dL, p<0.001) and body fat percentage (119±33 vs. 94±24mg/dL, p<0.001). Differently, obese girls presented with higher non-HDL cholesterol when compared with those non-obese only according to the body fat percentage classification (118±24 vs. 96±26mg/dL, p=0.001). A large shift to the right in the distribution curve of non-HDL cholesterol among obese girls compared with non-obese was observed only when body fat percentage was used to discriminate between obese and non-obese. CONCLUSION Body fat percentage was better than the indicators of weight status to identify children and adolescents with unfavorable lipid profile, mainly among girls.