Waist-to-height ratio is as reliable as biochemical markers to discriminate pediatric insulin resistance

• Published in: Jornal de pediatria 2019-07, Vol.95 (4), p.428-434
• Main Authors: Alvim, Rafael de Oliveira, Zaniqueli, Divanei, Neves, Felipe Silva, Pani, Virgilia Oliveira, Martins, Caroline Resende, Peçanha, Marcos Alves de Souza, Barbosa, Míriam Carmo Rodrigues, Faria, Eliane Rodrigues de, Mill, José Geraldo
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescentes; Adolescents; Biomarkers - analysis; Blood Glucose - analysis; Body Mass Index; Brazil; Child; Children; Cholesterol, HDL - blood; Crianças; Cross-Sectional Studies; Female; Humans; Insulin resistance; Insulin Resistance - physiology; Lipoproteins, HDL - blood; Male; Metabolic Syndrome - blood; Metabolic Syndrome - physiopathology; Overweight - blood; Overweight - physiopathology; PEDIATRICS; Razão cintura-altura; Razão triglicérides-HDL-C; Resistência à insulina; Triglycerides - blood; Triglycerides-to-HDL-C ratio; Triglycerides/glucose index; Waist Circumference - physiology; Waist-Height Ratio; Índice de triglicerídeos/glicose
• ISSN: 0021-7557; 1678-4782; 1678-4782
• DOI: 10.1016/j.jped.2018.04.004

Given the importance of incorporating simple and low-cost tools into the pediatric clinical setting to provide screening for insulin resistance, the present study sought to investigate whether waist-to-height ratio is comparable to biochemical markers for the discrimination of insulin resistance in children and adolescents. This cross-sectional study involved students from nine public schools. In total, 296 children and adolescents of both sexes, aged 8–14 years, composed the sample. Waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio were determined according to standard protocols. Insulin resistance was defined as homeostatic model assessment for insulin resistance with cut-off point ≥ 3.16. Age, body mass index, frequency of overweight, waist circumference, waist-to-height ratio, insulin, glucose, homeostatic model assessment for insulin resistance, triglycerides, triglycerides/glucose index, and triglycerides-to-HDL-C were higher among insulin resistant boys and girls. Moderate correlation of all indicators (waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio) with homeostatic model assessment for insulin resistance was observed for both sexes. The areas under the receiver operational characteristic curves ware similar between waist-to-height ratio and biochemical markers. The indicators provided similar discriminatory power for insulin resistance. However, taking into account the cost-benefit ratio, we suggest that waist-to-height ratio may be a useful tool to provide screening for insulin resistance in pediatric populations. Considerando a importância de incorporar ferramentas simples e de baixo custo no cenário clínico-pediátrico para a triagem de resistência à insulina, o presente estudo buscou investigar se a razão cintura/estatura é comparável a marcadores bioquímicos na discriminação de resistência à insulina em crianças e adolescentes. Este estudo transversal envolveu estudantes de nove escolas públicas. No total, 296 crianças e adolescentes, de ambos os sexos, com idades entre 8 e 14 anos, compuseram a amostra. A razão cintura/estatura, o índice triglicerídeos/glicose e a razão triglicerídeos/HDL-C foram determinados de acordo com protocolos padrão. A resistência à insulina foi definida por meio do modelo de avaliação homeostática para resistência insulínica, com ponto de corte ≥ 3.16. Idade, índice de massa corporal, frequência de excesso de peso, circunferência da cintura, raz