Neck Circumference for Identification of Excess Adiposity in Adolescents with Cancer: A Better Parameter for Use in Clinical Practice?

Purpose: Excess weight in adolescents with cancer during treatment does affect cancer outcomes. Neck circumference (NC), an easygoing anthropometric measure, may present greater metabolic risk, and is associated with excess adiposity. The aim of this study was to identify the prevalence of elevated NC in adolescents with cancer and associated factors. Methods: Cross-sectional study with adolescents aged 10-19 years, under antineoplastic treatment, evaluated from 2015 to 2017, at a Pediatric Oncology Institute's outpatient clinic. Anthropometric parameters were collected, besides diagnosis, sex, and age. The classification of elevated NC was carried out considering cutoff values for adolescents, according to sex and age group. A binary logistic regression was used to determine relationships between NC and associated factors. Results: Among 496 eligible cases, most were male (n = 299, 60.3%). A total of 31.9% of cases had high NC. There is significant and moderate correlation between skinfold thickness (TS) and NC (ρ = 0.6; p = 0.000), and a significant but weak correlation between TS and body mass index (ρ = 0.267; p = 0.000). The adjusted analysis for sex, age group, and type of tumor showed that females are more likely to belong to the high NC category, to have excess adiposity. The age group between 10 and 12 years was the most associated with this outcome (2.795 [0.979-7.977]; p < 0.05). TS is also associated with high NC (1.114 [1.050-1.182]; p < 0.05). Conclusion: It was concluded that there is high prevalence of elevated NC and higher risks for this outcome considering type of tumor, sex, age group, besides being an easy and simple measure for use in clinical practice.

Elevated neck circumference and associated factors in adolescents.

BACKGROUND: Upper body subcutaneous fat, estimated by neck circumference (NC), may present greater metabolic risk than visceral fat. The aim of this study was to determine cutoff values for NC in adolescents that identify overweight and obesity, the prevalence of elevated NC, and its association with associated factors. METHODS: Cross-sectional study with adolescents from public schools in São Paulo. Anthropometric variables, blood pressure and pubertal stage were collected. Cutoff values for NC were determined by Receiver Operating Characteristic curves. A binary logistic regression was used to determine relationships between NC and associated factors. RESULTS: Among 1668 adolescents studied, 54.92% were female. The cutoff values of NC in girls and boys that identified overweight were 31.25 and 34.25 cm, and obesity, 32.65 and 37.95 cm, respectively, and the prevalence of adolescents with high NC was 32.63% in females and 37.63% among males. NC for overweight was observed that there was an association with sex, weight, body mass index, arm, waist and thigh circumferences, pubertal stages and body fat percent (BF%). NC for obesity was found association with gender, weight, arm and thigh circumferences, and BF% (p < 0.001). CONCLUSION: It was concluded that there is high prevalence of elevated NC and higher risks for this outcome considering overweight and obesity, sex, weight, arm and thigh circumferences, BF%, besides being an easy and simple measure for use in clinical practice.

Alteração da pressão arterial em adolescentes e sua relação com estado nutricional / Blood pressure in adolescents and its relationship with nutritional status

Objetivo: Avaliar a correlação entre estado nutricional e pressão arterial em adolescentes. Métodos: Estudo descritivo, em corte transversal retrospectivo. Foram analisados prontuários de adolescentes de 10 a 18 anos incompletos que deram entrada em um Centro Especializado entre 1997 a 2006. Foi calculado o índice de massa corporal, os valores iniciais da pressão arterial sistólica e diastólica, convertidos em percentis. Para análise estatística foi utilizada correlação de Spearman, com nível de significância p<0,05. Resultados: Foram selecionados 983 adolescentes, entre 10 e 18 anos incompletos, 506 do sexo feminino e 477 do sexo masculino. Entre as 46,44% de meninas e os 37,53% de meninos, todos apresentavam excesso de peso. Em relação aos níveis pressóricos ficou evidente que os adolescentes com excesso de peso apresentaram maiores percentis de pressão arterial, tanto sistólica quanto diastólica. Todas as correlações de pressão arterial, sistólica e diastólica, em valores absolutos e em percentis, com índice de massa corporal foram significativas (p<0,001). Porém, os adoles-centes eutróficos também apresentaram alterações importantes das cifras pres-sóricas. Conclusão: Apesar do excesso de peso apresentar forte associação com a elevação da pressão arterial, verificou-se também esta alteração em adolescentes eutróficos. Este artigo demonstra a importância de se avaliar periodicamente a pressão arterial de adolescentes como forma de prevenir alterações na mesma, promovendo um estilo de vida mais adequado