Department of Physiological Sciences, Federal University of Amazonas, Manaus, Brazil.
Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil.
Nutrition. 2022 Jul-Aug;99-100:111656. doi: 10.1016/j.nut.2022.111656. Epub 2022 Mar 20.
The aims of this study was to determine the cutoff values for tri-ponderal mass index (TMI) and investigate the association between overweight/obesity as classified by TMI and cardiometabolic risk factors in Brazilian adolescents aged 12 to 17 y.
This was a cross-sectional study comprising 37 815 adolescents (40 % boys; 12-17 y) enrolled in the Study of Cardiovascular Risks in Adolescents. TMI was calculated as weight divided by cubed height (kg/m). Overweight (TMI-for-age ≥85th percentile to <95th percentile) and obesity (TMI-for-age ≥95th percentile) were determined for both sexes. Poisson regression model analyses were used to test associations.
TMI was stable across the age span (12-17 y) in both sexes. Boys and girls classified by TMI as obese had higher prevalence ratios (PR) for hypertension (PR, 4.98; 95% confidence interval [CI], 3.26-7.61 for boys; PR, 6.88; 95% CI, 3.70-12.78 for girls), insulin resistance (PR, 19.72; 95% CI, 13.56-28.69 for boys; PR, 10.04; 95% CI, 7.47-13.50 for girls), hypercholesterolemia (PR,5.05; 95% CI, 3.68-6.94 for boys; PR, 1.44; 95% CI, 1.00-2.11 for girls), and hypertriacylglycerolemia (PR,7.36; 95% CI, 5.16-10.50 for boys; PR, 3.37; 95% CI, 2.52-4.51 for girls) when compared with normal weight counterparts.
Obesity, as classified by TMI, was strongly associated with several cardiovascular risk factors. Our data showed that TMI was stable across the age span. Therefore, a fixed cutoff value to determine weight status in Brazilian adolescents seems appropriate.
本研究旨在确定三部位体重指数（TMI）的截断值，并探讨巴西 12 至 17 岁青少年中 TMI 超重/肥胖分类与心血管代谢危险因素之间的关系。
这是一项横断面研究，共纳入 37815 名青少年（40%为男性；12-17 岁），他们参加了青少年心血管风险研究。TMI 计算为体重除以立方身高（kg/m）。男女均确定超重（TMI-年龄≥第 85 百分位至<第 95 百分位）和肥胖（TMI-年龄≥第 95 百分位）。使用泊松回归模型分析测试关联。
TMI 在男女两性的年龄范围内（12-17 岁）保持稳定。根据 TMI 分类为肥胖的男孩和女孩，高血压（PR，4.98；95%置信区间[CI]，3.26-7.61 为男孩；PR，6.88；95%CI，3.70-12.78 为女孩）、胰岛素抵抗（PR，19.72；95%CI，13.56-28.69 为男孩；PR，10.04；95%CI，7.47-13.50 为女孩）、高胆固醇血症（PR，5.05；95%CI，3.68-6.94 为男孩；PR，1.44；95%CI，1.00-2.11 为女孩）和高三酰甘油血症（PR，7.36；95%CI，5.16-10.50 为男孩；PR，3.37；95%CI，2.52-4.51 为女孩）的患病率比值（PR）均高于正常体重者。
根据 TMI 分类的肥胖与多种心血管危险因素密切相关。我们的数据表明，TMI 在整个年龄范围内保持稳定。因此，巴西青少年确定体重状况的固定截断值似乎是合适的。
