Indicadores de composição corporal na predição de risco de síndrome metabólica em crianças de seis a 10 anos de idade

Autores

DOI:

https://doi.org/10.1590/1980-0037.2023v25e85289

Palavras-chave:

Composição corporal, Síndrome metabólica, Criança

Resumo

Objetivou-se desenvolver percentis de indicadores de composição corporal e determinar pontos de corte para predizer o risco de síndrome metabólica (SM) em crianças de seis a 10 anos de idade. Estudo epidemiológico de corte transversal, de base populacional, com participação de 1480 escolares de seis a 10 anos de idade. A avaliação antropométrica (massa corporal, estatura e dobras cutâneas) e a aferição da pressão arterial foram realizadas nas escolas. O índice de massa corporal (IMC) bem como o percentual de gordura (%GC), percentual de massa magra (%MM), massa corporal gorda (MCG) foram calculados de acordo com fórmulas padronizadas para crianças. A coleta de sangue para avaliar o perfil lipídico e glicêmico também foi realizada na escola, em dias e horários pré-estabelecidos. O diagnóstico da SM foi determinado com base em alterações nos triglicerídeos, HDL-c, glicemia, perímetro de cintura e pressão arterial. O método LMS foi utilizado para desenvolver os percentis, a área sob a curva ROC (AUC) para identificar a acurácia dos indicadores e a sensibilidade e especificidade para determinar os pontos de corte. MCG e %GC apresentaram valores significativamente superior nas meninas e também valores inferiores para a MCM em relação aos meninos (p<0,05). Os indicadores de composição corporal, IMC, MCG e %GC apresentaram acurácia na predição do risco de SM para ambos os sexos em todas as idades. Os principais indicadores de composição corporal para predição do risco de SM, em ambos os sexos, foram o IMC, %GC e MCG. Esses achados sugerem que medidas antropométricas simples, que podem ser realizadas na prática clínica, tem potencial para direcionar ações não medicamentosas.

Referências

World Health Organization. The global burden of disease: 2004 update. Geneva: World Health Organization; 2008.

Huang TT-K, Ball GD, Franks PW. Metabolic syndrome in youth: current issues and challenges. Appl Physiol Nutr Metab. 2007;32(1):13-22.

McNeill AM, Rosamond WD, Girman CJ, Golden SH, Schmidt MI, East HE, et al. The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes care. 2005;28(2):385-90.

Chen W, Srinivasan SR, Li S, Xu J, Berenson GS. Metabolic syndrome variables at low levels in childhood are beneficially associated with adulthood cardiovascular risk The Bogalusa Heart Study. Diabetes Care. 2005;28(1):126-31.

Formisano A, Bammann K, Fraterman A, Hadjigeorgiou C, Herrmann D, Iacoviello L, et al. Efficacy of neck circumference to identify metabolic syndrome in 3–10 year-old European children: Results from IDEFICS study. Nutr Metab Cardiovasc Dis. 2016;26(6):510-6.

Shafiee G, Kelishadi R, Heshmat R, Qorbani M, Motlagh ME, Aminaee T, et al. First report on the validity of a continuous Metabolic Syndrome score as an indicator for Metabolic Syndrome in a national sample of paediatric population—the CASPIAN-III study. Endokrynol Pol. 2013;64(4):278-84.

Tailor AM, Peeters PH, Norat T, Vineis P, Romaguera D. An update on the prevalence of the metabolic syndrome in children and adolescents. Int J Pediatr Obes. 2010;5(3):202-13.

Kuschnir MCC, Bloch KV, Szklo M, Klein CH, Barufaldi LA, Abreu GdA, et al. ERICA: prevalence of metabolic syndrome in Brazilian adolescents. Rev Saude Publica. 2016;50 (Suppl 1):11s.

Haffner SM. The metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. Am J Cardiol. 2006;97(2):3-11.

Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240-3.

Slaughter MH, Lohman TG, Boileau RA, Horswill CA, Stillman RJ, Van Loan MD, et al. Skinfold equations for estimation of body fatness in children and youth. Hum Biol. 1988;60(5):709-23.

Sociedade Brasileira de Cardiologia; Sociedade Brasileira de Hipertensão; Sociedade Brasileira de Nefrologia. VI Diretrizes Brasileiras de hipertensão. Arq Bras Cardiol. 2010;95(1 Suppl):1-51.

de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation. 2004;110(16):2494-7.

Cole TJ, Green PJ. Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med. 1992;11(10):1305-19.

Conde WL, Monteiro CA. Body mass index cutoff points for evaluation of nutritional status in Brazilian children and adolescents. J Pediatr (Rio J). 2006;82(4):266-72.

Cali AM, Caprio S. Ectopic fat deposition and the metabolic syndrome in obese children and adolescents. Horm Res. 2009;71 Suppl 1:2-7.

Thivel D, Malina RM, Isacco L, Aucouturier J, Meyer M, Duché P. Metabolic syndrome in obese children and adolescents: dichotomous or continuous? Metab Syndr Relat Disord. 2009;7(6):549-55.

Ferreira AP, Oliveira CE, Franca NM. Metabolic syndrome and risk factors for cardiovascular disease in obese children: the relationship with insulin resistance (HOMA-IR). J Pediatr (Rio J). 2007;83(1):21-6.

Monzavi R, Dreimane D, Geffner ME, Braun S, Conrad B, Klier M, et al. Improvement in risk factors for metabolic syndrome and insulin resistance in overweight youth who are treated with lifestyle intervention. Pediatrics. 2006;117(6):e1111-8.

Ice CL, Murphy E, Minor VE, Neal WA. Metabolic syndrome in fifth grade children with acanthosis nigricans: results from the CARDIAC project. World J Pediatr. 2009;5(1):23-30.

Moreno LA, Pineda I, Rodriguez G, Fleta J, Sarria A, Bueno M. Waist circumference for the screening of the metabolic syndrome in children. Acta Paediatr. 2002;91(12):1307-12.

Ferreira AP, Ferreira CB, Brito CJ, Pitanga FJ, Moraes CF, Naves LA, et al. Prediction of metabolic syndrome in children through anthropometric indicators. Arq Bras Cardiol. 2011;96(2):121-5.

Halley Castillo E, Borges G, Talavera JO, Orozco R, Vargas-Alemán C, Huitrón-Bravo G, Diaz-Montiel JC, Castañón S, Salmerón J. Body mass index and the prevalence of metabolic syndrome among children and adolescents in two Mexican populations. J Adolesc Health. 2007;40(6):521-6.

Elizondo-Montemayor L, Serrano-Gonzalez M, Ugalde-Casas PA, Bustamante-Careaga H, Cuello-Garcia C. Waist-to-height: cutoff matters in predicting metabolic syndrome in Mexican children. Metab Syndr Relat Disord. 2011;9(3):183-90.

Sellers EA, Singh GR, Sayers SM. Large waist but low body mass index: the metabolic syndrome in Australian Aboriginal children. J Pediatr. 2008;153(2):222-7.

Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med. 2003;157(8):821-7.

Deurenberg P, Pieters JJ, Hautvast JG. The assessment of the body fat percentage by skinfold thickness measurements in childhood and young adolescence. Br J Nutr. 1990;63(2):293-303.

Lohman T. The use of skinfolds to estimate body fatness on children and youth. JOPERD. 1987;58:98-102.

Sun SS, Deng X, Sabo R, Carrico R, Schubert CM, Wan W, et al. Secular trends in body composition for children and young adults: the Fels Longitudinal Study. Am J Hum Biol. 2012;24(4):506-14.

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Publicado

2024-03-01