Bandeira Cesar Pirajá, Schaan Beatriz D, Cureau Felipe Vogt
Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Graduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Faculty of Medical Sciences, Porto Alegre, RS, Brazil.
J Pediatr (Rio J). 2025 Jan-Feb;101(1):30-37. doi: 10.1016/j.jped.2024.07.007. Epub 2024 Aug 12.
To investigate how body mass index (BMI) and waist circumference (WC) may be associated with insulin resistance and type 2 diabetes (T2DM) in Brazilian adolescents.
Cross-sectional study using data from the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA) including adolescents aged 12-17 years. The relationship between adiposity and T2DM was investigated using ordinal logistic regression models. To study the association between adiposity categories and the occurrence of insulin resistance, linear regression models were used.
The prevalence of T2DM for the same BMI category did not increase with the presence of high WC. Regarding insulin resistance, for the same BMI categories, having a high WC resulted in a higher prevalence of insulin resistance (HOMA-IR). The only groups significantly associated with prediabetes and T2DM were those with obesity by BMI with elevated WC (POR 1.68, 95 % CI 1.45; 1.94) and obesity with normal WC (POR 1.58, 95 % CI 1.01; 2.46). Similar findings were observed concerning insulin resistance, where the increased WC had its greatest effect when associated with obesity by BMI (β Coefficient 2.20, 95 % CI 1.89; 2.50).
The combination of BMI and WC is better for assessing adolescents at risk of developing T2DM.
探讨体重指数(BMI)和腰围(WC)与巴西青少年胰岛素抵抗及2型糖尿病(T2DM)之间的关联。
采用巴西青少年心血管风险研究(ERICA)的数据进行横断面研究,研究对象为12至17岁的青少年。使用有序逻辑回归模型研究肥胖与T2DM之间的关系。为研究肥胖类别与胰岛素抵抗发生之间的关联,使用线性回归模型。
对于相同BMI类别,T2DM的患病率不会因高腰围的存在而增加。关于胰岛素抵抗,对于相同BMI类别,高腰围导致胰岛素抵抗(HOMA-IR)患病率更高。与糖尿病前期和T2DM显著相关的唯一群体是BMI肥胖且腰围升高的群体(优势比1.68,95%置信区间1.45;1.94)以及腰围正常的肥胖群体(优势比1.58,95%置信区间1.01;2.46)。在胰岛素抵抗方面也观察到类似结果,即腰围增加与BMI肥胖相关时影响最大(β系数2.20,95%置信区间1.89;2.50)。
BMI和WC相结合更有利于评估有患T2DM风险的青少年。