Universidade Federal do Espírito Santo (UFES), Clínica de Investigação Cardiovascular, Vitória, ES, Brazil; Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brazil.
Universidade Federal do Espírito Santo (UFES), Clínica de Investigação Cardiovascular, Vitória, ES, Brazil.
J Pediatr (Rio J). 2019 Jul-Aug;95(4):428-434. doi: 10.1016/j.jped.2018.04.004. Epub 2018 May 7.
Given the importance of incorporating simple and low-cost tools into the pediatric clinical setting to provide screening for insulin resistance, the present study sought to investigate whether waist-to-height ratio is comparable to biochemical markers for the discrimination of insulin resistance in children and adolescents.
This cross-sectional study involved students from nine public schools. In total, 296 children and adolescents of both sexes, aged 8-14 years, composed the sample. Waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio were determined according to standard protocols. Insulin resistance was defined as homeostatic model assessment for insulin resistance with cut-off point ≥ 3.16.
Age, body mass index, frequency of overweight, waist circumference, waist-to-height ratio, insulin, glucose, homeostatic model assessment for insulin resistance, triglycerides, triglycerides/glucose index, and triglycerides-to-HDL-C were higher among insulin resistant boys and girls. Moderate correlation of all indicators (waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio) with homeostatic model assessment for insulin resistance was observed for both sexes. The areas under the receiver operational characteristic curves ware similar between waist-to-height ratio and biochemical markers.
The indicators provided similar discriminatory power for insulin resistance. However, taking into account the cost-benefit ratio, we suggest that waist-to-height ratio may be a useful tool to provide screening for insulin resistance in pediatric populations.
鉴于在儿科临床环境中纳入简单且低成本的工具来提供胰岛素抵抗筛查的重要性，本研究旨在探讨腰高比是否可与生化标志物相媲美，用于鉴别儿童和青少年的胰岛素抵抗。
这是一项横断面研究，涉及 9 所公立学校的学生。共有 296 名 8-14 岁的男女学生组成样本。根据标准方案测定腰高比、甘油三酯/葡萄糖指数和甘油三酯/高密度脂蛋白胆固醇比值。胰岛素抵抗定义为稳态模型评估的胰岛素抵抗，截断值≥3.16。
胰岛素抵抗男孩和女孩的年龄、体重指数、超重频率、腰围、腰高比、胰岛素、血糖、稳态模型评估的胰岛素抵抗、甘油三酯、甘油三酯/葡萄糖指数和甘油三酯/高密度脂蛋白胆固醇均较高。所有指标（腰高比、甘油三酯/葡萄糖指数和甘油三酯/高密度脂蛋白胆固醇比值）与男女两性的稳态模型评估的胰岛素抵抗均呈中度相关。接受者操作特征曲线下面积在腰高比和生化标志物之间相似。
这些指标对胰岛素抵抗具有相似的判别能力。然而，考虑到成本效益比，我们建议腰高比可能是一种有用的工具，可用于在儿科人群中提供胰岛素抵抗筛查。
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