Tri-Ponderal Mass Index Is Useful for Screening Children and Adolescents With Insulin Resistance

Abstract

Objective: To investigate whether tri-ponderal mass index and body mass index Z scores are equivalent for screening children and adolescents with insulin resistance.Methods: 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).Results: The HOMA-IR was higher in the 4 th quartile of body mass index Z scores and tri-ponderal mass index compared to 1 st and 2 nd 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: R 2 =0.269; tri-ponderal mass index: R 2 =0.289; p<0.001) and boys (body mass index Z scores: R 2 =0.175; tri-ponderal mass index: R 2 =0.210; p<0.001). Conclusions: The tri-ponderal mass index and body mass index Z scores were similar to discriminate children and adolescents with Objetivo: Investigar se o índice de massa tri-ponderal e os escores-z do índice de massa corporal são equivalentes na triagem de crianças e adolescentes com resistência à insulina. Métodos: Estudo transversal com 296 crianças e adolescentes matriculados em escolas públicas de Vitória, Espírito Santo, Brasil, com idades entre oito e 14 anos. O índice de massa tri-ponderal foi calculado como a razão entre o peso e a altura ao cubo. O índice de massa corporal foi calculado como a razão entre o peso e a altura ao quadrado. A resistência à insulina foi definida pelo modelo de avaliação da homeostase para resistência à insulina (HOMA-IR).Resultados: O HOMA-IR foi maior no 4 º quartil dos escores-z do índice de massa corporal e do índice de massa tri-ponderal, em relação ao 1 º e 2 º quartis em ambos os sexos. As áreas sob as curvas receiver operating characteristic ajustadas por idade foram semelhantes em meninas (escores-z do índice de massa corporal=0,756; índice de massa tri-ponderal=0,763) e meninos (escores-z do índice de massa corporal=0,831; índice de massa tri-ponderal=0,843). Além disso, de acordo com as estimativas das análises de regressão linear simples, os escores-z do índice de massa corporal e o índice de massa triponderal explicaram uma fração significativa da variabilidade do modelo de avaliação da homeostase para meninas (escores-z do índice de massa corporal: R 2 =0,269; índice de massa tri-ponderal: R 2 =0,289; p<0,001) e meninos (escores-z do índice de massa corporal: R 2 =0,175; índice de massa tri-...

Association of Tri-Ponderal Mass Index vs Body Mass Index With Mid-Upper Arm Circumference Among Adolescent Girls

“…The value is quite less compared to another study 19 and is higher compared to some other studies. [20][21][22] The present study found that TMI values tend to increase with age. This finding corroborates with another study.…”

Tri-Ponderal Mass Index as a Screening Tool for Identifying Body Fat and Cardiovascular Risk Factors in Children and Adolescents: A Systematic Review

“…Table 1 describes the characteristics of the included studies including 14 for the association between TMI and body fat in childhood and adolescence ( 10 , 14 , 18 – 26 , 41 – 43 ), 20 for TMI and CVRFs in childhood and adolescence ( 13 – 18 , 21 , 26 – 34 , 42 – 45 ), and 4 for the association in adulthood ( 35 – 37 , 46 ). Twenty-five of the included studies used a cross-sectional design ( 10 , 13 , 15 – 28 , 30 – 34 , 41 – 43 , 45 ), 2 a retrospective design ( 14 , 44 ), 1 a case-control design ( 29 ), and 4 a cohort design ( 35 – 37 , 46 ).…”

“…Twenty articles on the association between TMI and MetS and its components were included in this systematic review ( Table 2 ) ( 13 – 18 , 21 , 26 – 34 , 42 – 45 ).…”

“…Eight articles compared TMI and BMI for identifying insulin resistance (IR) or impaired glucose in children and adolescents ( Table 2 ) ( 13 , 14 , 21 , 29 , 31 , 32 , 34 , 45 ). Among these eight articles, seven reported that BMI (used as a continuous variable) performed similarly or marginally better than TMI for identifying IR ( 13 , 21 , 29 , 31 , 32 , 34 , 45 ). In addition, compared to BMI, TMI was more likely to underestimate IR ( 14 ).…”

“…It is however unclear whether the emerging TMI can better identify adiposity in childhood or adolescence than the commonly used BMI ( 10 , 14 , 18 – 26 ) and better predict obesity-related cardiovascular risk factors (CVRFs) such as high blood pressure, dyslipidemia, insulin resistance, and the MetS in childhood ( 13 – 16 , 18 , 21 , 26 – 34 ) or adulthood ( 35 – 37 ). The misclassification of obesity may lead to either omissions of children who are at high risk of obesity-related diseases or excessive anxiety due to overdiagnosis and then unnecessary waste of medical resources ( 38 ).…”