Oliveira Raphael Gonçalves de, Guedes Dartagnan Pinto
Universidade Norte do Paraná (Unopar), Centro de Pesquisa em Ciências da Saúde, Londrina, PR, Brazil.
Universidade Norte do Paraná (Unopar), Centro de Pesquisa em Ciências da Saúde, Londrina, PR, Brazil.
J Pediatr (Rio J). 2017 Sep-Oct;93(5):525-531. doi: 10.1016/j.jped.2016.11.014. Epub 2017 May 30.
To analyze the performance of three different diagnostic criteria of overweight and obesity (WHO, IOTF and Conde and Monteiro) using body mass index (BMI) as predictors of metabolic syndrome (MetS) in a representative sample of adolescents.
A sample of 1035 adolescents aged 12-20 years (565 girls and 470 boys) was used in the study. BMI was calculated through the quotient of weight (kg)/height squared (m), and MetS was defined according to the criteria of the International Diabetes Federation. Sensitivity, specificity, and overall accuracy (area under the curve) were estimated using the receiver operating characteristic (ROC) curves method and used to describe the predictive performance.
The three diagnostic criteria showed higher absolute values of sensitivity and specificity for predicting MetS in boys and older adolescents. The highest sensitivity to identify MetS was found using the IOTF criterion (60-85%), while specificity values ≥ 90% were found for the three criteria. The Conde and Monteiro diagnostic criterion pointed to a significantly lower overall accuracy (0.52-0.64) than that of the WHO (0.70-0.84) and IOTF (0.75-0.89) diagnostic criterion.
Overweight and obesity using BMI showed a moderate association with MetS, regardless of the diagnostic criteria used. However, the IOTF criterion showed better predictive capacity for the presence of MetS than the WHO and the Conde and Monteiro criteria.
在青少年代表性样本中，分析三种不同的超重和肥胖诊断标准（世界卫生组织（WHO）、国际肥胖工作组（IOTF）以及康德和蒙泰罗标准），使用体重指数（BMI）作为代谢综合征（MetS）的预测指标的性能。
本研究使用了1035名12 - 20岁青少年的样本（565名女孩和470名男孩）。BMI通过体重（千克）除以身高平方（米）的商来计算，MetS根据国际糖尿病联盟的标准来定义。使用受试者工作特征（ROC）曲线方法估计敏感性、特异性和总体准确性（曲线下面积），并用于描述预测性能。
这三种诊断标准在预测男孩和年龄较大青少年的MetS时，显示出更高的敏感性和特异性绝对值。使用IOTF标准发现识别MetS的敏感性最高（60 - 85%），而三种标准下的特异性值均≥90%。康德和蒙泰罗诊断标准的总体准确性（0.52 - 0.64）显著低于WHO（0.70 - 0.84）和IOTF（0.75 - 0.89）诊断标准。
无论使用何种诊断标准来衡量，利用BMI得出的超重和肥胖与MetS存在中度关联。然而，与WHO以及康德和蒙泰罗标准相比，IOTF标准对MetS存在情况的预测能力更强。
