Utility of body mass index, waist circumference and waist-to-height ratio as screening tools for hyperglycemia in young people

Abstract

Objectives: To evaluate the ability of BMI, WC and WHtR to discriminate hyperglycemia in young people, and to determine whether there is an increase in the accuracy with the addition of WC and/or WHtR to BMI. Subjects and methods: A cross-sectional study was conducted on 1,139 schoolchildren aged 6 to 17 years from Northeastern Brazil. Body weight, height, WC and fasting glucose levels were measured, and the BMI and WHtR were calculated. The presence of hyperglycemia was defined as a fasting glucose level ≥ 100 mg/dL. Results: The prevalence of hyperglycemia was 6.6%. Strong correlations were observed between the anthropometric indicators studied (BMI vs. WC = 0.87; BMI vs. WHtR = 0.87; WC vs. WHtR = 0.90). Hyperglycemia was more likely to be present in young people with excess weight (PR = 1.70), high WC (PR = 1.85), and high WHtR (PR = 1.91). The accuracies to discriminate hyperglycemia were significant, but low, for the individual (BMI = 0.56; WC = 0.53; WHtR = 0.55) and combined indicators (BMI + WC = 0.55; BMI + WHtR = 0.55). Conclusion: Our findings do not support the use of BMI, WC or WHtR as screening tools for hyperglycemia in children and adolescents. Arch Endocrinol Metab. 2016;60(6):526-31

Predictores de riesgo cardiometabólico en adolescentes de Quito

“…Así, un estudio en adolescentes reportó que los tres índices antropométricos fueron útiles para identificar dislipidemia pero recomiendan el uso de r-CT como indicador de riesgos cardiovasculares [64], mientras que otro no recomienda el uso de ninguno de los tres indicadores como herramientas de tamizaje para hiperglicemia [65]. En Argentina, se demostró asociación significativa entre CC, r-CT e IMC y la presencia de hipertensión [66]. En Colombia un estudio determinó que CC tiene mejor asociación con riesgos cardiometabólicos individuales que r-CT [23], en tanto que otro mostró que r-CT ≥0.5 se asocia significativamente con niveles menores de HDL, niveles mayores de triglicéridos, resistencia a la insulina e hipertensión luego de controlar por edad, sexo, condición socio económica y actividad física [67].…”

Is body mass index still a good tool for obesity evaluation?

“…Quadros and cols. (13) did not demonstrate advantage to add WC and WHR to BMI for hyperglycemia screen, however they performed only one measurement of fasting glucose and this can be a bias for under diagnosis. Although anthropometric indicators correlation to metabolic diseases in children and adolescents is still in discussion, they should continue be used because of their simplicity, low cost and noninvasive method.…”