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Introducción: Obesidad en la adolescencia se asocia con trastornos cardiometabólicos en la edad adulta. Es necesario contar con un índice de obesidad fácilmente aplicable para predecir riesgo cardiometabólico en adolescentes. Objetivo: Comparar la utilidad de los índices radio Cintura/Talla (r-CT), circunferencia de cintura (CC) y el índice de masa corporal (IMC) para determinar obesidad y predecir riesgos cardiometabólicos en adolescentes. Métodos: En este estudio trasversal, bajo criterios de la International Diabetes Federation (IDF) se determinó obesidad mediante tres índices, hipertensión arterial, hiperglicemia, hipertrigliceridemia y bajo HDL en 931 adolescentes mestizos ecuatorianos. La asociación de los índices de obesidad (r-CT, IMC y CC) con los factores de riesgo cardiometabólico se determinaron mediante radios de Odds ajustados y áreas bajo la curva (AUC, siglas en inglés) ROC (Característica Operativa del Receptor, siglas en inglés). Resultados: El r-CT ≥0.5 determinó mayor porcentaje de obesidad (36.6%) respecto a CC (17.4%) e IMC (6.7%). IMC ≥95 percentil se asoció significativamente con los cuatro factores de riesgo cardiometabólico, mientras que CC y r-CT se asociaron con tres de los cuatro factores. Los tres índices de obesidad determinan la concurrencia de tres o más factores de riesgo cardiometabólico con alta sensibilidad y especificidad con un AUC mayor de 0.80. Conclusiones: El IMC ≥ al percentil 95 es mejor predictor de riesgo cardiometabólico, pero no determina bien obesidad. El r-CT parece ser el indicador antropométrico más adecuado para detectar obesidad y predecir riesgo cardiometabólico en adolescentes mestizos debido a su fácil determinación y uso.

Background: Obesity in adolescence is associated with cardiometabolic problems in adulthood. It is necessary to have an easily applicable obesity index to predict cardiometabolic risk in adolescents. Objective: To compare the usefulness of waist to-height ratio (WHtR), waist circumference (WC), and body mass index (BMI) to determine obesity and predict cardiometabolic risks in adolescents. Methods: In this cross-sectional study, under the criteria of the International Diabetes Federation (IDF), obesity, hypertension, hyperglycemia, hypertriglyceridemia and low HDL rates were determined in 931 Ecuadorian mestizo adolescents. The association of the three obesity indices with the cardiometabolic risk factors was determined by means of adjusted Odds radios and area under the Receiver Operating Characteristic curve (AUC-ROC). Results: WHtR ≥0.5 determined the highest percentage of obesity (36.6%) with respect to WC (17.4%) and BMI (6.7%). BMI ≥95 percentile was significantly associated with the four cardiometabolic risk factors, while WC and WHtR were associated with three out of four factors. The three obesity indices determine the concurrence of three or more cardiometabolic risk factors with high sensitivity and specificity with an AUC greater than 0.80. Conclusions: BMI ≥95th percentile is a better predictor of cardiometabolic risk, but it is not a good determinant of obesity. The WHtR seems to be the most suitable anthropometric indicator to detect obesity and predict cardiome- tabolic risk in mestizo adolescents due to its easy determination and use.

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This study systematised and synthesised the results of observational studies that were aimed at supporting the association between dietary patterns and cardiometabolic risk (CMR) factors among adolescents. Relevant scientific articles were searched in PUBMED, EMBASE, SCIENCE DIRECT, LILACS, WEB OF SCIENCE and SCOPUS. Observational studies that included the measurement of any CMR factor in healthy adolescents and dietary patterns were included. The search strategy retained nineteen articles for qualitative analysis. Among retained articles, the effects of dietary pattern on the means of BMI (n 18), waist circumference (WC) (n 9), systolic blood pressure (n 7), diastolic blood pressure (n 6), blood glucose (n 5) and lipid profile (n 5) were examined. Systematised evidence showed that an unhealthy dietary pattern appears to be associated with poor mean values of CMR factors among adolescents. However, evidence of a protective effect of healthier dietary patterns in this group remains unclear. Considering the number of studies with available information, a meta-analysis of anthropometric measures showed that dietary patterns characterised by the highest intake of unhealthy foods resulted in a higher mean BMI (0·57 kg/m²; 95 % CI 0·51, 0·63) and WC (0·57 cm; 95 % CI 0·47, 0·67) compared with low intake of unhealthy foods. Controversially, patterns characterised by a low intake of healthy foods were associated with a lower mean BMI (-0·41 kg/m²; 95 % CI -0·46,-0·36) and WC (-0·43 cm; 95 % CI -0·52,-0·33). An unhealthy dietary pattern may influence markers of CMR among adolescents, but considering the small number and limitations of the studies included, further studies are warranted to strengthen the evidence of this relation.

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Obesity prevalence has increased worldwide over the last decades and has reached alarming rates in low middle-income countries. Childhood has been affected by this epidemic, leading to premature dramatic health problems. Adipose tissue is currently considered as an endocrine organ modulating an inflammatory state and important metabolic processes (insulin resistance, hypertension, glucose intolerance) leading to consequences of the cardiovascular system. This situation may be worst if the excess of body fat distribution such as abdominal obesity (AO) is involved because it is associated with a more atherogenic risk profile determining the cardiometabolic risks mainly in children and adolescents. Hence, the knowledge regarding the association between AO and cardiometabolic factors aims to prevent and treat the obesity in this young population, avoiding early harmful consequences of adulthood health.

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Contexto: el síndrome metabólico (SM) en adolescentes constituye un problema de salud pública mundial; los estudios sobre este síndrome y sus factores de riesgo cardiometabólico en población adolescente ecuatoriana son limitados. Objetivo: determinar la prevalencia de SM y los factores de riesgo cardiometabólico en adolescentes escolares de la ciudad de Quito. Métodos: se realizó un estudio transversal en 220 adolescentes con edades entre 11 a 18 años de edad, estudiantes de la "Unidad Educativa Santiago de Guayaquil" de la ciudad de Quito, una institución pública. Se midió peso, talla, perímetro abdominal, presión arterial y se dosificó concentraciones séricas de glucosa, triglicéridos y HDL en ayunas. La presencia de SM y los factores de riesgo cardiometabólico se determinaron de acuerdo con la definición de la Federación International de Diabetes (IDF) para niños y adolescentes. Resultados: la prevalencia del SM fue 2,3% (5/220), con predominio no significativo en hombres (60%). El 46% (102/215) de los participantes sin SM presentaron 1 o más factores de riesgo cardiometabólico siendo el factor de riesgo más frecuente la hiperglucemia. El perímetro de cintura demostró ser el predictor de hipertensión arterial y de baja concentración de HDL (regresión lineal múltiple). La presencia de obesidad central se asoció con un riesgo 6 veces mayor de hipertensión sistólica o diastólica (regresión logística). Conclusiones: el SM está presente en adolescentes de la ciudad de Quito; los adolescentes sin SM exhiben alta prevalencia de factores de riesgo cardiometabólico, sin embargo, se requiere ampliar los estudios para afianzar estos hallazgos.

Background: metabolic syndrome (MetS) in adolescents is a worldwide public health problem. However, little is known about this syndrome and the cardiometabolic factors in Ecuadorian adolescents. Objective: to determine the prevalence of MetS and cardio metabolic factors in Ecuadorians adolescents. Methods: we performed a cross-sectional study in 220 adolescents (11-18 y) who studied at "Unidad Educativa Santiago de Guayaquil de Quito", a public institution. Weight, height, waist circumference, and blood pressure were obtained. Fasting glucose, triglycerides. and HDL serum concentrations were determined. Mets and cardiometabolic risk factors were defined according to the International Diabetes Federation (IDF) criteria for children and adolescents. Results: mets was prevalent in 2.3% (5/220) of adolescents, with no significant predominance in males (60% vs 40%). Additionally, 46% (102/215) of subjects without MetS showed one or more cardiometabolic risk factors. Hyperglycemia was the most frequent risk factor among those without MetS. Waist circumference showed to be a predictor of both hypertension and low HDL concentrations (Multiple linear regression). Central obesity was associated with 6 times risk of both systolic and diastolic hypertension (Logistic regression). Conclusions: mets is present in adolescents of Quito, and those without MetS exhibit high prevalence of cardio metabolic risk factors; however, more studies are required to strengthen these findings.

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