Abstract
BackgroundIt is not clear which is the best anthropometric indicator to predict metabolic syndrome (MetS) in adolescents. Our objective was to identify the predictive power, with respective cut-off points, of anthropometric indicators associated with the quantity and distribution of body fat for the presence of MetS and to determine the strength of the association between the proposed cut-off points and MetS in adolescents.MethodsThe sample consisted of 1035 adolescents (565 girls and 470 boys) aged between 12 and 20 years. Four anthropometric indicators were considered: waist circumference (WC), body mass index (BMI), waist-height ratio (WHtR), and conicity index (C-Index). MetS was defined according to the criteria of the International Diabetes Federation. Predictive performance was described through analysis of Receiver Operating Characteristic (ROC) curves with a 95% confidence interval. The most accurate cut-off points were identified through sensitivity, specificity and Area Under the Curve (AUC) values.ResultsThe four anthropometric indicators presented significant AUCs close to 0.70. At younger ages (12-15 years) the girls presented a statistically greater capacity to discriminate MetS; however, at more advanced ages (16-20 years) both sexes presented similar AUCs. Among the anthropometric indicators investigated, regardless of sex and age, the WHtR showed the highest discriminant value for MetS, while the C-Index demonstrated a significantly lower capacity to predict MetS. The AUCs equivalent to WC and BMI did not differ statistically. The proposed cut-off points for WHtR (12-15 years = 0.46, 16-20 years = 0.48) presented the highest values of sensitivity and specificity, between 60% and 70%, respectively.ConclusionConsidering that the best AUC was found for WHtR, we suggest the use of this anthropometric indicator, with the cut-off points presented herein, for the prediction of MetS in adolescents with characteristics similar to the study sample.
Highlights
It is not clear which is the best anthropometric indicator to predict metabolic syndrome (MetS) in adolescents
The objectives of the present study were to identify the predictive power, with respective cut-off points, of four anthropometric indicators associated with the quantity and distribution of body fat (WC, body mass index (BMI), waist-height ratio (WHtR), and conicity index (C-Index)) for the presence of MetS and to determine the strength of the association between the proposed cut-off points and MetS in adolescents
According to the diagnostic criteria based on BMI proposed by International Obesity Task Force [23], the excess body weight was identified in 21,3% of the sample, showing no significant difference between girls and boys (22.2% and 20.3%, respectively), but significantly higher in older adolescents (19.4% versus 23.2%)
Summary
It is not clear which is the best anthropometric indicator to predict metabolic syndrome (MetS) in adolescents. Our objective was to identify the predictive power, with respective cut-off points, of anthropometric indicators associated with the quantity and distribution of body fat for the presence of MetS and to determine the strength of the association between the proposed cut-off points and MetS in adolescents. Metabolic syndrome (MetS) refers to a set of risk factors that, when altered, may increase the chances of developing cardiovascular diseases and diabetes mellitus [1,2,3]. Oliveira and Guedes BMC Pediatrics (2018) 18:33 In this sense, efforts have been directed in the attempt to indicate more affordable and inexpensive alternatives for epidemiological tracking and, direct specific procedures to those at risk of developing MetS [6,7,8,9,10]
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