Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity.
BMC Public Health
; 23(1): 1549, 2023 08 15.
Article
em En
| MEDLINE
| ID: mdl-37582739
ABSTRACT
BACKGROUND:
Childhood overweight/obesity has been associated with an elevated risk of insulin resistance and cardiometabolic disorders. Waist-to-height ratio (WHtR) may be a simple screening tool to quickly identify children at elevated risk for cardiometabolic disorders. The primary objective of the present study was to create sex-specific tertile cut points of WHtR and assess its association with Insulin resistance and elevated liver enzyme concentrations in children, factors using cross-sectional data from the randomized, controlled Family Weight Management Study.METHODS:
Baseline data from 360 children (7-12 years, mean Body Mass Index (BMI) ≥ 85th percentile for age and sex) were used to calculate WHtR tertiles by sex, male ≤ 0.55 (T1), > 0.55- ≤ 0.59 (T2), > 0.59 (T3); female ≤ 0.56 (T1), > 0.56- ≤ 0.6 (T2), > 0.6 (T3). The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was used to categorize participants as insulin-resistant (HOMA-IR ≥ 2.6) and insulin-sensitive (HOMA-IR < 2.6). Liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were categorized as normal vs. elevated (AST of < 36.0 µkat/L or ≥ 36.0 µkat/L; ALT of < 30.0 µkat/L or ≥ 30.0 µkat/L; ALT > 26 µkat/L males, > 22 µkat/L females). We examined differences in baseline cardiometabolic risk factors by WHtR tertiles and sex-specific multivariable logistic regression models to predict HOMA-IR and elevation of liver enzymes.RESULTS:
Study participants had a mean WHtR of 0.59 ([SD 0.06]). Irrespective of sex, children in WHtR T3 had higher BMIz scores, blood pressure, triglycerides, 2-h glucose, fasting 2-h insulin, and lower high-density lipoprotein cholesterol (HDL-C) concentrations than those in T2 and T1. After adjusting for covariates, the odds of elevated HOMA-IR (> 2.6) were over five-fold higher among males in T3 versus T1 [OR, 95%CI 5.83, 2.34-14.52] and T2 [OR, 95%CI 4.81, 1.94-11.92] and females in T3 [OR, 95%CI 5.06, 2.10-12.20] versus T1. The odds of elevated ALT values (≥ 30) were 2.9 [95%CI 1.01-8.41] fold higher among females in T3 compared to T1.CONCLUSION:
In public health settings, WHtR may be a practical screening tool in pediatric populations to identify children at risk of metabolic syndrome.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Resistência à Insulina
/
Doenças Cardiovasculares
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Síndrome Metabólica
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Obesidade Infantil
Tipo de estudo:
Clinical_trials
/
Etiology_studies
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Observational_studies
/
Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Child
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Female
/
Humans
/
Male
Idioma:
En
Revista:
BMC Public Health
Assunto da revista:
SAUDE PUBLICA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos