Lowering body mass index cutoffs better identifies obese persons with spinal cord injury

Study design:Cross-sectional, non-experimental design.Objectives:(1) Determine the sensitivity and specificity of the general population body mass index (BMI) cutoff for obesity (30 kg m−2) in a representative sample of persons with spinal cord injury (SCI); (2) develop a more sensitive BMI cutoff for obesity based on percentage of fat mass (%FM) and C-reactive protein (CRP).Setting:Ontario, Canada.Methods:A total of 77 community-dwelling adults with chronic SCI underwent anthropometric measures (%FM by bioelectrical impedance analysis, length, weight, BMI (kg m−2)) and provided blood samples to determine CRP. Sensitivity and specificity analyses, piecewise regression, non-linear regression, and receiver–operator characteristic curves were used to determine new BMI cutoffs.Results:A BMI cutoff of 30 kg m−2 failed to identify 73.9% of obese participants vs 26.1% at a lowered cutoff of 25 kg m−2. BMI cutoffs based on risk levels of the %FM and CRP considered together ranged from 22.1 kg m−2–26.5 kg m−2.Conclusions:People with chronic SCI and BMI values >22 kg m−2 should be considered as being at high risk for obesity and obesity-related chronic diseases.Sponsorship:Canadian Institutes of Health Research.