Abstract
ABSTRACTObjective: To investigate whether tri-ponderal mass index and body mass index Z scores are equivalent for screening children and adolescents with insulin resistance.Methods: Cross-sectional study with 296 children and adolescents enrolled at public schools of Vitória, Espírito Santo, Brazil, aged eight to 14 years. The tri-ponderal mass index was calculated as the ratio between weight and height cubed. The body mass index was calculated as the ratio between weight and height squared. Insulin resistance was defined with the homeostatic model assessment (HOMA-IR).Results: The HOMA-IR was higher in the 4th quartile of body mass index Z scores and tri-ponderal mass index compared to 1st and 2nd quartiles for both girls and boys. The areas under the age-adjusted receiver operating characteristic curves were similar between the indices for girls (body mass index Z scores=0.756; tri-ponderal mass index=0.763) and boys (body mass index Z scores=0.831; tri-ponderal mass index=0.843). In addition, according to the simple linear regression analyses estimations, both body mass index Z scores and tri-ponderal mass index explained a significant fraction of the homeostatic model assessment variability for girls (body mass index Z scores: R2=0.269; tri-ponderal mass index: R2=0.289; p<0.001) and boys (body mass index Z scores: R2=0.175; tri-ponderal mass index: R2=0.210; p<0.001).Conclusions: The tri-ponderal mass index and body mass index Z scores were similar to discriminate children and adolescents with insulin resistance. It is noteworthy that the use of tri-ponderal mass index is clearly advantageous, because it can be calculated with no concerns on adjustments for the age, a fact that makes it very applicable in the clinical practice.
Highlights
Insulin resistance (IR) is a metabolic disorder largely associated with obesity and it is recognized as a determining condition for the onset of type 2 diabetes mellitus (T2D).[1]
A significantly higher body fat percentage was observed among girls and boys in the upper quartiles for body mass index Z scores (BMIz) and tri-ponderal mass index (TMI)
The results of this study confirmed that TMI was similar to BMIz in the identification of IR in children and adolescents
Summary
Insulin resistance (IR) is a metabolic disorder largely associated with obesity and it is recognized as a determining condition for the onset of type 2 diabetes mellitus (T2D).[1] Among children, studies have shown that IR is significantly associated with obesity and cardiometabolic risk.[2] the concern about alarming rates of T2D has motivated researchers to drive attention on the early IR onset and its close relationship with obesity.[3,4,5]. Simple and inexpensive surrogate indices, such as the homeostasis model assessment of insulin resistance (HOMA-IR) have been proposed. HOMA-IR has been shown as highly reliable as an estimator of IR in obese children and adolescents.[10]
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