Nogueira-de-Almeida Carlos Alberto, Ued Fábio da Veiga, Contini Andrea Aparecida, Martinez Edson Zangiacomi, Del Ciampo Luiz Antonio, Nogueira-de-Almeida Maria Eduarda, Ferraz Ivan Savioli, Silva Raquel Farias Barreto, de Mello Elza Daniel, Fisberg Mauro
Medical Department, Federal University of São Carlos, São Carlos, Brazil.
Nutrition Department, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Front Nutr. 2022 Jun 9;9:908562. doi: 10.3389/fnut.2022.908562. eCollection 2022.
Anthropometric indicators have been used to predict health problems. The objective was to determine which indicators present better correlation with dyslipidemia, hyperglycemia and peripheral insulin resistance, as well as the cutoff points capable of predicting lipid and glycemic alterations in Brazilian children and adolescents.
A cross-sectional study conducted with 568 overweight individuals, aged between 5 and 18 years, living in Southeast and South Brazilian regions, submitted to anthropometric and body composition evaluation by bioimpedance, in addition to fasting laboratory tests [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), fasting glycemia, and homeostasis model assessment-insulin resistance (HOMA-IR)]. Pearson's correlation was used to evaluate the association between anthropometric indicators and serum biomarkers. The ROC curve with Youden's J index was used to suggest anthropometric cutoff points with better ability to predict or rule out lipid and glycemic changes.
Cutoff points obtained for the z-score of body mass index (BMI), waist circumference (WC), and waist circumference for height (WC/H) showed high specificity (52 to 87%) and low sensitivity (23 to 59%), indicating greater ability to exclude changes in HDL-c, TG, and HOMA-IR levels. Cutoff points suggested for BMI ranged from +1.86 to +2.20 z-score. WC cutoff points ranged from +1.29 to +1.72, and, for the WC/H index, from +1.21 to +1.25. It was suggested the use of the following cutoff points to rule out changes in HDL-c, TG, and HOMA-IR values in clinical practice: BMI < z-score +2 and WC/H < z-score +1.29. In body fat percentage (BFP) analyses, the cutoff point < of 34% may be able to rule out changes in HDL-c (specificity of 70%), while the cutoff point > 36.6% may be able to predict changes in the HOMA-IR index (sensitivity of 76%).
It is not yet possible to state which anthropometric parameter has the best correlation with lipid and glycemic alterations in overweight children and adolescents. We suggest considering BMI, WC, and WC/H cutoff points together to rule out changes in HDL-c, TG, and HOMA-IR, and use the BFP cutoff point to predict changes in HOMA-IR.
人体测量指标已被用于预测健康问题。目的是确定哪些指标与血脂异常、高血糖和外周胰岛素抵抗具有更好的相关性，以及能够预测巴西儿童和青少年血脂和血糖变化的临界值。
对568名年龄在5至18岁之间、生活在巴西东南部和南部地区的超重个体进行了一项横断面研究，除了空腹实验室检查[总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-c）、高密度脂蛋白胆固醇（HDL-c）、空腹血糖和稳态模型评估-胰岛素抵抗（HOMA-IR）]外，还通过生物阻抗法进行了人体测量和身体成分评估。采用Pearson相关性分析评估人体测量指标与血清生物标志物之间的关联。使用具有约登指数的受试者工作特征（ROC）曲线来确定能够更好地预测或排除血脂和血糖变化的人体测量临界值。
体重指数（BMI）、腰围（WC）和身高腰围比（WC/H）的z评分所获得的临界值显示出高特异性（52%至87%）和低敏感性（23%至59%），表明其更有能力排除HDL-c、TG和HOMA-IR水平的变化。BMI的建议临界值范围为+1.86至+2.20 z评分。WC的临界值范围为+1.29至+1.72，WC/H指数的临界值范围为+1.21至+1.25。建议在临床实践中使用以下临界值来排除HDL-c、TG和HOMA-IR值的变化：BMI < z评分+2且WC/H < z评分+1.29。在体脂百分比（BFP）分析中，临界值<34%可能能够排除HDL-c的变化（特异性为70%），而临界值>36.6%可能能够预测HOMA-IR指数的变化（敏感性为76%）。
目前尚无法确定哪种人体测量参数与超重儿童和青少年的血脂和血糖变化具有最佳相关性。我们建议综合考虑BMI、WC和WC/H的临界值以排除HDL-c、TG和HOMA-IR的变化，并使用BFP临界值来预测HOMA-IR的变化。
