Hypertriglyceridemic Waist Phenotype Indicates Insulin Resistance in Adolescents According to the Clamp Technique in the BRAMS Study

This study aimed to identify cutoff points for detecting hypertriglyceridemic waist phenotype (HTWP) in adolescents and to investigate the association of the HTWP with insulin resistance (IR) and metabolic syndrome components. A multicentric cross-sectional study of 861 adolescents (10-19 years of a...

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Published in:Childhood obesity 2016-12, Vol.12 (6), p.446-454
Main Authors: Barreiro-Ribeiro, Francieli, Vasques, Ana Carolina Junqueira, da Silva, Cleliani de Cassia, Zambon, Mariana Porto, Rodrigues, Ana Maria De Bernardi, Camilo, Daniella Fernandes, Antonio, Maria Ângela Reis de Góes Monteiro, Dâmaso, Ana Raimunda, Campos, Raquel Munhoz da Silveira, Tufik, Sergio, de Mello, Marco Túlio, Geloneze, Bruno
Format: Article
Language:English
Subjects:
Adolescent
Blood Pressure
Brazil - epidemiology
Child
Cross-Sectional Studies
Female
Glucose Tolerance Test
Humans
Hypertriglyceridemic Waist - blood
Hypertriglyceridemic Waist - epidemiology
Insulin resistance
Insulin Resistance - physiology
Male
Pediatric Obesity - blood
Pediatric Obesity - epidemiology
Phenotype
Puberty - physiology
Risk Factors
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Summary:This study aimed to identify cutoff points for detecting hypertriglyceridemic waist phenotype (HTWP) in adolescents and to investigate the association of the HTWP with insulin resistance (IR) and metabolic syndrome components. A multicentric cross-sectional study of 861 adolescents (10-19 years of age, 504 girls) was conducted. Pubertal stage, anthropometric, and laboratory parameters were assessed. IR was assessed by Homeostasis Model Assessment for Insulin Resistance (HOMA1-IR) index and hyperglycemic clamp (n = 80). HTWP was defined by the presence of increased plasma triglycerides (TGs) and increased waist circumference (WC) according to cutoff points obtained in ROC curve analysis given the HOMA1-IR index as a reference method. Cutoffs for WC and TGs, with a higher sum of sensitivity (S) and specificity (E), were, respectively: >84 cm (S:65.1%, E:71.9%) and >87 mg/dL (S:65.1%, E:73.4%) in pubertal girls; >88.5 cm (S:80.2%, E:60.2%) and >78 mg/dL (S:60.5%, E:53.2%) in postpubertal girls; >94 cm (S:73.1%, E:83.1%) and >79 mg/dL (S:61.5%, E:60.2%) in pubertal boys; and >99 cm (S:81.3%, E:78.7%) and >86 mg/dL in postpubertal boys (S:68.1%, E:60.7%). HTWP frequency was 27.5%. In the phenotype presence, after adjustment for age and pubertal stage, blood pressure and fasting glucose levels were elevated and high-density lipoprotein cholesterol was lower (p 
ISSN:2153-2168
2153-2176
DOI:10.1089/chi.2016.0180