The TyG index cutoff point and its association with body adiposity and lifestyle in children / Ponto de corte do índice TyG e sua associação com a adiposidade corporal e estilo de vida em crianças

Abstract Objective: To investigate the factors associated with insulin resistance in children aged 4-7 years, and to identify the cutoff point of the triglyceride-glucose index for the prediction of insulin resistance in this population. Methods: A cross-sectional study was conducted with 403 children from a retrospective cohort. Insulin resistance was also evaluated in a sub-sample using the HOMA index. Four indicators of body adiposity were assessed: body mass index, waist-to-height ratio, and the percentages of total and central body fat. Food habits were evaluated by the identification of dietary patterns, using principal component analysis. Information was also collected on lifestyle, socioeconomic status, and breastfeeding time. Results: The median index observed in the sample was 7.77, which did not differ between the genders. The shorter the time spent in active activities, the higher the triglyceride-glucose value; and increase in the values of body adiposity indicators was positively associated with triglyceride-glucose. The cutoff point with the best balance between sensitivity and specificity values was 7.88 (AUC = 0.63, 95% CI: 0.51-0.74). Conclusion: The present study identified that total and central body adiposity and shorter time spent in lively activities was positively associated with insulin resistance, evaluated through the triglyceride-glucose index. The cutoff point of 7.88 may be used in this population for insulin resistance risk screening, but caution is required when using it in other populations.

Resumo Objetivo: Investigar os fatores associados à resistência à insulina em crianças de 4 a 7 anos, e identificar o ponto de corte do índice triglicerídeos-glicemia (TyG) para predição da RI nessa população. Métodos: Estudo transversal, com 403 crianças pertencentes a uma coorte retrospectiva. A resistência à insulina foi avaliada pelo índice triglicerídeos-glicemia e também pelo índice HOMA, este em uma subamostra. Avaliou-se quatro indicadores de adiposidade corporal: o índice de massa corporal, a relação cintura-estatura e os percentuais de gordura corporal total e central. O hábito alimentar foi avaliado pela identificação dos padrões alimentares, utilizando-se a análise de componentes principais. Foram coletadas também informações sobre estilo de vida, condição socioeconômica e tempo de aleitamento materno. Resultados: A mediana observada do índice triglicerídeos-glicemia na amostra foi de 7,77 e não diferiu entre os sexos. Quanto menor o tempo diário em atividades ativas, maior o valor de triglicerídeos-glicemia; e o aumento nos valores dos indicadores de adiposidade corporal associou-se positivamente com o triglicerídeos-glicemia. O ponto de corte com melhor equilíbrio entre os valores de sensibilidade e especificidade foi o de 7,88 (AUC = 0,63; IC 95% 0,51 - 0,74). Conclusão: O presente estudo identificou que a adiposidade corporal total e central e o menor tempo diário em atividades ativas associou-se positivamente com a resistência à insulina, avaliada pelo índice triglicerídeos-glicemia. O ponto de corte de 7,88 pode ser utilizado nessa população para triagem do risco de resistência à insulina, mas é necessário cautela na sua utilização em outras populações.

The TyG index cutoff point and its association with body adiposity and lifestyle in children.

OBJECTIVE: To investigate the factors associated with insulin resistance in children aged 4-7 years, and to identify the cutoff point of the triglyceride-glucose index for the prediction of insulin resistance in this population. METHODS: A cross-sectional study was conducted with 403 children from a retrospective cohort. Insulin resistance was also evaluated in a sub-sample using the HOMA index. Four indicators of body adiposity were assessed: body mass index, waist-to-height ratio, and the percentages of total and central body fat. Food habits were evaluated by the identification of dietary patterns, using principal component analysis. Information was also collected on lifestyle, socioeconomic status, and breastfeeding time. RESULTS: The median index observed in the sample was 7.77, which did not differ between the genders. The shorter the time spent in active activities, the higher the triglyceride-glucose value; and increase in the values of body adiposity indicators was positively associated with triglyceride-glucose. The cutoff point with the best balance between sensitivity and specificity values was 7.88 (AUC=0.63, 95% CI: 0.51-0.74). CONCLUSION: The present study identified that total and central body adiposity and shorter time spent in lively activities was positively associated with insulin resistance, evaluated through the triglyceride-glucose index. The cutoff point of 7.88 may be used in this population for insulin resistance risk screening, but caution is required when using it in other populations.

Anthropometric patterns of adiposity, hypertension and diabetes mellitus in older adults of Viçosa, Brazil: A population-based study.

AIM: To identify anthropometric patterns of adiposity and estimate their association with hypertension and diabetes mellitus (DM) in older adults. METHODS: A cross-sectional study with 537 older adults aged ≥60 years was carried out. Weight, height, and waist, hip and calf circumference were measured. The following indices were calculated: a body shape index, body roundness index, conicity index, body adiposity index, body mass index, waist-to-height ratio, waist-to-calf ratio, waist-to-hip ratio and waist-to-hip-to-height ratio. The anthropometric patterns of adiposity were obtained by factor analysis of principal components, and their association with hypertension and DM was identified by multiple Poisson regression with robust variance. RESULTS: Two anthropometric patterns of adiposity were identified. Pattern 1 and 2 explained approximately 53% and 33% of the total variance, respectively, in both sexes. Pattern 1 indicated of global adiposity, and weight, body mass index and hip circumference were the variables most strongly correlated with this pattern in both sexes. Pattern 2 represented the body fat distribution, being a body shape index the most important variable in this factor. After adjustment by confounding factors, only the pattern 2 remained significantly associated with DM in women. CONCLUSIONS: Only the anthropometric pattern of adiposity central was associated with DM in older women. Geriatr Gerontol Int 2018; 18: 584-591.

Body fat location and cardiovascular disease risk factors in overweight female adolescents and eutrophic female adolescents with a high percentage of body fat.

BACKGROUND: Excessive body fat, mainly abdominal fat, is associated with higher cardiovascular risk. However, a fat localisation measurement that would be more indicative of risk in adolescents has not yet been established. OBJECTIVE: This study was conducted in order to evaluate the correlation between body fat location measurements and cardiovascular disease risk factors in female adolescents. MATERIALS AND METHODS: A total of 113 girls - 38 eutrophic according to their body mass index but with a high percentage of body fat, 40 eutrophic with adequate body fat, and 35 with excessive weight - were evaluated using 15 anthropometrical measurements and 10 cardiovascular risk factors. RESULTS: The central skinfold was the best measurement for predicting variables such as glycaemia and high-density lipoprotein; waist circumference for insulin and homeostasis model assessment; coronal diameter for total cholesterol and low-density lipoprotein; sagittal abdominal diameter for triglycerides and leptin; hip circumference for blood pressure; and the central/peripheral skinfold ratio for homocysteine. The correlation between the measurements and the number of risk factors showed that waist circumference and the waist/stature ratio produced the best results. CONCLUSIONS: The results suggest that the body fat distribution in adolescents is relevant in the development of cardiovascular risk factors. Simple measurements such as waist circumference and the waist/stature ratio were the best predictors of a risk of disease and they should therefore be associated with the body mass index in clinical practice in order to identify those adolescents at higher risk.

Influência do excesso de peso corporal e da adiposidade central na glicemia e no perfil lipídico de pacientes portadores de diabetes mellitus tipo 2 / Influence of body weight excess and central adiposity in glycemic and lipid profile in patients with type 2 diabetes mellitus

O propósito do presente estudo foi avaliar, em pacientes diabéticos do tipo 2, a influência do excesso de peso corporal avaliado pelo IMC e da adiposidade central aferida pela circunferência da cintura (CC) no perfil lipídico sangüíneo e na glicemia de jejum. Foram avaliados 145 indivíduos atendidos em uma unidade de saúde, com idade > 20 anos. A freqüência do sexo feminino foi de 61,4 por cento. Nos homens, o excesso de peso correlacionou-se com o HDL (r = -0,34, p < 0,05), colesterol total (r = 0,35, p < 0,01) e triglicerídeos (r = 0,49, p < 0,0001), sendo que nas mulheres houve correlação apenas com os triglicerídeos (r = 0,24, p < 0,05). A CC correlacionou-se com a glicemia de jejum nas mulheres (r = 0,3, p < 0,01), com o colesterol total nos homens (r = 0,33, p < 0,05) e com os triglicerídeos em ambos os sexos (F: r = 0,22, p < 0,05; M: r = 0,49, p < 0,001). Maiores níveis glicêmicos e de triglicerídeos estiveram presentes nos pacientes com excesso de peso e adiposidade central e menores níveis de HDL estiveram associados ao excesso de peso. Conclui-se que há associação entre inadequado perfil metabólico e excesso de peso e/ou adiposidade central, evidenciando a necessidade de intervenção nutricional e clínica em pacientes diabéticos do tipo 2 de forma a reduzir o risco de complicações crônicas futuras.

The purpose of the present study was to evaluate, in diabetic type 2 patients, the influence of body weight excess assessed by BMI and the central adiposity assessed by the waist circumference in the lipid and glycemic profile. One hundred and forty five individuals assisted in a unit of health, aged > 20 years old, were appraised. The female frequency was 61.4 percent. Among men, the weight excess was correlated with HDL (r = -0.34, p < 0.05), with the total cholesterol (r = 0.35, p < 0.01), and with the triglycerides (r = 49, p < 0.0001), and among women there was correlation just with the triglycerides (r = 0.24, p < 0,05). Waist circumference was correlated with the fast glycemia women's group (r = 0.3, p < 0.01), with the total cholesterol among men (r = 0.33, p < 0.05) and with triglycerides in both genders (F: r = 0.22, p < 0.05; M: r = 0.49, p < 0.001). Highest glycemic and triglycerides levels were present in patients with excess body weight and central adiposity and lower HDL levels were present in patients with body weight excess. In conclusion, there is association between inadequate metabolic profile and the excess of body weight and/or central obesity, evidencing the need for a nutritional and clinical intervention in the diabetic type 2 patients, in order to reduce the risk of future chronic complications.

[Influence of body weight excess and central adiposity in glycemic and lipid profile in patients with type 2 diabetes mellitus]. / Influência do excesso de peso corporal e da adiposidade central na glicemia e no perfil lipídico de pacientes portadores de diabetes mellitus tipo 2.

The purpose of the present study was to evaluate, in diabetic type 2 patients, the influence of body weight excess assessed by BMI and the central adiposity assessed by the waist circumference in the lipid and glycemic profile. One hundred and forty five individuals assisted in a unit of health, aged >or= 20 years old, were appraised. The female frequency was 61.4%. Among men, the weight excess was correlated with HDL (r = -0.34, p < 0.05), with the total cholesterol (r = 0.35, p < 0.01), and with the triglycerides (r = 49, p < 0.0001), and among women there was correlation just with the triglycerides (r = 0.24, p < 0,05). Waist circumference was correlated with the fast glycemia women's group (r = 0.3, p < 0.01), with the total cholesterol among men (r = 0.33, p < 0.05) and with triglycerides in both genders (F: r = 0.22, p < 0.05; M: r = 0.49, p < 0.001). Highest glycemic and triglycerides levels were present in patients with excess body weight and central adiposity and lower HDL levels were present in patients with body weight excess. In conclusion, there is association between inadequate metabolic profile and the excess of body weight and/or central obesity, evidencing the need for a nutritional and clinical intervention in the diabetic type 2 patients, in order to reduce the risk of future chronic complications.