Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
Universidade Federal do Amazonas, Manaus, AM, Brazil.
Rev Paul Pediatr. 2020 Mar 16;38:e2019066. doi: 10.1590/1984-0462/2020/38/2019066. eCollection 2020.
To investigate whether tri-ponderal mass index and body mass index Z scores are equivalent for screening children and adolescents with insulin resistance.
Cross-sectional study with 296 children and adolescents enrolled at public schools of Vitória, Espírito Santo, Brazil, aged eight to 14 years. The tri-ponderal mass index was calculated as the ratio between weight and height cubed. The body mass index was calculated as the ratio between weight and height squared. Insulin resistance was defined with the homeostatic model assessment (HOMA-IR).
The HOMA-IR was higher in the 4th quartile of body mass index Z scores and tri-ponderal mass index compared to 1st and 2nd quartiles for both girls and boys. The areas under the age-adjusted receiver operating characteristic curves were similar between the indices for girls (body mass index Z scores=0.756; tri-ponderal mass index=0.763) and boys (body mass index Z scores=0.831; tri-ponderal mass index=0.843). In addition, according to the simple linear regression analyses estimations, both body mass index Z scores and tri-ponderal mass index explained a significant fraction of the homeostatic model assessment variability for girls (body mass index Z scores: R2=0.269; tri-ponderal mass index: R2=0.289; p<0.001) and boys (body mass index Z scores: R2=0.175; tri-ponderal mass index: R2=0.210; p<0.001).
The tri-ponderal mass index and body mass index Z scores were similar to discriminate children and adolescents with insulin resistance. It is noteworthy that the use of tri-ponderal mass index is clearly advantageous, because it can be calculated with no concerns on adjustments for the age, a fact that makes it very applicable in the clinical practice.
研究三比重指数和体质指数 Z 评分是否等效于筛查胰岛素抵抗的儿童和青少年。
巴西圣埃斯皮里图州维多利亚公立学校的 296 名 8 至 14 岁的儿童和青少年参与了这项横断面研究。三比重指数是体重与身高立方的比值。体质指数是体重与身高平方的比值。胰岛素抵抗采用稳态模型评估(HOMA-IR)定义。
女孩和男孩的体质指数 Z 评分和三比重指数的第 4 四分位数的 HOMA-IR 均高于第 1 和第 2 四分位数。在年龄调整后,两个指数的受试者工作特征曲线下面积相似(女孩:体质指数 Z 评分=0.756;三比重指数=0.763;男孩:体质指数 Z 评分=0.831;三比重指数=0.843)。此外,根据简单线性回归分析的估计,体质指数 Z 评分和三比重指数都能很好地解释 HOMA-IR 变异的一部分,无论是女孩(体质指数 Z 评分:R2=0.269;三比重指数:R2=0.289;p<0.001)还是男孩(体质指数 Z 评分:R2=0.175;三比重指数:R2=0.210;p<0.001)。
三比重指数和体质指数 Z 评分相似,可用于区分胰岛素抵抗的儿童和青少年。值得注意的是,三比重指数的使用具有明显优势,因为它可以在不考虑年龄调整的情况下计算,这使其在临床实践中非常适用。