Examining Biomarkers for Dyslipidemia, Diabetes, and NAFLD by CDC's 2022 Extended BMI Percentiles in US Youth Aged 6-17 Years.

Abstract

This study examined associations between CDC's 2022 extended BMI percentiles (BMIp) and cardiometabolic biomarkers. Using electronic medical record data, we included patients aged 6-17 years with BMI ≥ 85th percentile who had at least one of the following: total cholesterol, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglycerides, alanine aminotransferase (ALT), and hemoglobin A1c (HbA1c). We calculated adjusted prevalence ratios (aPR) for (1) borderline or abnormal and (2) abnormal lab values by extended BMIp (85th-< 95th, 95th-< 98th, 98th-< 99th, 99th-< 99.9th, ≥ 99.9th). Compared to those with overweight (BMIp 85th-< 95th), patients in higher extended BMIp categories had a higher prevalence of borderline or abnormal HbA1c (aPR range: 1.46-2.79), ALT (aPR range: 1.58-2.59), triglycerides (aPR range: 1.24-1.46), total cholesterol (aPR range: 1.11-1.23), HDL (aPR range: 1.40-1.94), and LDL (aPR range: 1.23-1.55). Dose-response relationships were observed for multiple cardiometabolic biomarkers. Similar patterns were found for abnormal lab values. Many US youth aged 6-17 with overweight and obesity had borderline or abnormal cardiometabolic biomarkers. Risks varied within obesity: higher extended BMIp were linked to a greater likelihood of borderline or abnormal lab values. Identifying extended BMIp thresholds tied to these risks could facilitate clinical practice, including identifying high-risk patients and informing escalation of care.