Instituto de la Grasa-CSIC, Campus Universidad Pablo de Olavide, Edificio 46, 41013, Seville, Spain.
Department of Nursing, University of Granada, Av Ilustración, 60, 18016, Granada, Spain.
Nutr Res. 2017 Sep;45:38-45. doi: 10.1016/j.nutres.2017.06.007. Epub 2017 Jul 4.
Both waist circumference (WC) and waist-to-hip ratio (WHR) have been proposed as predictors of metabolic syndrome (MetS) in adolescents, but no consensus has been reached to date. This study hypothesizes that WC provides a greater predictive value for MetS in Spanish adolescents than WHR. A cross-sectional study was performed on 1001 adolescents (13.2 ± 1.2 years) randomly recruited from schools in southeast Spain. Anthropometric measures were correlated with the components of MetS (triglycerides, glucose, blood pressure, and high-density lipoprotein cholesterol) as well as inflammation markers (interleukin-6 and tumor necrosis factor-alpha , C-reactive protein, and ceruloplasmin). Receiver-operator curves were created to determine the predictive value of these variables for MetS. Boys had higher values of all anthropometric parameters compared with girls, but the prevalence of MetS was significantly higher in girls. WHR was the only parameter that correlated significantly with all biochemical and inflammatory variables in boys. In girls, WHR, body mass index, waist-to-height ratio, WC, and body fat percentage correlated only with plasma insulin levels, systolic and diastolic pressures, and ceruloplasmin. In both groups, all anthropometric measures were able to predict MetS (area under the curve > 0.94). In particular, WC was able to predict MetS with area under the curve = 1.00. However, WHR was able to predict a higher number of components of MetS. WHR was the anthropometric index that showed the highest predictive value for MetS components, whereas WC was the one that best predicted the MetS among the population of adolescents studied. These findings justify the need to incorporate WHR and WC determinations into daily clinical practice to predict the MetS.
腰围（WC）和腰臀比（WHR）均被认为是青少年代谢综合征（MetS）的预测指标，但目前尚未达成共识。本研究假设 WC 对西班牙青少年 MetS 的预测价值大于 WHR。一项横断面研究对西班牙东南部学校随机抽取的 1001 名青少年（13.2±1.2 岁）进行了研究。对人体测量学指标与 MetS 成分（甘油三酯、葡萄糖、血压和高密度脂蛋白胆固醇）以及炎症标志物（白细胞介素-6 和肿瘤坏死因子-α、C 反应蛋白和铜蓝蛋白）进行了相关性分析。绘制了受试者工作特征曲线，以确定这些变量对 MetS 的预测价值。与女孩相比，男孩的所有人体测量参数值均较高，但女孩的 MetS 患病率显著更高。在男孩中，只有 WHR 与所有生化和炎症变量显著相关。在女孩中，WHR、体重指数、腰高比、WC 和体脂百分比仅与血浆胰岛素水平、收缩压和舒张压以及铜蓝蛋白相关。在两组中，所有人体测量指标均能预测 MetS（曲线下面积>0.94）。特别是，WC 的曲线下面积可达到 1.00，能够预测 MetS。然而，WHR 能够预测更多的 MetS 成分。WHR 是预测 MetS 成分的人体测量指标中具有最高预测价值的指标，而 WC 是该人群中预测 MetS 的最佳指标。这些发现证明，需要将 WHR 和 WC 测定纳入日常临床实践，以预测 MetS。
