Acurácia da gordura corporal e do perímetro da cintura para predizer alterações metabólicas de risco cardiovascular em adolescentes

Abstract

RESUMOObjetivo: Avaliar a acurácia do percentual de gordura corporal (%GC) e do perímetro da cintura (PC) na predição de alterações metabólicas em adolescentes. Sujeitos e métodos: Estudo transversal com amostra probabilística de 573 estudantes de 12 a 19 anos da rede estadual de ensino de Niterói, RJ. Utilizou-se a Receiver Operating Characteristic Curve para avaliar a acurá-cia do %GC e PC na predição de alterações de pressão arterial, perfil lipídico e glicemia. Resultados: Os melhores pontos de corte do %GC foram 21% para meninos e 23% para as meninas, com sensibilidade (SE) e especificidade (ESP) de aproximadamente 60%. Para o PC, 71 cm para meninos e 66 cm para meninas apresentaram melhor SE (55% a 70%) e ESP (55% a 78%). Conclusão: Mesmo os melhores pontos de corte identificam incorretamente proporções elevadas de adolescentes com alterações metabólicas, sugerindo cautela no uso desses indicadores para triagem de risco cardiovascular nessa faixa etária. Arq Bras Endocrinol Metab. 2014;58(4):341-51 Descritores Adolescentes; gordura corporal; perímetro da cintura; hiperlipidemias; hipertensão arterial ABSTRACT Objective: To evaluate the performance of percent body fat (%BF) and waist circumference (WC) in predicting metabolic abnormalities indicating cardiovascular risk in adolescents. Subjects and methods: Cross-sectional study with a probabilistic sample of 573 adolescents aged 12 to 19 years from state public schools in Niterói, RJ. The Receiver Operating Characteristic Curve was used to evaluate the accuracy of WC and %BF in predicting alterations in blood pressure, lipid profile, and blood glucose. Results: The best %BF cutoff points were 21% for boys, and 23% for girls, with sensitivity (SE) and specificity (SP) of approximately 60%. The best WC cutoff points were 71 cm for boys, and 66 cm for girls (SE: 55% to 70%; SP: 55% to 78%). Conclusion: Even the best cutoff points misidentified high proportions of adolescents with metabolic abnormalities. Caution is recommended in the use of these indicators for cardiovascular risk screening in this age group. Arq Bras Endocrinol Metab. 2014;58 (4) INTRODUÇÃON o Brasil, 20,5% dos adolescentes apresentam excesso de peso, prevalência que aumentou em seis vezes entre meninos e três vezes entre meninas nas úl-timas quatro décadas (1). Esse avanço é preocupante, pois alterações como hipertensão arterial sistêmica, dislipidemias e diabetes melito tipo 2 já foram observadas em adolescentes obesos brasileiros (2) e aumentam o risco para doenças cardiovasculares na vida adulta (3).O índice de massa corporal (IMC) tem sido utilizado na avaliação de excesso de peso e obesidade em adolescentes por ser prático, de baixo custo e apresentar

Triagem da pressão arterial elevada em crianças e adolescentes de Amargosa, Bahia: utilidade de indicadores antropométricos de obesidade

“…However, regardless of the criterion used to classify BMI, sensitivity was low. Moraes et al 15 tested the BMI cut-off points proposed by IOTF 19 , CDC 21 , and Conde and Monteiro 22 to predict high BP in 817 young people aged 6 to 13 years. As in the present study, sensitivity showed low values (31 to 44%), no matter the criterion used, with the Brazilian one being the most sensitive.…”

“…In addition, cut-off points from high-income countries do not seem to be the most suitable to use in middle-and low-income ones 42 . Previous studies that tested cut-off points developed based on their samples showed high values for both sensitivity and specificity 15,39,42 . Thus, we can reasonably affirm that the success of screening for cardiovascular risk factors in children and adolescents using anthropometric indices might be related to the development and use of specific cut-off points for each population.…”

“…Several studies have investigated the power of BMI, WC, and WHtR in predicting high BP in young people, but it is still not clear which of these anthropometric indices would be more suitable for high BP screening 9,10,[12][13][14][15] . In addition, the definition of the BMI, WC, and WHtR classification criterion with better sensitivity and specificity in detecting high BP among young Brazilians remains open, as previous investigations tested few cut-off points of these indices 10,12,15 . These gaps are even more evident in children given that a large part of national studies included only adolescents in their sample 10,12,15 .…”

“…In addition, the definition of the BMI, WC, and WHtR classification criterion with better sensitivity and specificity in detecting high BP among young Brazilians remains open, as previous investigations tested few cut-off points of these indices 10,12,15 . These gaps are even more evident in children given that a large part of national studies included only adolescents in their sample 10,12,15 . Thus, the objective of this study was to:…”

Can anthropometry measure the body fat of people living with HIV/AIDS?: A systematic review

“…When linked to indexes or predictive equations, these body measurements, also referred to as anthropometric indicators, can provide information on the quantity of the individual's fat mass 17,18 . Several studies have been carried out with the objective of investigating the accuracy of anthropometric measurements in the description of body fat quantity in different populations, justified by the need to gather measurements in a shorter timeframe, with lower cost and greater simplicity [19][20][21][22] . Therefore, this review proposes a response to the following central question: Can anthropometry accurately measure the body fat of PLWHA?…”