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Esmaeili P, Roshanravan N, Ghaffari S, Mesri Alamdari N, Asghari-Jafarabadi M. Unraveling atherosclerotic cardiovascular disease risk factors through conditional probability analysis with Bayesian networks: insights from the AZAR cohort study. Sci Rep 2024; 14:4361. [PMID: 38388574 PMCID: PMC10883955 DOI: 10.1038/s41598-024-55141-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 02/20/2024] [Indexed: 02/24/2024] Open
Abstract
This study aimed at modelling the underlying predictor of ASCVD through the Bayesian network (BN). Data for the AZAR Cohort Study, which evaluated 500 healthcare providers in Iran, was collected through examinations, and blood samples. Two BNs were used to explore a suitable causal model for analysing the underlying predictor of ASCVD; Bayesian search through an algorithmic approach and knowledge-based BNs. Results showed significant differences in ASCVD risk factors across background variables' levels. The diagnostic indices showed better performance for the knowledge-based BN (Area under ROC curve (AUC) = 0.78, Accuracy = 76.6, Sensitivity = 62.5, Negative predictive value (NPV) = 96.0, Negative Likelihood Ratio (LR-) = 0.48) compared to Bayesian search (AUC = 0.76, Accuracy = 72.4, Sensitivity = 17.5, NPV = 93.2, LR- = 0.83). In addition, we decided on knowledge-based BN because of the interpretability of the relationships. Based on this BN, being male (conditional probability = 63.7), age over 45 (36.3), overweight (51.5), Mets (23.8), diabetes (8.3), smoking (10.6), hypertension (12.1), high T-C (28.5), high LDL-C (23.9), FBS (12.1), and TG (25.9) levels were associated with higher ASCVD risk. Low and normal HDL-C levels also had higher ASCVD risk (35.3 and 37.4), while high HDL-C levels had lower risk (27.3). In conclusion, BN demonstrated that ASCVD was significantly associated with certain risk factors including being older and overweight male, having a history of Mets, diabetes, hypertension, having high levels of T-C, LDL-C, FBS, and TG, but Low and normal HDL-C and being a smoker. The study may provide valuable insights for developing effective prevention strategies for ASCVD in Iran.
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Affiliation(s)
- Parya Esmaeili
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Epidemiology and Biostatistics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Roshanravan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammad Asghari-Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Cabrini Research, Cabrini Health, Malvern, VIC, 3144, Australia.
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, 3004, Australia.
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, 3168, Australia.
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da Silva TPR, Mendes LL, Barreto VMJ, Matozinhos FP, Duarte CK. Total cholesterol and low-density lipoprotein alterations in children and adolescents from Brazil: a prevalence meta-analysis. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:19-44. [PMID: 35929904 PMCID: PMC9983790 DOI: 10.20945/2359-3997000000508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective The aim of the present study was to evaluate the prevalence of total cholesterol (TC) and low-density lipoprotein (LDL) alterations in children and adolescents in Brazil. Subjects and methods A systematic review and meta-analysis of prevalence. The search for articles was carried out in the databases: Medline (PubMed), Embase, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (Lilacs). The meta-analysis was performed using the random effects model. The I2 test was used to identify heterogeneity. Results The present metanalysis revealed a significant prevalence of altered lipid profile in children and adolescents in Brazil. Regarding lipoprotein fractions, the prevalence of altered TC level was 27.47% (95% CI 24.36-30.82), and a smaller prevalence was observed for LDL cholesterol (19.29% - 95% CI 15.21-24.16). The models revealed high heterogeneity (I2 = 99%; p < 0.01), however the precise source of it was not identified; although type of school, age group, year and the region of Brazil appeared to influence the estimations of altered lipid profiles. Conclusion An important prevalence of lipid alterations was observed among Brazilian children and adolescents. Those results reinforce the importance of knowing the lipid profile of children and adolescents to perform early interventions for this public.
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Affiliation(s)
| | - Larissa Loures Mendes
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Virgínia Maria Jorge Barreto
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Fernanda Penido Matozinhos
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Camila Kümmel Duarte
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil,
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Martinović M, Belojević G, Jakšić M, Kavarić N, Klisić A. CARDIOMETABOLIC RISK AMONG MONTENEGRIN URBAN CHILDREN IN RELATION TO OBESITY AND GENDER. Acta Clin Croat 2021; 60:3-9. [PMID: 34588715 PMCID: PMC8305352 DOI: 10.20471/acc.2021.60.01.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 07/12/2018] [Indexed: 12/24/2022] Open
Abstract
Considering previously reported discrepant results in the literature, we aimed to investigate the impact of gender and overweight/obesity on cardiometabolic risk (CMR) among Montenegrin urban children. The cross-sectional study included random sample of 201 schoolchildren aged 7-12 years (64% of boys) from Podgorica. Children's nutritional status was determined according to the International Obesity Task Force criteria. CMR was assessed using a sum of z values of the following five indicators: glucose, total cholesterol, inverted value of high-density lipoprotein cholesterol, triglycerides, and hypertension. Higher CMR was found among both overweight and obese boys compared to normal weight boys (p<0.001). The effect size of the difference in CMR between overweight and obese girls and normal weight counterparts was less prominent (p<0.05). Logistic regression analysis revealed that body mass index was independent predictor of high CMR [odds ratio (OR)=1.06; 95% confidence interval (CI)=1.02-1.10); p=0.002]. On the contrary, we found no impact of socioeconomic status, physical activity or sedentary time on CMR in the examined cohort of schoolchildren. In conclusion, both overweight and obesity even among young population are related to higher CMR and this effect is more prominent among boys as compared to girls.
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Affiliation(s)
| | - Goran Belojević
- 1Faculty of Medicine, Department of Pathophysiology and Laboratory Medicine, University of Montenegro, Podgorica, Montenegro; 2Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia; 3Institute for Children's Diseases, Department of Laboratory Diagnostics, Podgorica, Montenegro; 4Primary Health Care Centre, Podgorica, Montenegro
| | - Marina Jakšić
- 1Faculty of Medicine, Department of Pathophysiology and Laboratory Medicine, University of Montenegro, Podgorica, Montenegro; 2Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia; 3Institute for Children's Diseases, Department of Laboratory Diagnostics, Podgorica, Montenegro; 4Primary Health Care Centre, Podgorica, Montenegro
| | - Nebojša Kavarić
- 1Faculty of Medicine, Department of Pathophysiology and Laboratory Medicine, University of Montenegro, Podgorica, Montenegro; 2Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia; 3Institute for Children's Diseases, Department of Laboratory Diagnostics, Podgorica, Montenegro; 4Primary Health Care Centre, Podgorica, Montenegro
| | - Aleksandra Klisić
- 1Faculty of Medicine, Department of Pathophysiology and Laboratory Medicine, University of Montenegro, Podgorica, Montenegro; 2Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia; 3Institute for Children's Diseases, Department of Laboratory Diagnostics, Podgorica, Montenegro; 4Primary Health Care Centre, Podgorica, Montenegro
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Silveira JF, Reuter CP, Welser L, Pfeiffer KA, Andersen LB, Pohl HH, Lima RA. Tracking of cardiometabolic risk in a Brazilian schoolchildren cohort: a 3-year longitudinal study. J Sports Med Phys Fitness 2021; 61:997-1006. [PMID: 33615759 DOI: 10.23736/s0022-4707.20.11479-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Clustering of cardiometabolic risk factors is a sign of detrimental health. Tracking is a term used to describe a variable longitudinal stability across time. High tracking provides the chance to determine which cardiometabolic risk factors should be the target of early treatment and prevention efforts. The present study aims to analyze the tracking of cardiometabolic risk factors and clustered cardiometabolic risk score in children across a 3-year time span, and to verify the odds of staying at risk (measured by the clustered score) from baseline to follow-up. METHODS Longitudinal study that included 354 (155 boys) children, aged 7-12 years at baseline. A clustered score was calculated by summing the systolic blood pressure, waist circumference, triglycerides, glucose, and the TC/HDL-C ratio Z-scores divided by five. A second clustered score was calculated including cardiorespiratory fitness (CRF). RESULTS CRF and anthropometric parameters presented high tracking (r≥0.662), whereas the cardiometabolic parameters exhibited low-to-moderate tracking (0.100≤r≤0.571). The clustered scores' tracking was moderate (r≥0.508; r≥0.588 [CRF]). Participants in the higher risk groups at baseline presented 3.81 (95% CI: 2.40; 6.05) and 4.64 (95% CI: 2.85; 7.56), including CRF, times higher chance of remaining at risk three years later. Moreover, participants in the worst profile regarding CRF or anthropometrics at baseline presented at least 4.00 times higher chance of being at risk three years later. CONCLUSIONS Participants with worst CRF and adiposity had an increased risk of presenting higher clustered risk after three years.
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Affiliation(s)
- João F Silveira
- University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil
| | - Cézane P Reuter
- University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil - .,Department of Health Sciences, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil
| | - Letícia Welser
- University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil
| | - Karin A Pfeiffer
- Department of Kinesiology, Michigan State University (MSU), East Lansing, MI, USA
| | - Lars B Andersen
- Faculty of Education, Arts and Sport, Western Norway University of Applied Sciences, Songdal, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Hildegard H Pohl
- University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil.,Department of Health Sciences, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil
| | - Rodrigo A Lima
- Institute of Sport Science, University of Graz, Graz, Austria.,Research Group on Lifestyles and Health, University of Pernambuco, Recife, Brazil
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Cube natural sea salt ameliorates obesity in high fat diet-induced obese mice and 3T3-L1 adipocytes. Sci Rep 2020; 10:3407. [PMID: 32099024 PMCID: PMC7042290 DOI: 10.1038/s41598-020-60462-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 02/07/2020] [Indexed: 01/19/2023] Open
Abstract
Sodium is an essential component of the human body, with known influences on obesity. This paper reports the effect of cube natural sea salt (CNS) on the reduction of obesity in high fat diet-induced obese C57BL/6 mice and 3T3-L1 adipocytes, by ameliorating the obesity parameters and obesity-related gene mechanisms. The suppression of high fat diet-induced obesity and differentiated 3T3-L1 adipocytes by sea salt depends on the manufacturing process and mineral content. The manufacturing method using only new sea water (Cube natural sea salt) decreases the magnesium (Mg) and sulfur (S) content in the salt with different crystallization and morphologies, compared to the general manufacturing method (Generally manufactured sea salt, GS). Mg in salt is known to considerably affect obesity; an appropriate concentration of magnesium chloride (MgCl2) reduces lipid accumulation significantly and regulates the lipogenesis and liver enzyme activity. Our results indicate that sea salt contains an appropriate level of Mg as compared to table salt (purified salt, NaCl), and is important for regulating obesity, as observed in the in vivo and in vitro anti-obesity effects of CNS. The Mg content and mineral ratio of sea salt are important factors that ameliorate the lipid metabolism and liver enzyme activity in high fat diet induced obesity, and contents of Mg in sea salt can be altered by modifying the manufacturing process.
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Cruz NRC, Cardoso PC, Frossard TNSV, Ferreira FDO, Brener S, Gomides AFDF, Valente MAS, Velloso-Rodrigues C. Waist circumference as high blood pressure predictor in school age children. CIENCIA & SAUDE COLETIVA 2019; 24:1885-1893. [PMID: 31166521 DOI: 10.1590/1413-81232018245.18012017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 08/16/2017] [Indexed: 11/22/2022] Open
Abstract
Childhood hypertension is becoming more common with the increasing numbers of child obesity, which has encouraged new studies to identify a good anthropometric marker for high blood pressure levels. The objective this study was to identify the best anthropometric predictor of risk of hypertension in children between 8-10 years of age. The Children were evaluated for socioeconomic status and their blood pressure (BP), weight, height, waist circumference (WC) and percentage of body fat (PBF) were measured. The study included 445 children, of which 50.1% were females. The prevalence of obesity defined by body mass index (BMI) was 14.6%. Increased BP was found in 3.4% and 2.2% of the children, considering the pre-hypertension and hypertension classifications respectively. The arithmetic mean of BP value correlated significantly with BMI, WC and PBF. After height control, the correlations that were maintained significant were between WC and systolic blood pressure (SBP) and between WC and diastolic blood pressure (DBP). The variable with the highest predictive power of the occurrence of hypertension was WC. The results indicate that, in this population of children between 8 and 10 years old, WC is a measurement of higher value in predicting increased BP.
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Affiliation(s)
| | - Pollyanna Costa Cardoso
- Universidade Federal de Juiz de Fora. R. José de Tassis 350, Vila Bretas. 35030-250 Governador Valadares MG Brasil.
| | | | | | - Stela Brener
- Fundação e Centro de Hemoterapia e Hematologia de Minas Gerais. Belo Horizonte MG Brasil
| | | | - Maria Anete Santana Valente
- Universidade Federal de Juiz de Fora. R. José de Tassis 350, Vila Bretas. 35030-250 Governador Valadares MG Brasil.
| | - Cibele Velloso-Rodrigues
- Universidade Federal de Juiz de Fora. R. José de Tassis 350, Vila Bretas. 35030-250 Governador Valadares MG Brasil.
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Saldanha Filho N, Reuter CP, Renner JDP, Barbian CD, de Castro Silveira JF, de Borba Schneiders L, Pohl HH. Low levels of cardiorespiratory fitness and abdominal resistance are associated with metabolic risk in schoolchildren. J Pediatr Endocrinol Metab 2019; 32:455-460. [PMID: 31042640 DOI: 10.1515/jpem-2018-0236] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/07/2019] [Indexed: 01/07/2023]
Abstract
Background Low levels of physical fitness are associated with metabolic disorders in adults. However, this relationship has been little explored in children and adolescents. The aim of the present study was to investigate whether there is an association between physical fitness related to health and the presence of metabolic risk in schoolchildren. Methods The sample for this cross-sectional study was composed of 1251 schoolchildren of both genders between 7 and 17 years of age. Three indicators of physical fitness related to health were evaluated: cardiorespiratory fitness (CRF), flexibility and abdominal resistance. The continuous metabolic syndrome score (cMetS) was calculated by using the sum of the Z scores of the following indicators: body mass index (BMI), systolic blood pressure, glucose, total cholesterol, high- and low-density lipoprotein cholesterol (HDL-c and LDL-c) and triglycerides. Subsequently, the cMetS was dichotomized, considering the presence or absence of metabolic risk. The data were analyzed using prevalence ratio (PR) values and 95% confidence intervals (CI), using Poisson regression. Results A higher prevalence of metabolic risk was found among students with low levels of CRF (PR: 1.48; CI: 1.10-1.98) and abdominal resistance (PR: 1.45; CI: 1.08-1.95). No association with flexibility was found. Conclusions Low levels of CRF and abdominal resistance are associated with the presence of metabolic risk in schoolchildren.
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Affiliation(s)
- Neri Saldanha Filho
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,Department of Physical Education and Health, University of Santa Cruz do Sul - UNISC, Santa Cruz do Sul, Brazil
| | - Cézane Priscila Reuter
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,Department of Physical Education and Health, University of Santa Cruz do Sul - UNISC, Av. Independência, 2293 - Bl. 42, s. 4201, Santa Cruz do Sul, RS 96815-900, Brazil, Phone: +55 (51) 3717-7603, Fax: +55 (51) 3717-1855
| | - Jane Dagmar Pollo Renner
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,Department of Biology and Pharmacy, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Cláudia Daniela Barbian
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | | | - Letícia de Borba Schneiders
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Hildegard Hedwig Pohl
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,Department of Physical Education and Health, University of Santa Cruz do Sul - UNISC, Santa Cruz do Sul, Brazil
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Reuter CP, Andersen LB, de Moura Valim AR, Reuter ÉM, Borfe L, Renner JDP, de Mello ED. Cutoff points for continuous metabolic risk score in adolescents from southern Brazil. Am J Hum Biol 2019; 31:e23211. [PMID: 30635949 DOI: 10.1002/ajhb.23211] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/01/2018] [Accepted: 12/06/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE There is no consensus on the best diagnostic criteria for metabolic syndrome (MetS) in the child and adolescent population. Thus, the present study aimed to establish cutoff points for a continuous metabolic risk score (cMetS) in adolescents from southern Brazil. METHODS This was a cross-sectional study conducted between 2014 and 2015. The sample consisted of 1739 schoolchildren (985 girls), aged 10-17 years. cMetS was calculated by sum of the Z-score of the following parameters: waist circumference, systolic blood pressure, glucose, high-density lipoprotein cholesterol, triglycerides, and cardiorespiratory fitness. Three diagnostic criteria of MetS were used to create cut points for cMetS. RESULTS The best cutoff point for cMetS was set at 3.40 for boys (sensitivity: 100.0%, specificity: 92.9%, AUC: 0.978) and 3.61 for girls (sensitivity: 100, 0%, specificity: 93.1%, AUC: 0.991). For these cutoff points, metabolic risk was found in 8.9% of adolescents (9.4% for boys and 8.5% for girls). A linear relationship was found between the mean values of cMetS and the number of components of MetS (mean cMetS -1.09 for no component present and 6.66 for 3 or more components). CONCLUSIONS The use of cMetS is valid for adolescents and can detect a greater proportion of students with metabolic risk, compared to the current criteria for diagnosis of MetS.
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Affiliation(s)
- Cézane Priscila Reuter
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Departamento de Educação Física e Saúde, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil.,Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Lars Bo Andersen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Andréia Rosane de Moura Valim
- Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Éboni Marília Reuter
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Departamento de Educação Física e Saúde, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Leticia Borfe
- Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Jane Dagmar Pollo Renner
- Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Elza Daniel de Mello
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Vieira SA, Ribeiro AQ, Hermsdorff HHM, Pereira PF, Priore SE, Franceschini SDCC. WAIST-TO-HEIGHT RATIO INDEX OR THE PREDICTION OF OVERWEIGHT IN CHILDREN. ACTA ACUST UNITED AC 2017; 36:7. [PMID: 29166492 PMCID: PMC5849367 DOI: 10.1590/1984-0462/;2018;36;1;00002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 04/04/2017] [Indexed: 01/19/2023]
Abstract
Objective: To identify a low-cost abdominal adiposity index that has a higher accuracy in
predicting excess weight in children aged four to seven years old. Methods: A cross-sectional study with a sample of 257 children aged 4 to 7 years old.
Indicators of abdominal adiposity assessed were: waist circumference (WC),
waist-to-height ratio (WHR) and central fat percentage (measured by dual energy
X-ray absorptiometry - DEXA). Overweight children were classified using body mass
index by age (BMI/age). In the analysis, the prevalence ratio (PR) using Poisson
regression with a robust variance was estimated, and a receiver operating
characteristic (ROC) curve was built, with a statistical significance of
p<0.05. Results: The prevalence of overweight children was 24.9% and a higher median of all
abdominal adiposity indicators was observed in the overweight group. Children with
increased values of WC (PR=4.1; 95%CI 2.86-5.86), WHR (PR=5.76; 95%CI 4.14-8.02)
and a central fat percentage (PR=2.48; 95%CI 1.65-3.73) had a higher prevalence of
being overweight. Using the ROC curve analysis, the WHR index showed a higher area
under the curve, when compared to the WC and to the central fat percentage
estimated by DEXA for predicting the classification of being overweight. Conclusions: Given the results, WHR is suggested for the screening of overweight children.
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