Nascimento Henrique, Catarino Cristina, Mendonça Denisa, Oliveira Pedro, Alves Ana Inês, Medeiros Ana Filipa, Pereira Petronila Rocha, Rêgo Carla, Mansilha Helena Ferreira, Aires Luísa, Mota Jorge, Quintanilha Alexandre, Santos-Silva Alice, Belo Luís
Biological Science Department, Faculty of Pharmacy, University of Porto, Porto, Portugal ; Instituto de Biologia Molecular e Celular (Institute for Molecular and Cell Biology), Universidade do Porto, Porto, Portugal ; Instituto de Investigação e Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal.
Population Study Department, Biomedical Sciences Institute Abel Salazar (ICBAS), University of Porto, Porto, Portugal.
Diabetol Metab Syndr. 2015 Apr 8;7:32. doi: 10.1186/s13098-015-0022-7. eCollection 2015.
Growth-curves are an important tool for evaluating the anthropometric development in pediatrics. The different growth-curves available are based in different populations, what leads to different cut-offs. Pediatric obesity tracks into adulthood and is associated with increased cardiovascular risk. The accurate assessment of a child nutritional status using growth-curves can indicate individuals that are either obese or in risk of becoming obese, allowing an early intervention. Moreover, the association between the data obtained from growth-curves with specific metabolic risk factors further highlights the importance of these charts. This study aimed to evaluate the associations between body mass index z-score (BMIzsc), determined using the growth-curves from the Centre for Disease Control and Prevention (CDC) and from the World Health Organization (WHO), with cardiovascular risk factors, represented here by metabolic syndrome (MS) and insulin resistance (IR) related parameters. The study involved 246 obese adolescents (10-18 years, 122 females). MS was defined according to the International Diabetes Federation. IR was considered for HOMA-IR greater than 2.5.
No difference between both BMIzsc in identifying MS was noticeable by a ROC analysis. For both indexes the area-under-the-curve increased for older groups, particularly for males. CDC-BMIzsc was the best predictor of MS by logistic regression when all population was considered, however MS was better predicted by WHO-BMIzsc for females and by CDC-BMIzsc for males. Younger girls and older boys were in increased risk for MS. Similar results were obtained for IR.
A significant difference between the two BMIzsc regarding their association with MS and IR was not clear, being these associations weaker in younger individuals.
生长曲线是评估儿科人体测量发育的重要工具。现有的不同生长曲线基于不同人群，这导致了不同的临界值。儿童肥胖会持续到成年期，并与心血管风险增加相关。使用生长曲线准确评估儿童营养状况可以识别出肥胖或有肥胖风险的个体，从而实现早期干预。此外，从生长曲线获得的数据与特定代谢风险因素之间的关联进一步凸显了这些图表的重要性。本研究旨在评估使用美国疾病控制与预防中心（CDC）和世界卫生组织（WHO）的生长曲线确定的体重指数z评分（BMIzsc）与心血管风险因素之间的关联，这里以代谢综合征（MS）和胰岛素抵抗（IR）相关参数为代表。该研究纳入了246名肥胖青少年（10 - 18岁，122名女性）。MS根据国际糖尿病联盟的标准定义。当稳态模型评估胰岛素抵抗（HOMA-IR）大于2.5时考虑存在IR。
通过ROC分析，在识别MS方面，两种BMIzsc之间没有明显差异。对于这两个指标，曲线下面积在年龄较大的组中增加，尤其是男性。当考虑所有人群时，通过逻辑回归分析，CDC-BMIzsc是MS的最佳预测指标，然而对于女性，WHO-BMIzsc对MS的预测更好，对于男性，CDC-BMIzsc的预测更好。年龄较小的女孩和年龄较大的男孩患MS的风险增加。对于IR也获得了类似的结果。
两种BMIzsc在与MS和IR的关联方面没有明显差异，且这些关联在较年轻个体中较弱。
