Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileiros
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFPB |
Texto Completo: | https://repositorio.ufpb.br/jspui/handle/123456789/16276 |
Resumo: | Adolescence is a peculiar phase of human development, marked by intense physical, sexual, and behavioral transformations. Changes in the distribution of body fat during adolescence are strongly influenced by sexual maturation, and this phase is considered one of the critical periods for the onset of obesity, which in turn may be associated with a set of metabolic alterations such as dyslipidemias and insulin resistance. In this point of view, the objective of this study was to evaluate the relation of the Waist-to-height ratio (WHtR) with metabolic alterations in adolescents, according to the stage of sexual maturation. Variables of sexual maturation (Tanner planks), anthropometric variables (weight, height, waist circumference (CC), and biochemical variables (fasting glucose, fasting insulin, HOMA-IR, total cholesterol and fractions c and HDLc) and triglycerides), as well as demographic (sex and age). Data from 37,759 Brazilian adolescents aged 12-17 years, of both sexes, who participated in the national population-based study "Study of Cardiovascular Risks in Adolescents - ERICA" were analyzed. All analyzes were done in the program Stata 14.0 SE. The adolescents were described according to sex and stage of sexual maturation and were classified according to excess abdominal adiposity, according to the WHtR score. Linear regression models were constructed to observe the relationship between each of the metabolic variables, HOMA-IR, triglycerides, HDL-c, LDL-c, total cholesterol and fasting insulin, and the WHtR. The coefficients of determination of each equation (r2) and the values of the regression coefficients obtained were calculated. The determination of the best cutoff points for predicting insulin resistance, stratified by sex and stratified by sex and stage of sexual maturation, constructed an ROC curve for each group. The areas under the ROC curve and the confidence intervals (95% CI) were used to assess the diagnostic value of the WHtR. The mean age of the adolescents was 14.7 (± 0.008), the majority of the boys were in the final stages of maturation and the girls had a distribution around 30% in stages II, IV and V. Abdominal obesity evaluated by WHtR was more prevalent at the end of sexual maturation in girls and at maturation in boys. The relation of the WHtR varied according to the parameter evaluated. Insulin and HOMA-IR metabolic indicators presented the highest coefficients of determination in the regression equations obtained in the study, especially among boys (r ² 0.43 and r ¼ 0.40, respectively). After analyzing ROC, we observed that. The best cutoff points of rCERs stratifying only by sex were 0.45 for females and 0.44 for males. When Tanner stratification was included, cut-off points were reduced along maturation stages in boys and female adolescents showed an inverse behavior. Because it is easy to measure and interpret, it can be used in risk screening for metabolic changes, especially insulin resistance, especially in boys who initiate sexual maturation. |
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Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileirosPuberdadeObesidade abdominalResistência à insulinaRazão Cintura - EstaturaPubertyAbdominal obesityInsulin resistanceWaist-to-Height RatioRisco Metabólico - AdolescentesPuberdade – Obesidade abdominalCNPQ::CIENCIAS DA SAUDE::NUTRICAOAdolescence is a peculiar phase of human development, marked by intense physical, sexual, and behavioral transformations. Changes in the distribution of body fat during adolescence are strongly influenced by sexual maturation, and this phase is considered one of the critical periods for the onset of obesity, which in turn may be associated with a set of metabolic alterations such as dyslipidemias and insulin resistance. In this point of view, the objective of this study was to evaluate the relation of the Waist-to-height ratio (WHtR) with metabolic alterations in adolescents, according to the stage of sexual maturation. Variables of sexual maturation (Tanner planks), anthropometric variables (weight, height, waist circumference (CC), and biochemical variables (fasting glucose, fasting insulin, HOMA-IR, total cholesterol and fractions c and HDLc) and triglycerides), as well as demographic (sex and age). Data from 37,759 Brazilian adolescents aged 12-17 years, of both sexes, who participated in the national population-based study "Study of Cardiovascular Risks in Adolescents - ERICA" were analyzed. All analyzes were done in the program Stata 14.0 SE. The adolescents were described according to sex and stage of sexual maturation and were classified according to excess abdominal adiposity, according to the WHtR score. Linear regression models were constructed to observe the relationship between each of the metabolic variables, HOMA-IR, triglycerides, HDL-c, LDL-c, total cholesterol and fasting insulin, and the WHtR. The coefficients of determination of each equation (r2) and the values of the regression coefficients obtained were calculated. The determination of the best cutoff points for predicting insulin resistance, stratified by sex and stratified by sex and stage of sexual maturation, constructed an ROC curve for each group. The areas under the ROC curve and the confidence intervals (95% CI) were used to assess the diagnostic value of the WHtR. The mean age of the adolescents was 14.7 (± 0.008), the majority of the boys were in the final stages of maturation and the girls had a distribution around 30% in stages II, IV and V. Abdominal obesity evaluated by WHtR was more prevalent at the end of sexual maturation in girls and at maturation in boys. The relation of the WHtR varied according to the parameter evaluated. Insulin and HOMA-IR metabolic indicators presented the highest coefficients of determination in the regression equations obtained in the study, especially among boys (r ² 0.43 and r ¼ 0.40, respectively). After analyzing ROC, we observed that. The best cutoff points of rCERs stratifying only by sex were 0.45 for females and 0.44 for males. When Tanner stratification was included, cut-off points were reduced along maturation stages in boys and female adolescents showed an inverse behavior. Because it is easy to measure and interpret, it can be used in risk screening for metabolic changes, especially insulin resistance, especially in boys who initiate sexual maturation.NenhumaA adolescência é uma fase peculiar do desenvolvimento humano, marcada por intensas transformações físicas, sexuais e comportamentais. Modificações na distribuição de gordura corporal durante a adolescência são fortemente influenciadas pela maturação sexual e esta fase é considerada um dos períodos críticos para o início da obesidade, que, por sua vez, pode estar associada a um conjunto de alterações metabólicas, tais como dislipidemias e resistência à insulina. Diante disto, os objetivos deste trabalho foram avaliar a relação da Razão CinturaEstatura (RCEst) com alterações metabólicas em adolescentes, segundo o estágio de maturação sexual, bem como identificar os melhores pontos de corte para a RCEst, segundo o estágio de maturação sexual, na predição de resistência à insulina. Fizeram parte deste estudo variáveis de maturação sexual (Pranchas de Tanner), antropométricas (altura, circunferência da cintura (CC) e RCEst) e bioquímicas (glicemia de jejum, insulina de jejum, HOMA-IR, colesterol total e frações (LDL-c e HDL-c) e triglicerídeos), além das demográficas (sexo e idade). Analisou-se dados de 37.759 adolescentes brasileiros de 12-17 anos, de ambos os sexos, que participaram do estudo nacional de base populacional “Estudo de Riscos Cardiovasculares em Adolescentes – ERICA”. Todas as análises foram feitas no programa Stata 14.0 SE. Os adolescentes foram descritos em função do sexo e estágio de maturação sexual e foram classificados de acordo com excesso de adiposidade abdominal, segundo o indicador RCEst. Foram construídos modelos de regressão linear para observar a relação entre cada uma das variáveis metabólicas, HOMA-IR, Triglicerideos, HDL-c, LDL-c, Colesterol total e insulina de jejum e a RCEst. Foram calculados os coeficientes de determinação de cada equação (r2) e os valores dos coeficientes de regressão obtidos. Para determinar os melhores pontos de corte da RCEst para predizer resistência à insulina, para a amostra estratificada por sexo e estratificada por sexo e estágio de maturação sexual, foi construída uma curva ROC para cada grupo. As áreas sob a curva ROC e os intervalos de confiança (IC 95%) foram utilizados para avaliar o valor diagnóstico da RCEst. A idade média dos adolescentes foi de 14,7 (±0,008) anos, a maioria (66,1%) dos meninos encontrava-se nos estágios IV e V da maturação e as meninas tiveram uma distribuição em torno de 30% nos estágios II, IV e V. A obesidade abdominal avaliada pela RCEst foi mais prevalente no final da maturação sexual nas meninas (23,8%) e no início da maturação nos meninos (23,6%). A relação da RCEst variou de acordo com o parâmetro avaliado. Os indicadores metabólicos Insulina e HOMA-IR foram os que apresentaram maiores coeficientes de determinação nas equações de regressão obtidas no estudo, especialmente entre os meninos (r² 0,43 e r² 0,40, respectivamente). Após análise da ROC, foi observado que os melhores pontos de corte de RCEst estratificando somente por sexo, foram de 0,45 para o sexo feminino e 0,44 para o sexo masculino. Quando incluída a estratificação por Tanner, houve redução dos pontos de corte ao longo dos estágios de maturação nos meninos e as adolescentes do sexo feminino mostraram um comportamento inverso. A RCEst, por ser de fácil mensuração e interpretação, pode ser usada na triagem de risco para alterações metabólicas, principalmente resistência à insulina, especialmente em meninos que iniciam a maturação sexual.Universidade Federal da ParaíbaBrasilNutriçãoPrograma de Pós-Graduação em Ciências da NutriçãoUFPBVianna , Rodrigo Pinheiro de Toledohttp://lattes.cnpq.br/3915051035089861Lins, Pamela Rodrigues Martins2019-11-04T17:06:14Z2019-03-182019-11-04T17:06:14Z2019-02-21info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesishttps://repositorio.ufpb.br/jspui/handle/123456789/16276porAttribution-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nd/3.0/br/info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFPBinstname:Universidade Federal da Paraíba (UFPB)instacron:UFPB2019-11-04T17:06:14Zoai:repositorio.ufpb.br:123456789/16276Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufpb.br/PUBhttp://tede.biblioteca.ufpb.br:8080/oai/requestdiretoria@ufpb.br|| diretoria@ufpb.bropendoar:2019-11-04T17:06:14Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)false |
dc.title.none.fl_str_mv |
Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileiros |
title |
Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileiros |
spellingShingle |
Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileiros Lins, Pamela Rodrigues Martins Puberdade Obesidade abdominal Resistência à insulina Razão Cintura - Estatura Puberty Abdominal obesity Insulin resistance Waist-to-Height Ratio Risco Metabólico - Adolescentes Puberdade – Obesidade abdominal CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
title_short |
Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileiros |
title_full |
Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileiros |
title_fullStr |
Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileiros |
title_full_unstemmed |
Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileiros |
title_sort |
Análise e utilização do indicador antropométrico razão cintura-estatura na avaliação do risco metabólico em adolescentes brasileiros |
author |
Lins, Pamela Rodrigues Martins |
author_facet |
Lins, Pamela Rodrigues Martins |
author_role |
author |
dc.contributor.none.fl_str_mv |
Vianna , Rodrigo Pinheiro de Toledo http://lattes.cnpq.br/3915051035089861 |
dc.contributor.author.fl_str_mv |
Lins, Pamela Rodrigues Martins |
dc.subject.por.fl_str_mv |
Puberdade Obesidade abdominal Resistência à insulina Razão Cintura - Estatura Puberty Abdominal obesity Insulin resistance Waist-to-Height Ratio Risco Metabólico - Adolescentes Puberdade – Obesidade abdominal CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
topic |
Puberdade Obesidade abdominal Resistência à insulina Razão Cintura - Estatura Puberty Abdominal obesity Insulin resistance Waist-to-Height Ratio Risco Metabólico - Adolescentes Puberdade – Obesidade abdominal CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
description |
Adolescence is a peculiar phase of human development, marked by intense physical, sexual, and behavioral transformations. Changes in the distribution of body fat during adolescence are strongly influenced by sexual maturation, and this phase is considered one of the critical periods for the onset of obesity, which in turn may be associated with a set of metabolic alterations such as dyslipidemias and insulin resistance. In this point of view, the objective of this study was to evaluate the relation of the Waist-to-height ratio (WHtR) with metabolic alterations in adolescents, according to the stage of sexual maturation. Variables of sexual maturation (Tanner planks), anthropometric variables (weight, height, waist circumference (CC), and biochemical variables (fasting glucose, fasting insulin, HOMA-IR, total cholesterol and fractions c and HDLc) and triglycerides), as well as demographic (sex and age). Data from 37,759 Brazilian adolescents aged 12-17 years, of both sexes, who participated in the national population-based study "Study of Cardiovascular Risks in Adolescents - ERICA" were analyzed. All analyzes were done in the program Stata 14.0 SE. The adolescents were described according to sex and stage of sexual maturation and were classified according to excess abdominal adiposity, according to the WHtR score. Linear regression models were constructed to observe the relationship between each of the metabolic variables, HOMA-IR, triglycerides, HDL-c, LDL-c, total cholesterol and fasting insulin, and the WHtR. The coefficients of determination of each equation (r2) and the values of the regression coefficients obtained were calculated. The determination of the best cutoff points for predicting insulin resistance, stratified by sex and stratified by sex and stage of sexual maturation, constructed an ROC curve for each group. The areas under the ROC curve and the confidence intervals (95% CI) were used to assess the diagnostic value of the WHtR. The mean age of the adolescents was 14.7 (± 0.008), the majority of the boys were in the final stages of maturation and the girls had a distribution around 30% in stages II, IV and V. Abdominal obesity evaluated by WHtR was more prevalent at the end of sexual maturation in girls and at maturation in boys. The relation of the WHtR varied according to the parameter evaluated. Insulin and HOMA-IR metabolic indicators presented the highest coefficients of determination in the regression equations obtained in the study, especially among boys (r ² 0.43 and r ¼ 0.40, respectively). After analyzing ROC, we observed that. The best cutoff points of rCERs stratifying only by sex were 0.45 for females and 0.44 for males. When Tanner stratification was included, cut-off points were reduced along maturation stages in boys and female adolescents showed an inverse behavior. Because it is easy to measure and interpret, it can be used in risk screening for metabolic changes, especially insulin resistance, especially in boys who initiate sexual maturation. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-11-04T17:06:14Z 2019-03-18 2019-11-04T17:06:14Z 2019-02-21 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufpb.br/jspui/handle/123456789/16276 |
url |
https://repositorio.ufpb.br/jspui/handle/123456789/16276 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ |
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openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Nutrição Programa de Pós-Graduação em Ciências da Nutrição UFPB |
publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Nutrição Programa de Pós-Graduação em Ciências da Nutrição UFPB |
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Universidade Federal da Paraíba (UFPB) |
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Biblioteca Digital de Teses e Dissertações da UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB) |
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diretoria@ufpb.br|| diretoria@ufpb.br |
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