• Molly M Lamb, Cynthia L Ogden, Margaret D Carroll, David A Lacher, and Katherine M Flegal.
• Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
• Am. J. Clin. Nutr. 2011 Sep 1; 94 (3): 877-83.

BackgroundBMI is one factor that is used to determine a child's eligibility for lipid screening and treatment. BMI, which is an indirect measure of body fat, may inadequately represent the biological effect of body fat percentage on lipid concentrations.ObjectiveWe examined the relation between directly measured body fat percentage and lipid concentrations in a representative sample of US youths.DesignData from 7821 participants aged 8-19 y from the 1999-2004 NHANES were analyzed. Body fat percentage was measured by dual-energy X-ray absorptiometry. Total and HDL-cholesterol concentrations were measured in serum. Serum triglyceride and LDL-cholesterol concentrations were measured in a subsample of 2661 fasting NHANES participants aged 12-19 y. Prevalences of adverse total cholesterol (>200 mg/dL), LDL cholesterol (>130 mg/dL), triglycerides (>150 mg/dL), and HDL cholesterol (<35 mg/dL) were measured.ResultsApproximately 10.0% [±0.7% (SE)] of participants had high total cholesterol, 7.0 ± 0.4% of participants had low HDL cholesterol, 9.7 ± 1.0% of participants had high triglycerides, and 7.6 ± 0.7% of participants had high LDL cholesterol. Prevalence of adverse total cholesterol, HDL cholesterol, triglycerides, and LDL cholesterol in US youths with high adiposity (greater than or equal to the age- and sex-specific 75th percentile of body fat percentage) was significantly greater (P < 0.01) than for participants without high adiposity. In multiple linear regressions adjusted for age, survey period, and race-ethnicity, the variance in lipid concentrations explained by body fat percentage was 2-20% (P < 0.001).ConclusionAdverse lipid concentrations and high adiposity are significantly associated in youths.

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