Saldívar-Cerón HI, Vázquez-Martínez AL, Barrón-Torres MT

Language: Spanish
References: 22
Page: 79-87
PDF size: 719.93 Kb.

ABSTRACT

Introduction: The identification of obesity in childhood is complicated because the height continues to increase and body composition is constantly changing, the diagnosis is currently done through growth patterns proposed by the WHO, however diverse anthropometric indicators have been proposed for equivalent detection.
Objective: To determinate the diagnostic accuracy of waist circumference (WC), waist-to-height ratio (WHtR) and waist-hip ratio (WHR) for identification of childhood overweight and obesity.
Material and Method: A cross-sectional and analytical study with a sample of 1001 schoolchildren (aged 9 to 11-years). Anthropometric measurements of weight, height, WC and hip circumference were obtained. BMI, WHtR and WHR were calculated. The correlation of anthropometric indexes vs BMI was assessed and a ROC curve analysis was performed taking as a study variable: WC, WHtR and WHR and as baseline the BMI percentiles (WHO, 2007). Sensitivity (Se), specificity (Sp), areas under the curve (AUC), positive and negative predictive values (PPV, NPV) of anthropometric indicators and cutoffs points that identify overweight and obesity were obtained.
Results: The WC and WHtR showed strong positive correlation (r=0.75, 0.69, respectively; p ‹ 0.001), but the correlation was weak for the WHR (r=0.23; p ‹ 0.0001). WC and WHtR showed high ABC, Se, Sp, PPV and NPV for the identification of childhood-obesity.
Conclusions: WC and WHtR has a high predictive power to identify childhood-obesity but not for overweight. The suggested cut-off points for the diagnosis of childhood-obesity between 9 and 11 years are 70cm for WC and 0.5 for ICT for both genders.

REFERENCES

1. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization technical report series. 2000;894:i-xii, 1-253.

2. Amato M, Giordano C, Pitrone M, Galluzzo A. Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population. Lipids in Health and Disease. 2011;10(1):183.

3. Neovius M, Linne Y, Rossner S. BMI, waist-circumference and waist-hip-ratio as diagnostic tests for fatness in adolescents. International journal of obesity. 2005;29(2):163-9.

4. Ryo M, Kishida K, Nakamura T, Yoshizumi T, Funahashi T, Shimomura I. Clinical significance of visceral adiposity assessed by computed tomography: A Japanese perspective. World Journal of Radiology. 2014;6(7):409-16.

5. Duelo MM, Escribano CE, Muñoz VF. Obesidad. Rev Pediatr Aten Primaria. 2009;11(16):239-57.

6. de Onis M. Preventing childhood overweight and obesity. J Pediatr. 2015;91(2):105-7.

7. Kuba VM, Leone C, Damiani D. Is waist-to-height ratio a useful indicator of cardio-metabolic risk in 6-10-year-old children? BMC pediatrics. 2013;13:91.

8. Pérez BM, Landaeta-Jiménez M, Amador J, Vásquez M, Marrodán D. Sensibilidad y especificidad de indicadores antropométricos de adiposidad y distribución de grasa en niños y adolescentes Venezolanos. Interciencia. 2009;34:84-90.

9. Marrodan MD, Martinez-Alvarez JR, Gonzalez-Montero De Espinosa M, Lopez-Ejeda N, Cabanas MD, Prado C. Diagnostic accuracy of waist to height ratio in screening of overweight and infant obesity. Medicina clinica. 2013;140(7):296-301.

10. Saldívar-Ceron HI, Garmendia RA, Rocha AMA, Pérez-Rodríguez P. Obesidad infantil: factor de riesgo para desarrollar pie plano. Bol Med Hosp Infant Mex. 2015;72(1):55-60.

11. Sung RY, Yu CC, Choi KC, McManus A, Li AM, Xu SL, et al. Waist circumference and body mass index in Chinese children: cutoff values for predicting cardiovascular risk factors. International journal of obesity. 2007;31(3):550-8.

12. Van den Broeck J, Willie D, Younger N. The World Health Organization child growth standards: expected implications for clinical and epidemiological research. European journal of pediatrics. 2009;168(2):247-51.

13. Sanchez Gonzalez E, Carrascosa Lezcano A, Fernandez Garcia JM, Ferrandez Longas A, Lopez de Lara D, Lopez-Siguero JP. Spanish growth studies: the current situation, their effectiveness and recommendations for their use. Anales de pediatria (Barcelona, Spain : 2003). 2011;74(3):193. e1-16.

14. Altman DG, Bland JM. Statistics Notes: Diagnostic tests 2: predictive values1994 1994-07-09 07:00:00. 102 p.

15. Mihalopoulos NL, Holubkov R, Young P, Dai S, Labarthe DR. Expected changes in clinical measures of adiposity during puberty. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2010;47(4):360-6.

16. Kuba VM, Leone C, Damiani D. Is waist-to-height ratio a useful indicator of cardio-metabolic risk in 6-10-year-old children? BMC pediatrics. 2013;13:91.

17. Muñoz-Cano JM, Pérez-Sánchez S, Córdova-Hernández JA, X B-L. El índice cintura/talla como indicador de riesgo para enfermedades crónicas en una muestra de escolares. . Salud en Tabasco. 2010;16:921-7.

18. Gómez-Díaz RA, Martínez-Hernández AJ, Aguilar-Salinas CA, Violante R, Alarcón ML, Villarruel MJ, et al. Percentile distribution of the waist circumference among Mexican pre-adolescents of a primary school in Mexico City. Diabetes, Obesity and Metabolism. 2005;7(6):716-21.

19. Maffeis C, Pietrobelli A, Grezzani A, Provera S, Tato L. Waist circumference and cardiovascular risk factors in prepubertal children. Obesity research. 2001;9(3):179-87.

20. Perichart-Perera O, Balas-Nakash M, Schiffman-Selechnik E, Barbato-Dosal A, Vadillo-Ortega F. Obesity increases metabolic syndrome risk factors in school-aged children from an urban school in Mexico city. Journal of the American Dietetic Association. 2007;107(1):81-91.

21. Liu A, Hills AP, Hu X, Li Y, Du L, Xu Y, et al. Waist circumference cut-off values for the prediction of cardiovascular risk factors clustering in Chinese school-aged children: a cross-sectional study. BMC public health. 2010;10:82.

22. Romero-Collazos JF, Marrodán Serrano MD, Mesa Santurino MS, Bejarano I, Alfaro E, Martínez A. Grasa corporal y distribución de la adiposidad en escolares latinoamericanos y españoles. En: Gutiérrez-Redomero A, Sánchez-Andrés A, Galera Olmo V, editores. Diversidad Humana y Antropología Aplicada. Alcalá de Henares: Universidad de Alcalá de Henares. 2010. p. 221-7.