PURPOSE: To assess the diagnostic performance of the skinfold (SKF) method to detect obesity in patients enrolled in an outpatient cardiac rehabilitation (CR) program. METHODS: This study involves outpatients attending a phase II CR program who underwent air displacement plethysmography (ADP) to assess body composition. We measured body fat percentage (BF%), using a 3-site SKF method calculated through the Jackson-Pollock equation utilizing a Harpenden caliper. Air displacement plethysmography calculated BF% using a bicompartmental model, deriving the body composition after the direct calculation of body density (BD), using the Siri equation [(BF% = 495/BD) - 450]. We calculated the diagnostic performance of SKF to detect obesity, utilizing a BF% cutoff of ≥35% for women and ≥25% for men determined by SKF and ADP to define obesity. RESULTS: Our sample (n = 310) was 80% men, 60.2 ± 11 years of age, had a mean weight of 89.88 ± 17.96 kg, height 173.38 ± 8.68 cm, body mass index (BMI) 29.78 ± 5.01 kg/m, waist circumference 100.55 ± 14.38 cm, and waist-to-hip ratio of 0.96 ± 0.09. The evaluation of the diagnostic performance of SKF to detect obesity showed a sensitivity of 57%, specificity of 93%, a positive predictive value of 97%, and a negative predictive value of 33%. These values were not different from the diagnostic performance of BMI to detect obesity as defined by BF%. SKF and BMI misclassified 43% and 49% of obese patients as nonobese, respectively. CONCLUSION: Our findings underscore the limitation of using SKF to assess body fatness in the CR setting.

Department of Cardiovascular Diseases International Clinic Research Center St Anne's University Hospital Brno Brno Czech Republic

Division of Cardiovascular Diseases Mayo Clinic Rochester Minnesota

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