Original article
Accuracy of different cutoff points of body mass index to identify overweight according to body fat values estimated by DEXA
Precisão de diferentes pontos de corte do índice de massa corporal para identificar sobrepeso de acordo com valores de gordura corporal estimados por DEXA
Caroline Cristina Anzolina, Diego Augusto Santos Silvab, Edner Fernando Zanutoa, Suziane Ungari Cayresc, Jamile Sanches Codognoa, Paulo Costa Juniora, Dalmo Roberto Lopes Machadoc, Diego Giulliano Destro Christofaroa,
Corresponding author
a Universidade Estadual Paulista (UNESP), Programa de Pós-Graduação em Fisioterapia, Presidente Prudente, SP, Brazil
b Universidade Federal de Santa Catarina (UFSC), Departamento de Educação Física, Florianópolis, SC, Brazil
c Universidade de São Paulo (USP), Escola de Educação Física e Esporte, Ribeirão Preto, SP, Brazil
Read
2832
Timeswas read the article
1293
Total PDF
1539
Total HTML
Share statistics
array:25 [ "pii" => "S0021755716301048" "issn" => "00217557" "doi" => "10.1016/j.jped.2016.04.010" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "429" "copyright" => "Sociedade Brasileira de Pediatria" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "J Pediatr (Rio J). 2017;93:58-63" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 911 "formatos" => array:3 [ "EPUB" => 86 "HTML" => 491 "PDF" => 334 ] ] "Traduccion" => array:1 [ "pt" => array:20 [ "pii" => "S2255553616301045" "issn" => "22555536" "doi" => "10.1016/j.jpedp.2016.08.008" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "429" "copyright" => "Sociedade Brasileira de Pediatria" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "J Pediatr (Rio J). 2017;93:58-63" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1021 "formatos" => array:3 [ "EPUB" => 95 "HTML" => 638 "PDF" => 288 ] ] "pt" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>" "titulo" => "Accuracy of different cutoff points of body mass index to identify overweight according to body fat values estimated by DEXA" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "58" "paginaFinal" => "63" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Precisão de diferentes pontos de corte do índice de massa corporal para identificar sobrepeso de acordo com valores de gordura corporal estimados por DEXA" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1583 "Ancho" => 1589 "Tamanyo" => 91825 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Comparação entre a classificação de sobrepeso por DEXA e por pontos de corte do IMC.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Caroline Cristina Anzolin, Diego Augusto Santos Silva, Edner Fernando Zanuto, Suziane Ungari Cayres, Jamile Sanches Codogno, Paulo Costa Junior, Dalmo Roberto Lopes Machado, Diego Giulliano Destro Christofaro" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Caroline Cristina" "apellidos" => "Anzolin" ] 1 => array:2 [ "nombre" => "Diego Augusto Santos" "apellidos" => "Silva" ] 2 => array:2 [ "nombre" => "Edner Fernando" "apellidos" => "Zanuto" ] 3 => array:2 [ "nombre" => "Suziane Ungari" "apellidos" => "Cayres" ] 4 => array:2 [ "nombre" => "Jamile Sanches" "apellidos" => "Codogno" ] 5 => array:2 [ "nombre" => "Paulo Costa" "apellidos" => "Junior" ] 6 => array:2 [ "nombre" => "Dalmo Roberto Lopes" "apellidos" => "Machado" ] 7 => array:2 [ "nombre" => "Diego Giulliano Destro" "apellidos" => "Christofaro" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0021755716301048" "doi" => "10.1016/j.jped.2016.04.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716301048?idApp=UINPBA000049" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553616301045?idApp=UINPBA000049" "url" => "/22555536/0000009300000001/v1_201701310017/S2255553616301045/v1_201701310017/pt/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S002175571630122X" "issn" => "00217557" "doi" => "10.1016/j.jped.2016.04.011" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "437" "copyright" => "Sociedade Brasileira de Pediatria" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "J Pediatr (Rio J). 2017;93:64-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 840 "formatos" => array:3 [ "EPUB" => 82 "HTML" => 476 "PDF" => 282 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Physical self-efficacy is associated to body mass index in schoolchildren" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "64" "paginaFinal" => "69" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Autoeficácia física associada ao índice de massa corporal em crianças em idade escolar" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alicia Carissimi, Ana Adan, Lorenzo Tonetti, Marco Fabbri, Maria Paz Hidalgo, Rosa Levandovski, Vincenzo Natale, Monica Martoni" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Alicia" "apellidos" => "Carissimi" ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Adan" ] 2 => array:2 [ "nombre" => "Lorenzo" "apellidos" => "Tonetti" ] 3 => array:2 [ "nombre" => "Marco" "apellidos" => "Fabbri" ] 4 => array:2 [ "nombre" => "Maria Paz" "apellidos" => "Hidalgo" ] 5 => array:2 [ "nombre" => "Rosa" "apellidos" => "Levandovski" ] 6 => array:2 [ "nombre" => "Vincenzo" "apellidos" => "Natale" ] 7 => array:2 [ "nombre" => "Monica" "apellidos" => "Martoni" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2255553616301367" "doi" => "10.1016/j.jpedp.2016.04.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553616301367?idApp=UINPBA000049" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002175571630122X?idApp=UINPBA000049" "url" => "/00217557/0000009300000001/v1_201701260039/S002175571630122X/v1_201701260039/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S0021755716300699" "issn" => "00217557" "doi" => "10.1016/j.jped.2016.03.008" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "409" "copyright" => "Sociedade Brasileira de Pediatria" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "J Pediatr (Rio J). 2017;93:47-57" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 834 "formatos" => array:3 [ "EPUB" => 69 "HTML" => 491 "PDF" => 274 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Nutritional quality of dietary patterns of children: are there differences inside and outside school?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "47" "paginaFinal" => "57" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Qualidade nutricional dos padrões alimentares de crianças: existem diferenças dentro e fora da escola?" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Diva Aliete dos Santos Vieira, Michelle Alessandra Castro, Mauro Fisberg, Regina Mara Fisberg" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Diva Aliete dos Santos" "apellidos" => "Vieira" ] 1 => array:2 [ "nombre" => "Michelle Alessandra" "apellidos" => "Castro" ] 2 => array:2 [ "nombre" => "Mauro" "apellidos" => "Fisberg" ] 3 => array:2 [ "nombre" => "Regina Mara" "apellidos" => "Fisberg" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2255553616300799" "doi" => "10.1016/j.jpedp.2016.07.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553616300799?idApp=UINPBA000049" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716300699?idApp=UINPBA000049" "url" => "/00217557/0000009300000001/v1_201701260039/S0021755716300699/v1_201701260039/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Accuracy of different cutoff points of body mass index to identify overweight according to body fat values estimated by DEXA" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "58" "paginaFinal" => "63" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Caroline Cristina Anzolin, Diego Augusto Santos Silva, Edner Fernando Zanuto, Suziane Ungari Cayres, Jamile Sanches Codogno, Paulo Costa Junior, Dalmo Roberto Lopes Machado, Diego Giulliano Destro Christofaro" "autores" => array:8 [ 0 => array:3 [ "nombre" => "Caroline Cristina" "apellidos" => "Anzolin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Diego Augusto Santos" "apellidos" => "Silva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Edner Fernando" "apellidos" => "Zanuto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Suziane Ungari" "apellidos" => "Cayres" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Jamile Sanches" "apellidos" => "Codogno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Paulo" "apellidos" => "Costa Junior" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "Dalmo Roberto Lopes" "apellidos" => "Machado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 7 => array:4 [ "nombre" => "Diego Giulliano Destro" "apellidos" => "Christofaro" "email" => array:1 [ 0 => "diegochristofaro@yahoo.com.br" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Universidade Estadual Paulista (UNESP), Programa de Pós-Graduação em Fisioterapia, Presidente Prudente, SP, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidade Federal de Santa Catarina (UFSC), Departamento de Educação Física, Florianópolis, SC, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Universidade de São Paulo (USP), Escola de Educação Física e Esporte, Ribeirão Preto, SP, Brazil" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Precisão de diferentes pontos de corte do índice de massa corporal para identificar sobrepeso de acordo com valores de gordura corporal estimados por DEXA" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1839 "Ancho" => 1670 "Tamanyo" => 89525 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Receiver operating characteristic (ROC) curve for body mass index (BMI) ability to predict overweight estimated by dual energy X-ray absorptiometry (DEXA).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Obesity is a multifactorial disease whose increasing prevalence has been the focus of numerous investigations in both high-income<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">1,2</span></a> and middle-income countries<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">3</span></a> such as Brazil.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">4</span></a> This fact is of increasing concern due to the high incidence of this disease in the pediatric population.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In this context, different strategies to prevent and fight childhood obesity have been outlined in order to assess nutritional status<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">6,7</span></a> from body mass scores. Various methods, such as skinfold thickness, waist-hip ratio, waist circumference, and body mass index (BMI), can be used as nutritional status indicators.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">These anthropometric indicators have limitations in their measurements, but still show good predictive body fat values,<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">8</span></a> and findings in literature have indicated that BMI is an appropriate tool for cardiometabolic risk screening in the pediatric population,<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">9</span></a> although some differences point to other assessment methods as better body fat indicators.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">10</span></a> BMI has become a useful tool because it is considered to be low cost and easy to apply, being widely used in epidemiological studies to diagnose excess body adiposity.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">There is no consensus in literature regarding the cutoffs to stratify BMI values into underweight, overweight, and obesity in the pediatric population; different cutoff points have been developed for this purpose.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12–15</span></a> This lack of consensus in cutoff points to classify the nutritional status of this population makes the comparison between studies conducted in different locations difficult, as with data from a single sample, different overweight and obesity prevalence can be found, depending on the cutoff point used.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">16</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">One of the techniques that are more precise than anthropometric measurements to estimate body fat and other body composition components is the dual energy X-ray absorptiometry (DEXA), which consists of “scanning” the body through X-rays that, after passing through the organism, are measured by an energy-discriminating detector. DEXA performs transverse analysis of the body and is a noninvasive technique considered safe that can measure three body components: fat mass, free fat mass, and bone mass.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">17</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">This study aimed to analyze the sensitivity and specificity of different BMI cutoff points for predicting overweight/obesity according to the body fat values estimated by DEXA among Brazilian male adolescents.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">This descriptive/analytical cross-sectional study was conducted in a city in the state of São Paulo. This city has 210,000 inhabitants and is located in southeastern Brazil (human development index<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.806). The sample consisted of 229 male adolescents participating in the university extension project in partnership with philanthropic institutions of that city. The following inclusion criteria were adopted: (i) informed consent form signed by parents or guardians; and (ii) age from 10 to 15 years at the assessment date. This study was approved by the Research Ethics Committee involving humans of the University responsible for this study.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Total body fat was measured by the DEXA technique using a Lunar DPX-MD device, by General Electric (General Electric Company, model Lunar DPX-MD, USA), examining the entire body, with technique applied by a single trained evaluator. Initially, after testing the scanning quality, the volunteers were positioned in supine position without the use of metal objects and shoes, and during this test, they remained still for a period of approximately 15<span class="elsevierStyleHsp" style=""></span>min. Total body fat was expressed in percentages values by the GE Medical Systems Lunar software (GE Healthcare Life Sciences, Lunar<span class="elsevierStyleSup">®</span>, version 4.7., USA). Overweight and obesity classification by bone densitometry followed the recommendations of Williams et al.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">18</span></a> (overweight/obesity ≥25% body fat).</p><p id="par0045" class="elsevierStylePara elsevierViewall">Body weight was measured using an electronic scale Filizola<span class="elsevierStyleSup">®</span> (modelo Filizola, Personal Line 200, Brazil) with precision of 0.1<span class="elsevierStyleHsp" style=""></span>kg and height was estimated using wooden stadiometer fixed to the wall model Sanny (Sanny<span class="elsevierStyleSup">®</span>, Profissional model, Brazil), with accuracy of 0.1<span class="elsevierStyleHsp" style=""></span>cm and maximum height of 2<span class="elsevierStyleHsp" style=""></span>m. These anthropometric values were used to calculate BMI by body weight in kilograms divided by the height, squared, in meters.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Nutritional status was assessed by BMI according to the following cutoffs described in literature: (i) Must et al.,<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> established for the U.S. population aged from 6 to 74 years; (ii) Conde and Monteiro,<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> Brazilian classification for children and adolescents aged 2–19 years; (iii) Cole et al.,<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> a multicenter survey (Brazil, Great Britain, Hong Kong, Netherlands, Singapore, and the United States), established for the population aged 0–25 years; (iv) and the World Health Organization (WHO)<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> for children and adolescentes aged 5–19 years.</p><p id="par0055" class="elsevierStylePara elsevierViewall">As the sample was composed of male adolescents aged 10–15 years, the exact values of the different cutoff points were: Must et al.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> (10 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>22.60; 11 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23.73; 12 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>24.89; 13 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>25.93; 14 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26.93; 15 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>27.76); Conde & Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> (10 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13.09; 11 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13.32; 12 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13.63; 13 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14.02; 14 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14.49; 15 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>15.01); Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> (10 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19.84; 11 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20.55; 12 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>21.22; 13 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>21.91; 14 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>22.62; 15 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23.29); and WHO<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> (10 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>18.60; 11 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19.30; 12 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20.10; 13 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20.09; 14 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>21.9; 15 years<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>22.80).</p><p id="par0060" class="elsevierStylePara elsevierViewall">Sample characteristics were presented as mean and standard deviation. Spearman correction (<span class="elsevierStyleItalic">r</span>) was applied to assess the relationship between percentage body fat estimated by the reference method and the BMI, and the agreement of these values was verified by the Kappa test for categorical variables and intra-class coefficient correlation (ICC) for continuous variables. The comparison between the classification of overweight by DEXA and the cutoff points tested in the present study was performed using the McNemar test. The parameters of the ROC curve (sensitivity, specificity, area under the curve [AUC], negative predictive value [NPV], and positive predictive value [PPV]) were used to verify the ability of cutoff points in predicting overweight and obesity. The statistical significance adopted was equal to or less than 5% and the confidence interval was 95%. Statistical analysis was performed using the SPSS (SPSS Inc. Released 2007. SPSS for Windows, version 15.0, USA) and MedCalc (MedCalc<span class="elsevierStyleSup">®</span>, version 11.1, Belgium).</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">The sample consisted of 229 male adolescents aged 10–15 years. The mean characteristics of the sample were as follows: age, 12.31(±1.78) years; weight, 47.52 (±13.77) kg; height, 155.18 (±13.41) cm; and BMI, 19.41 (±13.66) kg/m<span class="elsevierStyleSup">2</span>.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Seventy young subjects (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>30.5%) were classified as having excess body fat by DEXA. The prevalence of overweight when analyzing the various cutoff points used in this study was shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>. No significant differences were observed between the overweight classification by DEXA compared to the cutoff points proposed by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> and by the WHO.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> Significant differences were observed using the cutoff points by Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> and by Must et al.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">When the relationship between body fat values identified by the reference method adopted in this study and BMI, good correlation was observed between these methods (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.78). The agreement of measurements performed by the different cutoff points was determined by the Kappa test, and the following values were observed: <span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.61 for Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a>; <span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.65 for Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a>; <span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.61 for Must et al.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a>; and <span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.63 for WHO.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> When considering the agreement between continuous variables, fat percentage by DEXA and BMI, good agreement was observed (ICC<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.72).</p><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows information on the area under the curve, sensitivity, specificity, PPV, and NPV. The highest sensitivity among the proposed criteria was verified for the cutoff of Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> and the highest specificity for the cutoff of Cole et al.,<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> as well as the highest PPV. The highest NPV was observed for the cutoff of Conde and Monteiro.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The ability of BMI has also been analyzed in this study (as a continuous variable) predicting overweight estimated by DEXA. High values of AUC, sensitivity, and specificity were observed, as shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the comparisons between different areas under the ROC curves and their respective confidence intervals of different cutoff points analyzed in this study. Statistically significant differences were observed when the cutoff points of Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> and Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> were compared.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">The present findings indicate that the cutoff established by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> showed higher AUC and sensitivity, which helps identifying more efficiently the presence of overweight and obesity among children and adolescents. Conversely, Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> showed higher specificity when compared to the other outcomes.</p><p id="par0100" class="elsevierStylePara elsevierViewall">In this study, the results showed that the cutoff points proposed by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> are more suitable, as they provide higher AUC, NPV, and a prognosis of greater sensitivity to excess adiposity in the assessed population. These results have already been disclosed in the literature.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">19</span></a> This result probably occurred due to the fact that these cutoff points proposed by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> have only been applied to Brazilian adolescents when compared to international standards,<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12–14</span></a> as the cutoff points used for the assessment of excess body weight built with features of other nations in the prevalence of overweight is greater, and may underestimate or be less sensitive when applied to populations in which the prevalence of overweight is lower.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">20</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">The overweight indicators assessed by DEXA showed positive correlation with the cutoff points analyzed. Other studies also found similar positive correlations,<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">21,22</span></a> which suggests that all these indexes are able to identify the nutritional status of children and adolescents. Moreover, with regard to the values proposed by Must et al.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> and by Cole et al.,<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> it was observed that such multicenter surveys were conducted in countries where the prevalence of overweight/obesity is high,<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">23</span></a> which may explain the lower sensitivity levels and the tendency of such indexes to underestimate overweight and obesity in the Brazilian population.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The cutoff point proposed by the WHO<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> shows large amplitude when compared with the other references, which may have provided lower sensitivity to the prognosis of overweight and obesity. Similar findings were reported by Veiga et al.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">24</span></a> However, when the ROC curves of cutoff points were observed, it was observed that those by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> showed more sensitive critical values in the identification of excess body fat compared to those by Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> This occurred because the model was built based on data obtained from young Brazilians a few years ago, when obesity rates were not similar to the worrisome current reality.<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">25</span></a> Another factor is that the values recommended for each age group by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> were lower than the other cutoff points analyzed in this study.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Although the sensitivity and specificity results were significant, when analyzing the misclassification of cutoff points compared with DEXA, statistically significant differences were observed in the cutoff points by Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> and by Must et al.,<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> may note that there may be erroneous ratings on the body fat index in certain populations, so the cutoff points established by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> and WHO,<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> are less likely to body fat misclassification. Moreover Neovius et al.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">26</span></a> examined the misclassification of some cutoffs in Swedish adolescents and found a better system of excess fat classification through the cutoff points of Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> and WHO.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> The difference between the findings may be related the characteristics analyzed population.</p><p id="par0120" class="elsevierStylePara elsevierViewall">To use the different types of cutoff points, healthcare professionals should be aware of the strengths and limitations of each cutoff point. For example, among those analyzed in the present study, that by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> was more sensitive, but also has the greatest chance of detecting false positives, <span class="elsevierStyleItalic">i.e.</span>, to classify as overweight individuals who are not. Unlike more specific cutoff points, those by Cole et al.,<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> by Must et al.,<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> and by the WHO<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> may classify some adolescents who are overweight as normal weight.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Furthermore, a limitation to be considered is that these different cutoff points should be tested against a number of cardiovascular risk factors in adolescents such as hypertension, diabetes, cholesterol, and triglycerides to assess their efficiency in detecting cardiovascular risks.</p><p id="par0130" class="elsevierStylePara elsevierViewall">As Neouvis et al.,<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">26</span></a> the present study also tested the accuracy, sensitivity and specificity of BMI on a continuous basis in predicting overweight observable good AUC (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). These results show that the higher the BMI, the greater are the chances of the subject presenting a high fat percentage based on BMI analysis <span class="elsevierStyleItalic">versus</span> body fat obtained by DEXA. Thus, the use of BMI by healthcare professionals should be encouraged, as it correlates well with body fat. Moreover, BMI is a simple and inexpensive technique.</p><p id="par0135" class="elsevierStylePara elsevierViewall">The following limitations of this study should be highlighted: (i) the cross-sectional design, which did not allow for the establishment of a causal relationship between outcomes; (ii) the sample, which consisted of male volunteers only; (iii) the use of DEXA as reference method, as previous results have shown that this technique tends to overestimate the percentage of body fat in individuals with high body fat levels and to underestimate it in those with low fat levels<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">27</span></a>; thus, for adolescents with extreme BMI values, DEXA results may not be as accurate. Nonetheless, this technique is more accurate than anthropometric measurements to estimate body fat. Further studies should be carried out using more accurate methods to estimate body fat and to verify the possible relationship between cutoff points.</p><p id="par0140" class="elsevierStylePara elsevierViewall">A practical application for obesity screening in the young population could be the use of different cutoff points simultaneously; for example, in the case of this study, the most sensitive and specific, because if an adolescent is classified as overweight by two cutoff points, he/she should be closely monitored. From these assessments, health promotion could be better prepared in the school environment. Referral of young overweight subjects assessed at different cutoff points to a Basic Healthcare Unit could be carried out with the purpose of performing routine tests to prevent cardiovascular problems typically associated with overweight.</p><p id="par0145" class="elsevierStylePara elsevierViewall">Thus, it can be concluded that the cutoff points proposed by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> was more sensitive in identifying overweight and obesity when compared to the reference method, and the cutoff points by Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> showed higher specificity for such outcomes.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicts of interest</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres794487" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec792805" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres794486" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec792804" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-08-28" "fechaAceptado" => "2016-04-06" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec792805" "palabras" => array:5 [ 0 => "Sensitivity and specificity" 1 => "Adolescent health" 2 => "Overweight" 3 => "Obesity" 4 => "Body composition" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec792804" "palabras" => array:5 [ 0 => "Sensibilidade e especificidade" 1 => "Saúde do adolescente" 2 => "Sobrepeso" 3 => "Obesidade" 4 => "Composição corporal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the sensitivity and specificity of different cutoff points of body mass index for predicting overweight/obesity according to body fat values estimated by DEXA among Brazilian adolescents.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional study including 229 male adolescents aged 10–15 years, in which body adiposity and anthropometric measures were assessed. Nutritional status was classified by BMI according to cutoff points described in scientific literature.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Moderate agreements were observed between body fat estimated by DEXA and cutoffs proposed by Cole et al. (<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.61), Conde and Monteiro (<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.65), Must et al. (<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.61) and WHO (<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.63). The BMI in continuous form showed good agreement with the Dexa (ICC<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.72). The highest sensitivity was observed for cutoff by Conde and Monteiro (0.74 [0.62, 0.84]) and the highest specificity by Cole et al. (0.98 [0.94, 0.99]). For the areas under the ROC curve of cutoff points analyzed, significant difference comparing the cutoff points by Cole et al. and Conde and Monteiro (0.0449 [0.00294, 0.0927]) was observed.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The cutoff proposed by Conde and Monteiro was more sensitive in identifying overweight and obesity when compared to the reference method, and the cutoff proposed by Cole et al. presented the highest specificity for such outcomes.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Avaliar a sensibilidade e a especificidade de diferentes pontos de corte do índice de massa corporal para o prognóstico de sobrepeso/obesidade de acordo com os valores de gordura corporal estimados por DEXA entre adolescentes brasileiros.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal que inclui 229 adolescentes do sexo masculino com idade entre 10-15 anos, no qual foram avaliadas a adiposidade corporal e medidas antropométricas. A situação nutricional foi classificada pelo IMC de acordo com os pontos de corte descritos na literatura científica.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Foram observadas concordâncias moderadas entre a gordura corporal estimada por DEXA e os cortes propostos por Cole et al. [<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,61], Conde e Monteiro [<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,65], Must et al. [<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,61] e a OMS [<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,63]. O IMC de forma contínua mostrou uma boa concordância com a Dexa [CCI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,72]. A maior sensibilidade foi observada em cortes por Conde e Monteiro [0,74 (0,62, 0,84)] e a maior especificidade por Cole et al. [0,98 (0,94, 0,99)]. Nas áreas abaixo da curva de ROC de pontos de corte analisados, foi observada uma diferença significativa ao comparar os pontos de corte de Cole et al. e Conde e Monteiro [0,0449 (0,00294, 0,0927)].</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusões</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">O corte proposto por Conde e Monteiro foi mais sensível na identificação de sobrepeso e obesidade em comparação ao método de referência, e o corte proposto por Cole et al. apresentou a maior especificidade para esses resultados.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Anzolin CC, Silva DA, Zanuto EF, Cayres SU, Codogno JS, Costa Junior P, et al. Accuracy of different cutoff points of body mass index to identify overweight according to body fat values estimated by DEXA. J Pediatr (Rio J). 2017;93:58–63.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1583 "Ancho" => 1589 "Tamanyo" => 85632 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Comparison between the overweight classification by dual energy X-ray absorptiometry (DEXA) and body mass index (BMI) cutoff points.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1839 "Ancho" => 1670 "Tamanyo" => 89525 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Receiver operating characteristic (ROC) curve for body mass index (BMI) ability to predict overweight estimated by dual energy X-ray absorptiometry (DEXA).</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AUC, area under the curve; 95% CI, 95% confidence interval; PPV, positive predictive value; NPV, negative predictive value; WHO, World Health Organization.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AUC (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sensitivity (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Specificity (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">PPV (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NPV (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.78<br>(0.72; 0.83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.58<br>(0.46; 0.70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.98<br>(0.94; 0.99) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.93<br>(0.81; 0.98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.84<br>(0.78; 0.89) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.83<br>(0.77; 0.87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.74<br>(0.62; 0.84) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.91<br>(0.85; 0.95) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.78<br>(0.67; 0.87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.88<br>(0.83; 0.93) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Must et al.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.78<br>(0.73; 0.84) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.60<br>(0.48; 0.72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.96<br>(0.92; 0.99) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.89<br>(0.76; 0.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.85<br>(0.78; 0.89) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">WHO<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.81<br>(0.76; 0.86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.70<br>(0.57; 0.80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.93<br>(0.88; 0.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.83<br>(0.71; 0.91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.87<br>(0.62; 0.75) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1328900.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Diagnostic properties of different cutoff points of body mass index to identify overweight according to body fat values estimated by dual energy X-ray absorptiometry (DEXA).</p>" ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">ROC, receiver operating characteristic, AUC, area under the curve; WHO, World Health Organization.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Difference between AUC (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a><span class="elsevierStyleItalic">versus</span> Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0449 (0.00294; 0.0927) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.006<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a><span class="elsevierStyleItalic">versus</span> Must et al.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.000917 (0.0253; 0.0271) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.945 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cole et al.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a><span class="elsevierStyleItalic">versus</span> WHO<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0358 (0.00549; 0.0771) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.089 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a><span class="elsevierStyleItalic">versus</span> Must et al.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0440 (0.00161; 0.0896) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.059 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a><span class="elsevierStyleItalic">versus</span> WHO<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.00908 (0.0248; 0.0430) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.599 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Must et al.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleItalic">versus</span> WHO<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0349 (0.00450; 0.0743) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.083 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1328901.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Comparison between ROC curves of different cutoff points.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib0140" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prevalence of obesity and obesity-related health conditions in a large, multiethnic cohort of young adults in California" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Koebnick" 1 => "N. Smith" 2 => "K. Huang" 3 => "M.P. Martinez" 4 => "H.A. Clancy" 5 => "L.H. Kushi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.annepidem.2012.05.006" "Revista" => array:6 [ "tituloSerie" => "Ann Epidemiol" "fecha" => "2012" "volumen" => "22" "paginaInicial" => "609" "paginaFinal" => "616" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22766471" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0145" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between household income and overweight of Korean and American children: trends and differences" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Kwon" 1 => "S. Oh" 2 => "S. Park" 3 => "Y. Park" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nutres.2010.06.015" "Revista" => array:6 [ "tituloSerie" => "Nutr Res" "fecha" => "2010" "volumen" => "30" "paginaInicial" => "470" "paginaFinal" => "476" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20797479" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0150" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abdominal obesity explains the positive rural–urban gradient in the prevalence of the metabolic syndrome in Benin, West Africa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Ntandou" 1 => "H. Delisle" 2 => "V. Agueh" 3 => "B. Fayomi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nutres.2009.02.001" "Revista" => array:6 [ "tituloSerie" => "Nutr Res" "fecha" => "2009" "volumen" => "29" "paginaInicial" => "180" "paginaFinal" => "189" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19358932" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0155" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Secular trends and factors associated with overweight among Brazilian preschool children: PNSN-1989, PNDS-1996, and 2006/07" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.A. Silveira" 1 => "F.A. Colugnati" 2 => "M. Cocetti" 3 => "J.A. Taddei" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Pediatr (Rio J)" "fecha" => "2014" "volumen" => "90" "paginaInicial" => "258" "paginaFinal" => "266" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0160" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of overweight and obesity among Portuguese youth: a study in a representative sample of 10–18-year-old children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.B. Sardinha" 1 => "R. Santos" 2 => "S. Vale" 3 => "A.M. Silva" 4 => "J.P. Ferreira" 5 => "A.M. Raimundo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/17477166.2010.490263" "Revista" => array:6 [ "tituloSerie" => "Int J Pediatr Obes" "fecha" => "2011" "volumen" => "6" "paginaInicial" => "e124" "paginaFinal" => "e128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20919807" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0165" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Body mass index as a measure of adiposity in children and adolescents: relationship to adiposity by dual energy X-ray absorptiometry and to cardiovascular risk factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.S. Lindsay" 1 => "R.L. Hanson" 2 => "J. Roumain" 3 => "E. Ravussin" 4 => "W.C. Knowler" 5 => "P.A. Tataranni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jcem.86.9.7760" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2001" "volumen" => "86" "paginaInicial" => "4061" "paginaFinal" => "4067" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11549626" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0170" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "BMI, waist-circumference and waist-hip-ratio as diagnostic tests for fatness in adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Neovius" 1 => "Y. Linne" 2 => "S. Rossner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Obes (Lond)" "fecha" => "2005" "volumen" => "29" "paginaInicial" => "163" "paginaFinal" => "169" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0175" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Body composition indices and single and clustered cardiovascular disease risk factors in adolescents: providing clinical-based cut-points" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Gracia-Marco" 1 => "L.A. Moreno" 2 => "J.R. Ruiz" 3 => "F.B. Ortega" 4 => "A.C. de Moraes" 5 => "F. Gottrand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.pcad.2015.11.002" "Revista" => array:6 [ "tituloSerie" => "Prog Cardiovasc Dis" "fecha" => "2016" "volumen" => "58" "paginaInicial" => "555" "paginaFinal" => "564" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26545445" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0180" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of fat and lean body mass index to BMI for the identification of metabolic syndrome in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.R. Weber" 1 => "M.B. Leonard" 2 => "J. Shults" 3 => "B.S. Zemel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2014-1684" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2014" "volumen" => "99" "paginaInicial" => "3208" "paginaFinal" => "3216" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24926951" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0185" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preferred clinical measures of central obesity for predicting mortality" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T.A. Welborn" 1 => "S.S. Dhaliwal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.ejcn.1602656" "Revista" => array:6 [ "tituloSerie" => "Eur J Clin Nutr" "fecha" => "2007" "volumen" => "61" "paginaInicial" => "1373" "paginaFinal" => "1379" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17299478" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0190" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aplicabilidade do índice de massa corporal na avaliação da gordura corporal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F.A. Rezende" 1 => "L.E. Rosado" 2 => "S.C. Franceschinni" 3 => "G.P. Rosado" 4 => "R.C. Ribeiro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Bras Med Esporte" "fecha" => "2010" "volumen" => "16" "paginaInicial" => "90" "paginaFinal" => "94" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0195" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Establishing a standard definition for child overweight and obesity worldwide: international survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T.J. Cole" 1 => "M.C. Bellizzi" 2 => "K.M. Flegal" 3 => "W.H. Dietz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "BMJ" "fecha" => "2000" "volumen" => "320" "paginaInicial" => "1240" "paginaFinal" => "1243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10797032" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0200" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development of a WHO growth reference for school-aged children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. de Onis" 1 => "A.W. Onyango" 2 => "E. Borghi" 3 => "A. Siyam" 4 => "C. Nishida" 5 => "J. Siekmann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Bull World Health Organ" "fecha" => "2007" "volumen" => "85" "paginaInicial" => "660" "paginaFinal" => "667" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18026621" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0205" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Must" 1 => "G.E. Dallal" 2 => "W.H. Dietz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Clin Nutr" "fecha" => "1991" "volumen" => "53" "paginaInicial" => "839" "paginaFinal" => "846" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2008861" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0210" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Body mass index cutoff points for evaluation of nutritional status in Brazilian children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W.L. Conde" 1 => "C.A. Monteiro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Pediatr (Rio J)" "fecha" => "2006" "volumen" => "82" "paginaInicial" => "266" "paginaFinal" => "272" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0215" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of three criteria for overweight and obesity classification in Brazilian adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Pelegrini" 1 => "D.A. Silva" 2 => "A.C. Gaya" 3 => "E.L. Petroski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1475-2891-12-5" "Revista" => array:5 [ "tituloSerie" => "Nutr J" "fecha" => "2013" "volumen" => "12" "paginaInicial" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23294869" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0220" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Methods of body composition evaluation in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.S. Sant’Anna" 1 => "S.E. Priore" 2 => "S.C. Franceschini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Paul Pediatr" "fecha" => "2009" "volumen" => "27" "paginaInicial" => "315" "paginaFinal" => "321" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0225" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.P. Williams" 1 => "S.B. Going" 2 => "T.G. Lohman" 3 => "D.W. Harsha" 4 => "S.R. Srinivasan" 5 => "L.S. Webber" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Public Health" "fecha" => "1992" "volumen" => "82" "paginaInicial" => "358" "paginaFinal" => "363" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1536350" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0230" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosing the nutritional status of schoolchildren: a comparison between Brazilian and international criteria" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.G. Silva" 1 => "V.L. Chiara" 2 => "M.E. Barros" 3 => "A.L. Rego" 4 => "A. Ferreira" 5 => "B.A. Pitasi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Pediatr (Rio J)" "fecha" => "2008" "volumen" => "84" "paginaInicial" => "550" "paginaFinal" => "555" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0235" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optimal cut-off values for obesity: using simple anthropometric indices to predict cardiovascular risk factors in Taiwan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.Y. Lin" 1 => "L.T. Lee" 2 => "C.Y. Chen" 3 => "H. Lo" 4 => "H.H. Hsia" 5 => "I.L. Liu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.ijo.0802040" "Revista" => array:6 [ "tituloSerie" => "Int J Obes Relat Metab Disord" "fecha" => "2002" "volumen" => "26" "paginaInicial" => "1232" "paginaFinal" => "1238" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12187401" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0240" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accuracy of different body mass index reference values to predict body fat in adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.C. Vieira" 1 => "M.M. Alvarez" 2 => "V.M. de Marins" 3 => "R. Sichieri" 4 => "G.V. da Veiga" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "/S0102-311X2006000800016" "Revista" => array:6 [ "tituloSerie" => "Cad Saude Publica" "fecha" => "2006" "volumen" => "22" "paginaInicial" => "1681" "paginaFinal" => "1690" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16832539" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0245" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of two classifications for overweight among Brazilian adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.R. Vitolo" 1 => "P.D. Campagnolo" 2 => "M.E. Barros" 3 => "C.M. Gama" 4 => "F. Ancona Lopez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Saude Publica" "fecha" => "2007" "volumen" => "41" "paginaInicial" => "653" "paginaFinal" => "656" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17589765" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0250" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of metabolic syndrome and obesity-associated hypertension in the racial ethnic minorities of the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Falkner" 1 => "N.D. Cossrow" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11906-014-0449-5" "Revista" => array:5 [ "tituloSerie" => "Curr Hypertens Rep" "fecha" => "2014" "volumen" => "16" "paginaInicial" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24819559" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0255" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of distribution curves of body mass index from Brazil and the United States for assessing overweight and obesity in Brazilian adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.V. Veiga" 1 => "P.C. Dias" 2 => "L.A. dos Anjos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Panam Salud Publica" "fecha" => "2001" "volumen" => "10" "paginaInicial" => "79" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11575243" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0260" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Wang" 1 => "C. Monteiro" 2 => "B.M. Popkin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Clin Nutr" "fecha" => "2002" "volumen" => "75" "paginaInicial" => "971" "paginaFinal" => "977" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12036801" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0265" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sensitivity and specificity of classification systems for fatness in adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.G. Neovius" 1 => "Y.M. Linne" 2 => "B.S. Barkeling" 3 => "S.O. Rossner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Clin Nutr" "fecha" => "2004" "volumen" => "80" "paginaInicial" => "597" "paginaFinal" => "603" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15321798" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0270" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Measurement of percentage of body fat in 411 children and adolescents: a comparison of dual-energy X-ray absorptiometry with a four-compartment model" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.B. Sopher" 1 => "J.C. Thornton" 2 => "J. Wang" 3 => "R.N. Pierson Jr." 4 => "S.B. Heymsfield" 5 => "M. Horlick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2004" "volumen" => "113" "paginaInicial" => "1285" "paginaFinal" => "1290" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15121943" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00217557/0000009300000001/v1_201701260039/S0021755716301048/v1_201701260039/en/main.assets" "Apartado" => array:4 [ "identificador" => "10179" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/00217557/0000009300000001/v1_201701260039/S0021755716301048/v1_201701260039/en/main.pdf?idApp=UINPBA000049&text.app=https://jped.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716301048?idApp=UINPBA000049" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 4 | 6 |
| 2024 October | 18 | 25 | 43 |
| 2024 September | 33 | 32 | 65 |
| 2024 August | 37 | 36 | 73 |
| 2024 July | 45 | 36 | 81 |
| 2024 June | 47 | 13 | 60 |
| 2024 May | 43 | 17 | 60 |
| 2024 April | 26 | 22 | 48 |
| 2024 March | 39 | 16 | 55 |
| 2024 February | 21 | 25 | 46 |
| 2024 January | 16 | 19 | 35 |
| 2023 December | 16 | 25 | 41 |
| 2023 November | 23 | 28 | 51 |
| 2023 October | 22 | 31 | 53 |
| 2023 September | 21 | 36 | 57 |
| 2023 August | 15 | 18 | 33 |
| 2023 July | 23 | 16 | 39 |
| 2023 June | 13 | 7 | 20 |
| 2023 May | 19 | 11 | 30 |
| 2023 April | 19 | 5 | 24 |
| 2023 March | 30 | 19 | 49 |
| 2023 February | 23 | 15 | 38 |
| 2023 January | 26 | 15 | 41 |
| 2022 December | 37 | 20 | 57 |
| 2022 November | 27 | 19 | 46 |
| 2022 October | 32 | 45 | 77 |
| 2022 September | 18 | 25 | 43 |
| 2022 August | 19 | 26 | 45 |
| 2022 July | 19 | 30 | 49 |
| 2022 June | 16 | 22 | 38 |
| 2022 May | 16 | 26 | 42 |
| 2022 April | 25 | 24 | 49 |
| 2022 March | 22 | 35 | 57 |
| 2022 February | 12 | 20 | 32 |
| 2022 January | 9 | 15 | 24 |
| 2021 December | 11 | 15 | 26 |
| 2021 November | 8 | 14 | 22 |
| 2021 October | 15 | 18 | 33 |
| 2021 September | 5 | 7 | 12 |
| 2021 August | 8 | 12 | 20 |
| 2021 July | 2 | 4 | 6 |
| 2021 June | 10 | 12 | 22 |
| 2021 May | 11 | 14 | 25 |
| 2021 April | 7 | 6 | 13 |
| 2021 March | 8 | 5 | 13 |
| 2021 February | 13 | 2 | 15 |
| 2021 January | 6 | 6 | 12 |
| 2020 December | 8 | 6 | 14 |
| 2020 November | 8 | 14 | 22 |
| 2020 October | 7 | 8 | 15 |
| 2020 September | 7 | 8 | 15 |
| 2020 August | 3 | 2 | 5 |
| 2020 July | 4 | 3 | 7 |
| 2020 June | 29 | 8 | 37 |
| 2020 May | 23 | 3 | 26 |
| 2020 April | 8 | 8 | 16 |
| 2020 March | 11 | 4 | 15 |
| 2020 February | 14 | 10 | 24 |
| 2020 January | 23 | 17 | 40 |
| 2019 December | 12 | 3 | 15 |
| 2019 November | 7 | 8 | 15 |
| 2019 October | 19 | 9 | 28 |
| 2019 September | 9 | 11 | 20 |
| 2019 August | 14 | 10 | 24 |
| 2019 July | 15 | 7 | 22 |
| 2019 June | 7 | 9 | 16 |
| 2019 May | 7 | 5 | 12 |
| 2019 April | 22 | 10 | 32 |
| 2019 March | 13 | 6 | 19 |
| 2019 February | 10 | 8 | 18 |
| 2019 January | 17 | 12 | 29 |
| 2018 December | 8 | 10 | 18 |
| 2018 November | 32 | 5 | 37 |
| 2018 October | 15 | 27 | 42 |
| 2018 September | 11 | 6 | 17 |
| 2018 August | 15 | 6 | 21 |
| 2018 July | 12 | 5 | 17 |
| 2018 June | 6 | 3 | 9 |
| 2018 May | 20 | 9 | 29 |
| 2018 April | 8 | 1 | 9 |
| 2018 March | 9 | 1 | 10 |
| 2018 February | 10 | 1 | 11 |
| 2018 January | 5 | 3 | 8 |
| 2017 December | 5 | 1 | 6 |
| 2017 November | 9 | 1 | 10 |
| 2017 October | 20 | 2 | 22 |
| 2017 September | 4 | 1 | 5 |
| 2017 August | 11 | 2 | 13 |
| 2017 July | 10 | 2 | 12 |
| 2017 June | 12 | 4 | 16 |
| 2017 May | 8 | 13 | 21 |
| 2017 April | 17 | 5 | 22 |
| 2017 March | 26 | 17 | 43 |
| 2017 February | 19 | 15 | 34 |
| 2017 January | 0 | 17 | 17 |
| 2016 December | 1 | 7 | 8 |
| 2016 November | 1 | 12 | 13 |
| 2016 October | 1 | 19 | 20 |
| 2016 September | 6 | 8 | 14 |
| 2016 August | 8 | 8 | 16 |
Show all
