Anthropometric measurements as a potential non-invasive alternative for the diagnosis of metabolic syndrome in adolescents

Abstract

Objective: To identify which anthropometric measurement would be the best predictor of metabolic syndrome (MetS) in Brazilian adolescents. Subjects and methods: Cross-sectional study conducted on 222 adolescents (15-17 years) from a city in southern Brazil. Anthropometric, physical activity, blood pressure and biochemical parameters were investigated. MetS criteria were transformed into a continuous variable (MetS score). Linear regression analyses were performed to assess the associations of BMI, hip circumference, neck circumference (NC), triceps skinfold, subscapular skinfold and body fat percentage with MetS score. ROC curves were constructed to determine the cutoff for each anthropometric measurement. Results: The prevalence of MetS was 7.2%. Each anthropometric measurement was significantly (p < 0.001) associated with MetS score. After adjusting for potential confounding variables (age, sex, physical activity, and maternal education), the standardized coefficients of NC and body fat percentage appeared to have the strongest association (beta = 0.69 standard deviation) with MetS score. The regression of BMI provided the best model fit (adjusted R 2 = 0.31). BMI predicted MetS with high sensitivity (100.0%) and specificity (86.4%). Conclusions: Our results suggest that BMI and NC are effective screening tools for MetS in adolescents. The early diagnosis of MetS combined with targeted lifestyle interventions in adolescence may help reduce the burden of cardiovascular diseases and diabetes in adulthood.

Evaluation of neck circumference as a predictor of elevated cardiometabolic risk outcomes in 5–8-year-old Brazilian children

“…In contrast to our findings, significant associations of NC with SBP, HDL-c, triglycerides, and HOMA remained for both boys and girls when Formisano et al (2016) adjusted models for BMI. These authors (Formisano et al 2016) and others (Gomez-Arbelaez et al 2016;Castro-Piñero et al 2017;Mastroeni et al 2019) have also found evidence that NC performs well in identifying individuals with elevated metabolic syndrome scores or cardiometabolic risk scores. We opted not to explore associations with a calculated risk score, owing to the observed correlation (pre-BMI adjustment) of NC with just SBP and HOMA in our sample, and its poor performance as a classifier of elevated measures.…”

“…Several authors have used Receiver Operating Characteristic (ROC) curves to assess the diagnostic ability of NC (Nafiu et al 2010;Katz et al 2014;Formisano et al 2016;Mastroeni et al 2019), however PR plots are more appropriate for imbalanced data sets where there is a large difference in positive vs negative outcomes (Saito and Rehmsmeier 2015). PR plots show precision on the y-axis against recall (sensitivity) on the x-axis.…”

“…Across these studies, NC correlated with other anthropometric parameters (e.g. WC and BMI), as well as single and clustered cardiometabolic risk factors, and performed well as a tool to identify those with, or at risk of, metabolic syndrome (Stabe et al 2013;Formisano et al 2016;Mastroeni et al 2019;Alzeidan et al 2019;Gomez-Arbelaez et al 2016).…”

“…There is good evidence that measures including waist circumference (WC), waist-tohip ratio (WHR), and waist-to-height ratio (WHtR) fulfill these criteria in both adults (Yusuf et al 2005) and children (Savva et al 2000), although see Sardinha et al (2016) and Li et al (2020). Neck circumference (NC) has also received wide interest as a proxy for upper body FM depots, with studies conducted in children, adolescents, and adults in a range of populations (Nafiu et al 2010;Stabe et al 2013;Katz et al 2014;Formisano et al 2016;Castro-Piñero et al 2017;Alzeidan et al 2019;Mastroeni et al 2019). Across these studies, NC correlated with other anthropometric parameters (e.g.…”

“…Of several studies conducted in Brazilian children (Silva et al 2014;Coutinho et al 2014;Filgueiras et al 2019;Mastroeni et al 2019), none have examined associations between NC and cardiometabolic risk factors in children under 10 years of age. To further explore the use of NC as a low-cost tool for the assessment of cardiometabolic risk, the current study tested associations of NC with blood pressure, lipid, and glycemic parameters of 5-8-year-old children in Jundiaí city, Brazil.…”