RESUMEN
AIMS/INTRODUCTION: Elevated concentrations of fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c) are well-established independent risk factors for progression to diabetes, cardiovascular comorbidities and mortality. Most previous studies on the relationships of anthropometric measures with hyperglycemia were carried out among adults and adolescents, but few data are available for the performance predication of the predictors for diagnosing elevated FPG or HbA1c among young children. MATERIALS AND METHODS: Involving 5,556 students of aged 7-9 years, a school-based cross-sectional survey was carried out between March and June 2019 in Shenzhen, China. Receiver operating characteristic curve analysis was utilized. RESULTS: The median was 4.6 (interquartile range [IQR] 4.3-4.8) mmol/L for FPG and 5.3% (IQR 5.1-5.5%) for HbA1c levels for all participants. For detecting elevated FPG, weight (0.651, IQR 0.583-0.719) and waist circumference (0.650, IQR 0.584-0.717) showed the highest area under the curve and 95% confidence interval, followed by body mass index and the z-score of body mass index (both 0.635, IQR 0.567-0.703); other anthropometric measures showed poorer diagnostic efficiencies or no ability. For detecting elevated HbA1c, lower efficiencies for the Conicity Index (0.651, IQR 0.583-0.719), waist-to-height ratio, waist-to-hip ratio and waist-to-chest ratio were shown. The correlations of FPG and HbA1c levels with anthropometric indices were weak (Spearman's r ≤ 0.179). CONCLUSIONS: None of the evaluated anthropometric indicators approached an adequate predictive accuracy for the detection of elevated FPG or HbA1c levels in Shenzhen children aged 7-9 years. The current study did not recommend anthropometry screening for prediabetes in young children.
Asunto(s)
Antropometría , Glucemia/análisis , Hemoglobina Glucada/análisis , Hiperglucemia/diagnóstico , Tamizaje Masivo/estadística & datos numéricos , Pueblo Asiatico/estadística & datos numéricos , Índice de Masa Corporal , Niño , China , Estudios Transversales , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/etiología , Ayuno/sangre , Femenino , Humanos , Hiperglucemia/complicaciones , Masculino , Tamizaje Masivo/métodos , Valor Predictivo de las Pruebas , Curva ROC , Medición de Riesgo , Factores de Riesgo , Circunferencia de la Cintura , Relación Cintura-EstaturaRESUMEN
BACKGROUND: Numerous studies have consistently demonstrated that high body mass index (BMI) is related to elevated serum alanine aminotransferase (ALT) among adults, but little is known about the association regarding adolescents, especially in China. In this study, we aimed to investigate the association between BMI and ALT activity among Chinese adolescents. METHODS: A school-based cross-sectional study was performed among nine high schools in Shenzhen, China between February 2017 and June 2018. A generalized linear-regression model adjusting for age and gender was conducted, and bivariate correlation analysis between ALT and BMI was also performed. RESULTS: A total of 7,271 adolescents aged from 9 years to 17 years were enrolled. Height, weight, BMI, and ALT were higher among boys than among girls (all P < 0.001). The mean (standard deviation) of serum ALT levels was 14.26 (14.77) U/L. In the entire BMI range, the BMI-ALT correlation was stronger for boys (Spearman's r = 0.396, P < 0.001) and adolescents of 14 years-17 years (r = 0.356, P < 0.001) than for girls (r = 0.203, P < 0.001) and adolescents of 9 years-13 years (r = 0.221, P < 0.001), respectively. Serum ALT increased rapidly and followed a linear pattern from the point of BMI ≥20.5 kg/m2, and each increase of 1 kg/m2 in BMI range above 20.5 kg/m2 was averagely correlated with an increase of 2.71 U/L in ALT levels (P < 0.001). CONCLUSIONS: We found a significant BMI-ALT relationship. BMI at 20.5 kg/m2 may be a cut-off for evaluating serum ALT. BMIs ≥27.1 kg/m2 for boys and ≥24.9 kg/m2 for girls were linked to an elevated ALT activity for Shenzhen adolescents.