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SUMMARY OBJECTIVE: The aim of this study was to assess the prevalence of functional constipation and its relationship with the food intake, overweight status, and physical activity of children. METHODS: This cross-sectional study included students from two public schools in the municipality of Osasco, which is located in the metropolitan area of São Paulo. Functional constipation was diagnosed if the clinical manifestations of the Rome IV criteria were present for more than 2 months. A 24-h recall survey was used to determine the daily food intake. Weight, height, abdominal circumference, and bioelectrical impedance were used to evaluate the weight status. Active commuting to school and physical activity scores were assessed using a questionnaire that has been validated in Brazil. RESULTS: A total of 452 children, aged 6-12 years, were evaluated. Functional constipation was observed in 22.3% of participants. A greater abdominal circumference was associated with functional constipation in girls (p=0.036) in the bivariate analysis but not in the logistic regression model. Boys with functional constipation consumed higher quantities of fats (p=0.041). There was no statistically significant relationship between functional constipation and overweight status (44.6 and 34.5% of children with and without constipation, respectively; p=0.083) and active commuting to school (48.5 and 56.7% of children with and without constipation, respectively; p=0.179). CONCLUSION: Functional constipation was associated with a greater abdominal circumference in girls in the bivariate analysis, however, without association in the logistic regression model. Boys with functional constipation consumed higher quantities of fat. No association was found between functional constipation, overweight status, and physical activity.
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Introducción: La biometría médica ha permitido identificar variables predictoras del peso al nacimiento. Objetivo: Determinar el poder discriminatorio local y desempeño de variables biométricas fetales a las 22 semanas sobre la condición trófica del recién nacido. Métodos: Se realizó estudio observacional, analítico y retrospectivo en tres áreas de salud del municipio Santa Clara, en el período comprendido entre enero de 2013 a diciembre de 2019. De una población de 6 035 nacidos se seleccionaron 2 454 por muestreo simple aleatorio. Se obtuvieron datos de registros de las consultas de genética. En el análisis se construyeron áreas bajo la curva Receiver Operating Characteristic y se calcularon indicadores de desempeño para pruebas diagnósticas. Resultados: Las áreas bajo la curva de las variables biométricas discriminan a los nacidos pequeños y grandes para la edad gestacional. En los pequeños sobrepasan a los 0,840 a excepción de la longitud del fémur; en los grandes el peso fetal estimado alcanza una curva de 0,715 el resto son inferiores. Se estiman puntos de corte locales. Los indicadores de desempeño de la biometría mantienen un comportamiento regular; los que se estiman al transformar los valores a partir de las tablas de referencia son más específicos con valores por encima del 80 %; mientras que los calculados después de transformar las variables por los puntos de corte estimados elevan la sensibilidad por encima del 60 %. Conclusiones: Todas las variables biométricas tienen capacidad discriminatoria para las desviaciones de la condición trófica al nacer, de preferencia para los nacimientos pequeños para la edad gestacional. Los puntos de corte óptimo identificados difieren de los establecidos en las tablas de referencias. Los indicadores de desempeño de las variables biométricas fetales demostraron superioridad según los puntos de corte estimados respecto a los de las tablas de referencia.
Introduction: Medical biometrics has made it possible to identify predictive variables of birth weight. Objective: To determine the local discriminatory power and performance of fetal biometric variables at 22 weeks on the trophic condition of the newborn. Methods: An observational, analytical and retrospective study was carried out in three health areas of the Santa Clara municipality, in the period between January 2013 and December 2019. From a population of 6,035 births, 2,454 were selected by simple random sampling. Data were obtained from records of genetic consultations. In the analysis, areas under the Receiver Operating Characteristic curve were constructed and performance indicators for diagnostic tests were calculated. Results: The areas under the curve of the biometric variables discriminate those born small and large for gestational age. In the small ones they exceed 0.840 except for the length of the femur; in the large ones, the estimated fetal weight reaches a curve of 0.715, the rest are lower. Local cut-off points are estimated. The performance indicators of the biometrics maintain a regular behavior; those that are estimated by transforming the values from the reference tables are more specific with values above 80%; while those calculated after transforming the variables by the estimated cut-off points raise the sensitivity above 60%. Conclusions: All biometric variables have discriminatory capacity for deviations of the trophic condition at birth, preferably for small births for gestational age. The optimal cut-off points identified differ from those established in the reference tables. The performance indicators of the fetal biometric variables showed superiority according to the estimated cut-off points with respect to those of the reference tables.
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BACKGROUND: Longevity, combined with a higher prevalence of obesity, particularly visceral obesity, has been associated with an increased risk of cardiovascular diseases. Insulin resistance (IR) is an important link between visceral obesity and cardiovascular diseases. An important association has been found between sagittal abdominal diameter, visceral obesity and IR. The objective of this study is to evaluate sagittal abdominal diameter as a marker of visceral obesity and correlate it with IR in older primary health care patients. METHODS: A cross-sectional study was performed with 389 patients over 60 years of age (70.6 ± 6.9), of whom 74% were female. Their clinical, anthropometric and metabolic profiles were assessed and their fasting serum insulin level was used to calculate the homeostasis model assessment insulin resistance (HOMA-IR). Sagittal abdominal diameter was measured in the supine position at the midpoint between the iliac crest and the last rib with abdominal calipers. RESULTS: Sagittal abdominal diameter was significantly correlated with anthropometric measures of general and visceral obesity and with HOMA-IR in both genders. There was no change in the association between sagittal abdominal diameter and HOMA-IR after adjusting for age, sex, diabetes and hypertension. CONCLUSION: It is feasible to use sagittal abdominal diameter in older primary care patients as a tool to evaluate visceral obesity, which is an indicator of cardiovascular risk.
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OBJECTIVE: To evaluate the association of the sagittal abdominal diameter (SAD) with insulin resistance (IR) and metabolic syndrome (MetS) components, and to compare SAD with waist circumference (WC). SUBJECTS/METHODS: This was a multicenter, cross-sectional study of 520 adolescents (10- to 18-years old). IR was assessed using the homeostasis model assessment of IR (HOMA-IR) and the hyperglycaemic clamp (n = 76). RESULTS: SAD and WC were positively correlated with HOMA-IR (r = 0.637 and r = 0.653) and inversely correlated with the clamp-derived insulin sensitivity index (ISI) (r = -0.734 and r = -0.731); P < .001. In the multivariable linear regression analysis, SAD was positively associated with HOMA-IR (B = 0.046 ± 0.003) and inversely associated with the clamp-derived ISI (B = -0.084 ± 0.009) after adjusting for sex, age, and Tanner's stages (P < .001). When WC replaced the SAD, it was positively associated with HOMA-IR (B = 0.011 ± 0.001) and inversely associated with the clamp-derived ISI (B = -0.018 ± 0.002); P < .001. The values of the areas under the curves (AUC) were 0.823 and 0.813 for SAD and WC, respectively. In Bland-Altman analysis, there were agreement between both, SAD and WC, with the clamp-derived ISI (mean = 0.00; P > .05). The SAD and WC were positively associated with blood pressure, triglycerides, and uric acid, and inversely associated with high-density lipoprotein (HDL)-cholesterol after adjusting for sex, age, and Tanner's stages. CONCLUSION: The SAD was associated with IR and MetS components, with a good discriminatory power for detecting IR. When compared to WC, SAD showed equivalent results.
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Resistencia a la Insulina , Síndrome Metabólico/fisiopatología , Diámetro Abdominal Sagital , Grasa Abdominal , Adolescente , Brasil , Niño , Estudios Transversales , Femenino , Técnica de Clampeo de la Glucosa , Humanos , Masculino , Circunferencia de la CinturaRESUMEN
RESUMO Objetivo: Correlacionar os perfis metabólico e nutricional com a presença e gravidade da síndrome da apneia obstrutiva do sono. Métodos: Estudo transversal com pacientes adultos e idosos, de ambos os sexos, atendidos no Laboratório do Sono e Coração do Pronto Socorro Cardiológico Universitário de Pernambuco, entre junho e setembro de 2014. Os pacientes se submeteram à polissonografia, à bioimpedância elétrica e a aferições antropométricas. Foram verificadas a presença da síndrome metabólica e outras morbidades. Resultados: A amostra total foi constituída por 50 pacientes, com idade média de 57,52±9,80 anos, sendo que 94% receberam diagnóstico de síndrome da apneia obstrutiva do sono e 74% possuíam síndrome metabólica. As seguintes médias foram obtidas: índice de massa corporal (31,54±5,82 kg/m2); circunferência do pescoço (39,14±4,33 cm); circunferência da cintura (106,72±11,22 cm); diâmetro abdominal sagital (23,00 cm [21,00-24,00]). O índice de massa corporal, a circunferência da cintura e o diâmetro abdominal sagital apresentaram valores mais elevados (p<0,05) entre os pacientes com síndrome da apneia obstrutiva do sono grave, quando comparados aqueles com a forma leve. O diâmetro abdominal sagital apresentou moderada correlação com o índice de apneia e hipopneia e a gordura corporal apresentou fraca correlação. Conclusão: A obesidade, a circunferência do pescoço, o diâmetro abdominal sagital e a síndrome metabólica tiveram associação positiva com a gravidade da síndrome da apneia obstrutiva do sono. Dentre os parâmetros antropométricos avaliados, o diâmetro abdominal sagital mostrou ser o mais adequado preditor para avaliar a presença e gravidade da síndrome da apneia obstrutiva do sono.
ABSTRACT Objective: To compare metabolic and nutritional profiles with the presence and severity of obstructive sleep apnea syndrome. Methods: This cross-sectional study included male and female adults and older adults treated at the Sleep and Heart Laboratory of Pernambuco Cardiologic Emergency Medical Services between June and September 2014. Patients underwent polysomnography, bioelectrical impedance analysis, and anthropometric measurements. Presence of the metabolic syndrome and other morbidities was investigated. Results: The sample consisted of 50 patients with a mean age of 57.52±9.80 years, of which 94% were diagnosed with obstructive sleep apnea syndrome, and 74% had the metabolic syndrome. Other mean sample characteristics were: body mass index (31.54±5.82 kg/m2); neck circumference (39.14±4.33 cm); waist circumference (106.72±22.11 cm); sagittal abdominal diameter (23.00 cm [21.00-24.00]). Patients with severe obstructive sleep apnea syndrome had higher body mass index, waist circumference, and sagittal abdominal diameter (p<0.05) than those with mild condition. Sagittal abdominal diameter was correlated moderately with the apnea-hypopnea index and mildly with body fat. Conclusion: Obesity, neck circumference, and the metabolic syndrome had a positive association with obstructive sleep apnea syndrome severity. Of the study anthropometric parameters, sagittal abdominal diameter was the most suitable predictor of presence and severity of obstructive sleep apnea syndrome.
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Humanos , Femenino , Embarazo , Persona de Mediana Edad , Anciano , Apnea Obstructiva del Sueño , Antropometría , Síndrome Metabólico , Circunferencia de la Cintura , Diámetro Abdominal Sagital , ObesidadRESUMEN
BACKGROUND: The use of sagittal abdominal diameter (SAD) has been proposed for screening cardio-metabolic risk factors; however, its accuracy can be influenced by the choice of thresholds values. AIM: To determine the SAD threshold values for cardio-metabolic risk factors in Mexican adults; to assess whether parallel and serial SAD testing can improve waist circumference (WC) sensitivity and specificity; and to analyze the effect of considering SAD along with WC and body mass index (BMI) in detecting cardio-metabolic risk. METHODS: This cross-sectional study was conducted during 2012-2014 in Northeast Mexico (n = 269). Data on anthropometric, clinical, and biochemical measurements were collected. Sex-adjusted receiver-operating characteristic curves (ROC) were obtained using hypertension, dysglycemia, dyslipidemia and insulin resistance as individual outcomes and metabolic syndrome as a composite outcome. Age-adjusted odds ratios and 95% confidence intervals (CI) were estimated using logistic regression. RESULTS: The threshold value for SAD with acceptable combination of sensitivity and specificity was 24.6 cm in men and 22.5 cm in women. Parallel SAD testing improved WC sensitivity and serial testing improved WC specificity. The co-occurrence of high WC/high SAD increased the risk for insulin resistance by 2.4-fold (95% CI: 1.1-5.3), high BMI/high SAD by 4.3-fold (95% CI: 1.7-11.9) and SAD alone by 2.2-fold (95% CI: 1.2.-4.2). CONCLUSIONS: The use of SAD together with traditional obesity indices such as WC and BMI has advantages over using either of these indices alone. SAD may be a powerful screening tool for interventions for high-risk individuals.
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Enfermedades Cardiovasculares/epidemiología , Enfermedades Metabólicas/epidemiología , Diámetro Abdominal Sagital , Adulto , Índice de Masa Corporal , Enfermedades Cardiovasculares/patología , Estudios Transversales , Femenino , Humanos , Masculino , Enfermedades Metabólicas/patología , México/epidemiología , Persona de Mediana Edad , Factores de Riesgo , Circunferencia de la Cintura , Adulto JovenRESUMEN
Introducción: Existe poca información de la asociación entre Psoriasis y síndrome metabólico (SM) en Chile. Objetivos: Determinar la prevalencia de SM en psoriáticos chilenos. Material y métodos: Se realizó un estudio caso-control, con 487 pacientes (238 psoriáticos y 239 controles). En ambos grupos se analizó la prevalencia de SM además del exceso de peso, hipertensión arterial, diabetes mellitus 2, hipertrigliceridemia y niveles de HDL bajo. Resultados: Los psoriáticos presentaron mayor probabilidad de padecer SM versus los controles (35,29% vs 23,29%) OR 1,8 (1,20-2,66) p<0,05. Se asoció también con circunferencia abdominal aumentada (57,14% vs 36,94) OR 2,6 (1,79 - 3,78), exceso de peso (85,99% vs 63,45%) OR 2,46 (1,62 3,73) p<0,05 y diabetes mellitus 2 (13,45% vs 4,42%) OR 3,85 (1,79 - 8,26) p<0,05. Conclusiones: Se encontró una mayor prevalencia de SM, exceso de peso, circunferencia abdominal aumentada y diabetes mellitus 2 en el grupo psoriático en comparación al grupo control.
Background: There is a paucity of information about Psoriasis and metabolic syndrome (MS) association in Chile. Aim: To determine the MS prevalence in Chilean psoriatic patients. Material and Methods: A case-control study was conducted which included 487 patients (238 psoriatic patients and 239 controls). In both groups, MS prevalence, overweight, hypertension, diabetes mellitus type 2, hypertriglyceridemia and low HDL were analyzed. Results: Psoriatic patients were more likely to present MS than controls (35.29% vs 23.29%) OR 1.8 (1.20 to 2.66) p <0.05. In addition, it was associated with increased abdominal circumference (57.14% vs 36.94) OR 2.6 (1.79 to 3.78), overweight (85.99% vs 63.45%) OR 2.46 (1.62 to 3.73) p <0.05 and diabetes mellitus type 2 (13.45% vs. 4.42%) OR 3.85 (1.79 to 8.26) p <0.05. Conclusions: There is a higher prevalence of MS, overweight, increased abdominal circumference and type 2 diabetes mellitus in the psoriatic group compared with the control group.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Psoriasis/epidemiología , Síndrome Metabólico/epidemiología , Índice de Severidad de la Enfermedad , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Comorbilidad , Chile/epidemiología , PrevalenciaRESUMEN
BACKGROUND: Measures of central adiposity such as waist circumference (PC) and sagittal abdominal diameter (SAD) are better predictors of metabolic complications than measures of total body fat. Thus, this study aimed to assess the relationship of different measures of WC and SAD with cardiometabolic risk factors in elderly men. METHODS: This is a cross-sectional study that included 69 men (aged 60-92 years old) enrolled in the Family Health Program of Viçosa, Minas Gerais, Brazil. The evaluations comprised anthropometric, biochemical and haemodynamic measurements. The WC (i.e., umbilical level; the narrowest waist; immediately above the iliac crests; and the midpoint between the last rib and iliac crest) and SAD (i.e., the narrowest point between the last rib and the iliac crest; higher abdominal diameter; umbilical level; and the midpoint between the iliac crests) were measured at different anatomical sites. Statistical analysis consisted of correlation coefficients between measures of abdominal adiposity and cardiometabolic risk factors. RESULTS: The strongest correlations were between the WC measured at the narrowest waist and triglycerides (TG), fasting blood glucose (FBG) and high-density lipoprotein cholesterol (HDL-C) levels, and between the SAD measured at the midpoint between the iliac crests and TG, FBG and HDL-C. CONCLUSIONS: SAD measured at the midpoint between the iliac crests and WC measured at the narrowest waist showed the best relationships with cardiometabolic risk factors in elderly men.
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Abdomen , Adiposidad , Enfermedades Cardiovasculares/etiología , Obesidad Abdominal/complicaciones , Diámetro Abdominal Sagital , Circunferencia de la Cintura , Anciano , Anciano de 80 o más Años , Antropometría , Glucemia/metabolismo , Brasil , Enfermedades Cardiovasculares/sangre , HDL-Colesterol/sangre , Estudios Transversales , Humanos , Masculino , Persona de Mediana Edad , Obesidad Abdominal/sangre , Factores de Riesgo , Triglicéridos/sangreRESUMEN
BACKGROUND: Obesity (abdominal adiposity) is a risk factor for cardiovascular diseases and the most used methods to measure the adiposity are body mass index (BMI), waist circumference (WC), and sagittal abdominal diameter (SAD). OBJECTIVE: To correlate BMI, WC, and SAD with biochemical parameters and blood pressure in adults. METHODS: A non-experimental exploratory/descriptive and cross sectional study was developed and it was assessed 133 subjects (59 men and 74 women) aging between 18 and 87 years. It was registered the patients' weight (kg), height (m), BMI (kg/m(2)), WC (cm) and SAD (cm), and these parameters were correlated with glycemia, triglycerides, total cholesterol, HDL-c, LDL-c and blood pressure. RESULTS: After adjustment for gender and age, it was observed a positive correlation between SAD and systolic arterial blood pressure (r = 0.20), glycemia (r = 0.20), triglycerides (r = 0.32), LDL (r = 0.26), total cholesterol (TC) (r = 0.33), and a negative correlation with HDL-c (r = -0.21) (p < 0.05). It was observed a positive correlation between WC and systolic arterial blood pressure (r = 0.14), triglycerides (r = 0.31), total cholesterol (r = 0.21), and a negative correlation with HDL-c (r = -0.24) (p < 0.05). BMI showed a positive correlation with systolic arterial blood pressure (r = 0.22), total cholesterol (r = 0.20), and triglycerides (r = 0.23) (p < 0.05). CONCLUSION: SAD correlated with almost all the cardiovascular risk factors analyzed and it might be considered the best predictor of abdominal fat and cardiovascular risk.
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Visceral adipose tissue (VAT) is linked with the metabolic consequences of obesity, being necessary the use alternative methods of predicting this type of fat, like anthropometry. The objective of this study was assess the performance of anthropometry in predicting visceral fat measured with computerized tomography in adults and older adults. Study transversal with 197 individuals underwent computerized tomography (CT) and anthropometry. The variables analized were: visceral adipose tissue area by CT, Sagittal Abdominal Diameter (SAD), Waist Circumference (WC) and Waist-Hip Ratio (WHR). A descriptive analysis, Pearson correlation and ROC curve were carried out. We observed Correlations higher than 0.7 (p=0.000) between the SAD, WC and the VAT area were found in adult men and older men and in adult women. WHR displayed the least correlations. The most sensitive and specific SAD cut-off points were equal for all the men (Adults: 20.2 cm /Older adults: 20.2 cm) but different for the women (Adults: 21.0 cm; sens.: 83.3; spec.: 79.1 /Older adults: 19.9 cm; sens.: 81.0; spec.:79.3). The WC cut-off points that identified a VAT area =130cm² were 90.2 cm and 92.2 cm for men (adult men - sens.: 86.7; spec.: 86.1 - and older men- sens.: 79.3; spec.: 77.8 -respectively), while for women the recorded values were 92.3 cm (adult women- sens.: 83.3; spec: 81.4) and 88.2 cm (older women - sens.:76.2; spec.: 69.0).This study showed that WC and SAD achieved the best performance in the identification of visceral fat considered at risk for the development of cardiometabolic diseases in adults and older adults.
Tejido adiposo visceral (TAV) está vinculado con las consecuencias metabólicas de la obesidad, siendo necesario el uso de métodos alternativos de predicción de este tipo de grasa, como la antropometría. El objetivo de este estudio fue evaluar el desempeño de la antropometría en la predicción de la grasa visceral medido con tomografía computarizada en adultos y adultos mayores. Estudio transversal con 197 individuos sometidos a tomografía computarizada y la antropometría. Las variables fueron: área de TAV, diámetro abdominal sagital (DAS), circunferencia de cintura (CC) y el índice cintura-cadera (RCC). Análisis descriptivo, de correlación de Pearson y la Curva ROC se llevaron a cabo. Hemos observado correlaciones superiores a 0,7 (p=0,000) entre el DAS, CC y TAV en los hombres adultos y adultos mayores y en mujeres adultas. RCC muestren la mínima correlación. Los puntos de corte de DAS más sensible y específico son iguales para los hombres (adultos y adultos mayores: 20,2cm), pero diferente para las mujeres (Adultos: 21,0cm - sens.:83.3; espec.:79.1 /adultos mayores: 19,9cm - sens.: 81.0; espec.: 79.3). El CC de los puntos de corte fueron de 90,2cm y 92,2cm para los hombres (Hombres adultos- sens.: 86.7; espec.: 86.1- y los hombres mayores - sens.: 79.3; espec.: 77.8, respectivamente), mientras que para las mujeres los valores registrados fueron de 92.3cm (mujeres adultas- sens.: 83.3; espec.:81.4) y 88.2cm (mujeres mayores- sens.: 76.2; espec.:69.0). Este estudio mostró que la CC y el DAS lograr el mejor rendimiento en la identificación de la grasa visceral considerados de riesgo para el desarrollo de enfermedades cardiometabólicas en los adultos y adultos mayores.
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Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Antropometría/métodos , Índice de Masa Corporal , Grasa Intraabdominal/anatomía & histología , Grasa Intraabdominal , Relación Cintura-Cadera , Brasil , Estudios Transversales , Curva ROC , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Circunferencia de la CinturaRESUMEN
OBJETIVOS: Avaliar a habilidade de indicadores antropométricos e de composição corporal em identificar a resistência à insulina (RI), determinando-se os pontos de corte para os que apresentarem melhor eficácia. MÉTODOS: Foram avaliados 138 homens. Determinou-se: perímetro da cintura (PC), diâmetro abdominal sagital (DAS), índice de conicidade (IC), índice de massa corporal (IMC), percentual de gordura corporal ( por centoGC), índice sagital (IS) e relações cintura-estatura (RCE), cintura-quadril (RCQ) e cintura-coxa (RCCoxa). A RI foi avaliada pelo HOMA-IR. Utilizou-se análise de correlação e análise ROC, com determinação das áreas abaixo da curva (AUC). RESULTADOS: O DAS (r = 0,482; AUC = 0,746) e o PC (r = 0,464; AUC = 0,739) apresentaram correlações mais fortes com o HOMA-IR e maior poder discriminante para RI (p < 0,001), sendo seus melhores pontos de corte 89,3 cm e 20,0 cm, respectivamente. CONCLUSÃO: Os indicadores de obesidade central, o PC e o DAS demonstraram maior habilidade em identificar RI em homens. Encoraja-se a realização de estudos com mulheres e idosos na busca dos melhores pontos de corte para toda a população.
OBJECTIVE: To assess the ability of anthropometric and body composition indicators in identifying insulin resistance (IR), determining cut-off points for those showing the best efficacy. METHOD: 138 men were evaluated. Waist perimeter (WP), sagittal abdominal diameter (SAD), conicity index, body mass index (BMI), body fat percent, sagittal index, and the waist-to-height, waist-to-hip and waist-to-thigh ratios were determined. IR was assessed by the HOMA-IR index. Statistical analysis consisted of Spearman correlation coefficient and ROC (receiver operating characteristic) curves, calculating the area under the curve (AUC). RESULTS: SAD (r=0.482, AUC=0.746) and WP (r=0.464, AUC=0.739) showed stronger correlations with the HOMA-IR and greater ability to identify IR (p<0.001), being 89.3 cm and 20.0 cm the best cut-offs, respectively. CONCLUSION: The anthropometric indicators of central obesity, WP and SAD, have shown greater ability to identify IR in men. We encourage studies in women and elderly people in search of the best cut-off points for the entire population.
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Adulto , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Antropometría , Composición Corporal/fisiología , Síndrome Metabólico/diagnóstico , Estudios Transversales , Homeostasis/fisiología , Resistencia a la Insulina/fisiología , Síndrome Metabólico/sangre , Valor Predictivo de las Pruebas , Valores de Referencia , Curva ROC , Circunferencia de la Cintura , Adulto JovenRESUMEN
OBJECTIVES: To evaluate the reliability of the sagittal abdominal diameter and its validity as a predictor of visceral abdominal fat, as well as to identify the most appropriate cut-off points to identify the area of visceral fat that is known to represent a risk factor for cardiovascular disease. DESIGN: Validation study. SUBJECTS: 92 healthy volunteers (57 women, 35 men), age: 20-83 y, body mass index: 19.3 to 35.9 kg/m². MEASUREMENTS: Sagittal abdominal diameter (SAD), weight, height, circumferences (waist, hip, and thigh), sub-scapular skinfold thickness, abdominal diameter index, and waist-hip ratio (WHR). METHOD OF CHOICE: Computed tomography (CT). STATISTIC: Receiver operating characteristic (ROC) curve. RESULTS: The reliability for SAD measurement was very high (Inter-class coefficient = 0.99). Visceral fat as measured by VAF through CT was highly correlated with SAD (women r = 0.80; men r = 0.64, p < 0.001), waist circumference (women r = 0.77; men r = 0.73, p < 0.001), and WHR (women r = 0.72; men r = 0.58, p < 0.001). The ROC curve indicated 19.3 cm and 20.5 cm as the threshold values for abdominal sagittal diameter in women and men (sensitivity 85 percent and 83 percent, specificity 77 percent and 82 percent, respectively). CONCLUSIONS: There was a high correlation between SAD and VAF. The cut-off values identified for SAD presented a sensitivity and specificity that were considered adequate.
OBJETIVOS: Avaliar a confiabilidade do diâmetro abdominal sagital e a sua validade enquanto preditor de gordura abdominal visceral, assim como identificar os pontos de corte mais apropriados para identificar a área de gordura visceral que é conhecida por representar fator de risco para doença cardiovascular. MÉTODOS: Desenho: Estudo de validação. Amostra: 92 voluntários saudáveis (57 mulheres, 35 homens), idade: 20-83 anos, índice de massa corporal: 19,3 a 35,9 kg/m². Medidas: Diâmetro abdominal sagital (DAS), peso, altura, circunferências (cintura, quadril e coxa), pregas cutâneas tricipital e subescapular, índice diâmetro abdominal e razão cintura-quadril (RCQ). MÉTODO DE ESCOLHA: Tomografia computadorizada (TC). ESTATíSTICA: Curva ROC (receiver operating characteristic). RESULTADOS: A confiabilidade do DAS foi muito alta (coeficiente inter-classe = 0,99). A área de gordura visceral medida pela TC teve uma alta correlação com o DAS (mulheres r = 0,80, homens r = 0,64, p < 0,001), circunferência da cintura (mulheres r = 0,77, homens r = 0,73, p < 0,001) e com a RCQ (mulheres r = 0,72, homens r = 0,58, p < 0,001). A curva ROC indicou 19,3 cm e 20,5 cm como valores limites para o diâmetro abdominal sagital em mulheres e homens (sensibilidade de 85 por cento e 83 por cento, especificidade de 77 por cento e 82 por cento, respectivamente). CONCLUSÕES: Observou-se alta correlação entre o DAS e a área de gordura abdominal visceral. Os pontos de corte identificados para o DAS apresentaram sensibilidade e especificidade adequadas.