[Diagnostic accuracy of the tri-ponderal mass index in identifying the unhealthy metabolic obese phenotype in obese patients].

Abstract Introduction The metabolically healthy obese phenotype (FOMS) defines obese patients who have preserved insulin sensitivity and absence of metabolic complications. This phenotype is associated with a lower risk of cardiovascular disease and type 2 diabetes in adulthood. Objectives To determine the prevalence of FOMS and the obese phenotype with metabolic risk (FORM) in a cohort of obese children and adolescents and to establish the predictive capacity of the tri-ponderal mass index (TMI) and other anthropometric parameters in order to identify these patients. Patients and methods A cross-sectional study was conducted on 239 obese patients (125 males) from 8 to 18 years of age. Grade 3 obesity was present in 45.9% of the patients. ROC curves were used to find the best cut-off point for: TMI, body mass index (BMI), BMI z-score (BMIzs), and waist/height index (WHI). FOMS components: plasma blood glucose, plasma triglycerides, HDL-cholesterol, and blood pressure. Results The prevalence of FOMS in the study cohort was 37.6%. No differences between genders were observed, and it was increasing with the age and the level of obesity. The TMI has a sensitivity of 75.8 and a specificity of 42.2 to identify the FORM patients. The best cut-off point for TMI is 18.7 kg/m3, for BMI it was 30.4 kg/m2, for BMIzs +3.5 SD, and 0.62 for WHI. Conclusions The diagnostic accuracy of TMI in identifying obese adolescents with metabolic risk was similar to BMI and WHI. However, the TMI makes it easier and simplifies the classification of the obesity level in both genders.