Percentile curves for fat patterning in German adolescents

Background: Because the body composition of adolescents varies more than that of adults and anthropometric parameters are regularly used for pediatric body fat measurements, we developed age-, gender-, and ethnicity-specific reference values for waist circumference (WC), hip circumference (HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and skinfold thickness (SFT) in German adolescents. Methods: A representative sample of 1633 boys and 1391 girls aged 12-18 years participated in this cross-sectional study. Weight, height, body mass index (BMI), WC, HC, WHR, WHtR, and SFT were measured and smoothed; age-, gender-, and ethnicity-specific reference curves were developed using the LMS method. Results: Females were significantly heavier than males at 12 years. Beyond age 14 males were significantly heavier and taller than females. The SFT sum increased continuously (+20%) in females and was significantly higher (7.4 mm) than in males. At the 90th percentile, SFTtriceps decreased (-12%) in males but increased (+11%) in females; SFTsubscapular increased in both genders. From 12 to 18 years, WHtR and WHR remained constant, whereas WC and HC increased in both genders. WHtR was the best predictor for abdominal obesity in males (area under the curve [AUC] 0.974 +/- 0.004) and females (AUC 0.986 +/- 0.003), followed by body fat percentage (AUG 0.937 +/- 0.008) in males and WHR (AUC 0.935 +/- 0.009) in females. Conclusion: These age- and gender-specific percentile curves for SFT, WC, HC, WHR, and WHtR, derived from a large national sample of German adolescents, may be useful for developing international reference values for waist circumference and other predictors of adult obesity. World J Pediatr 2011;7(1):16-23