Critério de obesidade central em população brasileira: impacto sobre a síndrome metabólica

Abstract

objective: To identify and propose the optimal waist circumference cut-off points (WCp) for the diagnosis of central obesity (CO) in a Brazilian population, so as to compare these cut-off points with those recommended by the ATPIII (WC-ATPIII), and to estimate the difference in prevalence rates of metabolic syndrome (MS) using the two criteria. Methods:Cross-sectional study conducted in a population subgroup of 1439 adults in the city of Salvador, Brazil. ROC curves of WC were plotted to identify diabetes mellitus (DM) and obesity. ROC curve sensitivity and specificity values ≥60% and the closest to each other were used to define WCp. The prevalence of MS was estimated using WCp and WC-ATPIII.results: Eight hundred and twenty nine women comprised 57.7% of the sample. The WCp selected were 84cm for women and 88cm for men. These cut-off points detected DM with a 68.7% and 70% sensitivity, and a 66.2% and 68.3% specificity, respectively. For obesity, sensitivity and specificity were 79.8% and 77.6% in women and 64.3% and 71.6% in men, respectively. Using WC-ATPIII, 88cm (for women) and 102cm (for men), the sensitivity was 53.3% and 26.5%, respectively, to diagnose DM. For obesity, sensitivity was 66.5% (for women) and 28.6% (for men). The prevalence of MS using WCp was 23.7%, 95%CI (21.6 -25.9), whereas using WC-ATPIII it was 19.0%, 95%CI (17.1-20.9), 1.2 times higher using WCp.conclusion: WC-ATPIII were inappropriate and underestimated the prevalence of MS in the population studied, particularly among men. We suggest that the WC cut-off points > 84cm for women and > 88cm for men should be tested in other Brazilian populations.

Combinação de fatores de risco relacionados à síndrome metabólica em militares da Marinha do Brasil

“…Thus, when assessing the impact of different cutoff points in the prevalence of MS, Barbosa et al 29 have reported that more conservative criteria of waist circumference -84 and 88 cm for women and men, respectively -provided more effective conditions to identify subjects with diabetes mellitus and obesity in the city of Analyzing the possible variables associated with MS, only age, smoking and PhA level maintained the association in the adjusted model. Although supposedly associated with both socioeconomic factors and the profile of occupational demands, the variable military rank lost significance after adjusting for age and the other variables.…”

Pressão arterial: efeito do índice de massa corporal e da circunferência abdominal em adolescentes

“…In relation to the WC cut-off point, it is also necessary to consider that the value currently used in this study may underestimate the degree of central obesity, since it is based on values obtained from American adolescents, whose anthropometric data are different from ours 24 . In this age range, there is still no value established for waist circumference from which the presence of increased visceral fat could be diagnosed.…”

Obesidade e intervenção coronariana: devemos continuar valorizando o Índice de Massa Corpórea?

“…In fact, despite the fact that BMI is a simple and convenient measurement for the diagnosis of obesity, the importance of the deleterious effect of abdominal obesity on coronary artery disease is increasingly more evident 10 . Compared to the BMI, the Waist Circumference, Conicity Index, and Waist-Hip Ratio have proved to be superior for identifying visceral adiposity and, consequently, metabolic disorders and cardiovascular risk 12 . In a study on risk factors in the city of São Paulo and in INTERHEART, a high Waist-Hip Ratio (intermediate tercile versus the inferior tercile) was independently associated with AMI, which did not occur with an altered BMI 13,14 .…”