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Identificar um indicador de adiposidade abdominal de baixo custo e com maior acurácia para predizer o excesso de peso em crianças de quatro a sete anos idade. Estudo transversal com amostra de 257 crianças de 4 a 7 anos. Os indicadores de adiposidade abdominal avaliados foram: perímetro da cintura (PC), relação cintura-estatura (RCE) e percentual de gordura central (avaliado pela técnica dual energy X-ray absorptiometry – DEXA). O excesso de peso foi classificado pelo índice de massa corporal por idade (IMC/I). Nas análises, estimou-se a razão de prevalência (RP) pela regressão de Poisson com variância robusta e utilizou-se a curva (receiver operating characteristics ­– ROC), considerando como significância estatística p

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior The central obesity in adolescence tends to continue in the adult life, harming the cardiovascular health in this stage. Thus, the establishment of simple actions for the early identification of the individuals at risk is a matter of public health. This work aimed to associate the central perimetry with adiposity, cardiometabolic, inflammatory and hormonal markers on the three adolescence stages. This epidemiological cross-sectional study was carried out with 800 teenagers (Subsample 1: 671; Subsample 2: 476 e Subsample 3: 372 teenagers) from 10 to 19 years old, from both genders, selected by a random simple sampling in all public and private rural and urban areas of Viçosa, Minas Gerais, Brazil. The teenagers have been subdivided in groups by age groups (10 to 13 years old: initial stage; 14 to 16: intermediate stage; 17 to 19 years old: final stage). The following characteristics have been measured: weight, height, waist perimeter (WP) in four anatomical points (WP1: umbilical scar; WP2: midpoint between the last rib and the iliac crest; WP3: 2,5cm above umbilical scar; WP4 smallest waist between chest and waist), hip perimeter (HP), neck perimeter (NP), triceps, bicipital, subscapular and suprailiac skin fold. These measurements have been used to calculate the body mass index (BMI), waist to hip ratio (WHR) e waist to stature ratio (WSR) and the center and periferic skin fold relation (RCP= subescapular + suprailiac/bicipital + tricipital). The total body fat, truncal and android fat have been determined by dual-energy X-ray absorptiometry (DXA). The following parameters have been analyzed: glucose, insulin, homeostatic model assessment (HOMA-IR), HDL, LDL, triglycerides, uric acid, systolic blood pressure (SBP), diastolic blood pressure (DBP), hypersensitive C-reactive protein (hs-CRP) , leukocyte count, gene expression of Intercellular Adhesion Molecule 1 (ICAM-1), cortisol and aldosterone. Life style characteristics (pattern of physical activity, alcohol consumption and smoking habbit) have been self-reported. There was presence of abdominal fat when the waist to stature ratio (WSR) was ≥0.50. The phenotype hypertriglyceridemic waist (HW) has been diagnosed by the concomitant presence of increased WP (≥percentil 75) and high triglyceride concentration (≥100 mg/dL), while the metabolic syndrome (MS) has been evaluated by de Ferranti et al (2004) criterion. The study has been approved by the Ethics Committee on Human Research of Universidade Federal de Viçosa (Of. Ref. N° 0140/2010 and Of. Ref. N° 674.045/2014). As a result, it was found out that the WP differed according to the measurement local, being WP40.5; p0,5; p

Adolescents with excess body fat and eutrophic had the same metabolic changes expected in obese individuals. To evaluate body composition, anthropometric changes, biochemical and clinical characteristics of female adolescents. A total of 113 adolescents from public schools in Viçosa, MG, divided into three groups: group 1 - consisting of eutrophic adolescents with excess body fat; group 2 - eutrophic with body fat within normal limits; and group 3 - with excess weight and body fat. Weight, height, waist and hip circumference, blood pressure were measured. The body mass index (BMI) and waist-hip ratio were calculated. The percentage of body fat was obtained by bioelectrical impedance horizontally, following its own protocol for this evaluation. The assessment of the percentage of body fat and biochemistry was performed after 12 hours of fasting, and analyzed the lipid profile, blood glucose and insulin, homocysteine, leptin and C-reactive protein. Insulin resistance was calculated by HOMA index. The group of eutrophic adolescents, with higher adiposity, behaved in relation to blood pressure, HDL and glucose levels, similarly to adolescents who are overweight. It can be seen that the HOMA index, insulin and leptin increased with increasing body fat. More than half of adolescents had total cholesterol and CRP levels above recommended levels. The most obvious metabolic disorder related to the lipid profile for both groups studied. Excess adiposity in normal weight adolescents may be related to clinical and biochemical changes similar to those found in adolescents who are overweight.

To evaluate the diagnostic validity of four waist circumference reference tables in female adolescents for detection of lipid abnormalities, hyperinsulinemia, high homeostasis model assessment (HOMA), hyperleptinemia, and high body adiposity. We evaluated 113 adolescents aged between 14 and 19 years enrolled in public schools of Viçosa (state of Minas Gerais, Brazil). Total cholesterol, LDL, HDL, triglycerides, insulin and leptin levels were measured. We also measured the percentage of body fat using tetrapolar bioelectrical impedance. Based on the measure of the smallest abdominal diameter, we defined the waist circumference and calculated sensitivity, specificity, positive and negative predictive values. Contingency tables for the classification of waist circumference in adolescents were developed for four criteria: Freedman et al., 1999; Taylor et al., 2000; McCarthy et al., 2001; and Moreno et al., 2007. Sensitivity values were generally low in the reference studies evaluated, and the highest values were found in the reference table by McCarthy et al. On the other hand, specificity values were high, especially for the table by Freedman et al. Positive predictive values were more relevant for total cholesterol and body fat percentage. The cutoff points for waist circumference provided by McCarthy et al. proved to be the most suitable for population studies. Because it has higher specificity, the proposal by Freedman et al. is useful for clinical use and can replace high cost tests, which are often unavailable for health professionals, such as those to measure leptin and insulin levels.

OBJETIVO: Avaliar a validade diagnóstica de quatro tabelas de referência para circunferência da cintura em adolescentes do sexo feminino para detecção de alterações lipídicas, hiperinsulinemia, homeostasis model assessment (HOMA) elevado, hiperleptinemia e elevada adiposidade corporal. MÉTODOS: Avaliadas 113 adolescentes com idade entre 14 e 19 anos, provenientes de escolas públicas de Viçosa (MG). Em amostras de sangue foram dosados colesterol total, LDL, HDL, triglicerídeos, insulina e leptina. Determinado percentual de gordura corporal através de bioimpedância elétrica tetrapolar. Pela medida de menor diâmetro abdominal foi determinada a circunferência da cintura do abdômen e calculados valores de sensibilidade, especificidade, valor preditivo positivo e negativo. Foram elaboradas tabelas de contingência de classificação de circunferência da cintura em adolescentes para quatro critérios: Freedman et al., 1999; Taylor et al., 2000; McCarthy et al., 2001; e Moreno et al., 2007. RESULTADOS: Valores de sensibilidade em geral foram baixos para as referências avaliadas, sendo os maiores obtidos para a de McCarthy et al. Ao contrário, as especificidades foram altas, principalmente para a tabela de Freedman et al. Os valores preditivos positivos foram mais relevantes para colesterol total e percentual de gordura corporal. CONCLUSÃO: Os pontos de corte para circunferência da cintura de McCarthy et al. demonstraram-se os mais adequados para avaliações populacionais. A proposta de Freedman et al. por apresentar maior especificidade, é útil para uso clínico e pode substituir a realização de exames de custo elevado que em muitos locais não se encontram ao alcance dos profissionais de saúde, como leptina e insulina. OBJECTIVE: Assess diagnostic validity of four reference tables for waist circumference in female teenagers in order to detect lipid alterations, hyperinsulin, elevated homeostasis model assessment (HOMA), hyperleptinemia and excess of body adiposity. METHODS: A total of 133 female subjects, ranging from 14 to 19 years opf age , were evaluated. All adolescents were recruited from public schools in Viçosa/MG. Blood samples were collected for determination of fasting plasma cholesterol total, LDL, HDL, triglycerides, insulin and leptin. Percentage of body fat was determined through tetrapolar electrical bioimpedance. Using the smallest abdominal measure it was possible to determine waist circumference and calculated values of sensibility, specificity, positive and negative predictive values. Waist circumference contingency tables were obtained using four criteria: Freedman et al., 1999; Taylor et al., 2000; McCarthy et al., 2001; e Moreno et al., 2007. RESULTS: In general, sensibility values were low for circumferences assessed and the highest values were obtained for the table of Mc Carthy et al., on the other hand, specificity values were high considering the table of Freedman et al. The positive predictive values were more relevant for total cholesterol and body fat percentage. CONCLUSION: Cutoffs for waist circumference used by Mc Carthy et al. were the most appropriate for populational assessments. Freedman's et al. proposal is appropriate for clinical use since it presents higher specificity. In addition, it can substitute high costs exams, out of the professionals' reach such as insulin and leptin.