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Proposal of cut points for the indication of abdominal obesity among adolescents

Rômulo Araújo Fernandes et al. Diego Giulliano Destro Chritofaro Jamile Sanches Codogno Camila Buonani … Denise Rodrigues Bueno Arli Ramos de Oliveira Clara Suemi da Costa Rosa Ismael Forte Freitas Júnior

BACKGROUND: The absence of critical values for the cardiovascular risk identification among Brazilian adolescents represents an important limitation. OBJECTIVES: To prepare critical values for the waist circumference and to analyze its efficiency in indicating increased values of the arterial pressure. METHODS: Transversal study that evaluated 1,145 adolescents, from 11 to 17 years old (536 of the male sex and 609 of the female), their body weight values, stature, resistance, reactance, tricipital cutaneous fold, waist circumference and arterial pressure (n = 334) were collected. The abdominal obesity was indicated by waist circumference values. RESULTS: The obese adolescents presented higher waist circumference values and, independently of the gender and age group, there was a significant relation between the waist circumference values and all the adiposity indicators adopted in the study. The proposed critical values presented higher sensibility in indicating increased values of the arterial pressure. CONCLUSIONS: The critical values proposed for the waist circumference were more sensitive in the indication of increased values of the blood pressure. However, other studies to investigate their efficacy in the indication of other clinical and laboratorial parameters are still needed.

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Different measurements of the sagittal abdominal diameter and waist perimeter in the prediction of HOMA-IR

Ana Carolina Junqueira Vasques et al. Lina Enriqueta Frandsen Paez de Lima Rosado Gilberto Paixão Rosado Rita de Cassia Lanes Ribeiro … Sylvia do Carmo Castro Franceschini Bruno Geloneze Silvia Eloiza Priore Dirce Ribeiro de Oliveira

BACKGROUND: The correlation between the increase in visceral fat and insulin resistance makes the sagittal abdominal diameter and the waist perimeter as potential tools for the prediction of insulin resistance. OBJECTIVE: To assess the reproducibility of different measurements of the sagittal abdominal diameter and the waist perimeter and analyze the discriminating power of the measurements when predicting insulin resistance. METHODS: A total of 190 adult males were studied. The sagittal abdominal diameter (smallest girth, larger abdominal diameter, umbilical level and midpoint between the iliac crests) and the waist perimeter (umbilical level, smallest girth, immediately above the iliac crest and midpoint between the iliac crest and the last rib) were measured at four different sites. Insulin resistance was assessed by the homeostasis model of assessment-insulin resistance (HOMA-IR) index. RESULTS: All measurements presented an intraclass correlation of 0.986-0.999. The sagittal abdominal diameter measured at the smallest girth (r=0.482 and AUC=0.739±0.049) and the waist perimeter measured at the midpoint between the last rib and the iliac crest (r=0.464 and AUC=0.746±0.05) presented the highest correlations with the HOMA-IR and the best discriminating power for HOMA-IR according to the ROC analysis (p<0.001). CONCLUSION: The sagittal abdominal diameter and waist perimeter showed to be highly reproducible and the sagittal abdominal diameter (smallest girth) and waist perimeter (midpoint between the iliac crest and the last rib) presented the best performance when predicting HOMA-IR. Further studies in other groups of the Brazilian population must be carried out to allow the use of these indicators of insulin resistance in the population as a whole, following standardized procedures.

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Effects of aerobic and anaerobic exercise on cardiac risk variables in overweight adults

Mônica Medeiros Moreira et al. Helder Porto Carozo de Souza Paulo Adriano Schwingel Cloud Kennedy Couto de Sá Cláudio Cesar Zoppi

BACKGROUND: Aerobic exercise is an important ally in the fight against cardiovascular risk factors. However, the effects of high-intensity exercise on these factors are still poorly known. OBJECTIVE: To compare the effects of aerobic and anaerobic exercise protocols on cardiac risk factors. METHODS: 22 individuals with mean age of 40±8 years were distributed into the following groups: control (CO), endurance training (ET) and interval training (IT). The protocols lasted 12 weeks, three times a week, with intensities of 10% below and 20% above the anaerobic threshold (AnT). The following measurements were taken: total body mass (TBM), body mass index (BMI), waist circumference (WC), hip circumference (HC), and body composition, in addition to plasma concentrations of glucose (GLU), total cholesterol (CHO), and triglycerides (TG). Waist-hip ratio (WHR) and conicity index (C index) were also calculated. RESULTS: The TBM, BMI, WC, GLU, and body composition variables showed significant changes in the ET and IT groups. CHO and HC values were significantly reduced in the ET group, whereas WHR showed a significant reduction in the IT group. AnT and C index in the IT group were significantly different in relation to ET. CONCLUSION: In view of the differences found in the results of the variables studied in relation to the training performed, we conclude that an exercise program that includes both high and low-intensity activities is more efficient to ensure the reduction of a greater number of cardiac risk variables.

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Body mass index and waist circumference as markers of arterial hypertension in adolescents

Maria Luiza Garcia Rosa et al. Evandro Tinoco Mesquita Emanuel Ribeiro Romeiro da Rocha Vânia de Matos Fonseca

OBJECTIVE: To evaluate the sensitivity and specificity of anthropometric measurements of body fat in a sample of Brazilian adolescents for the prediction of hypertension. METHODS: The arterial blood pressure was measured on two visits in a sample of 456 students aged 12 to 17 years, from public and private schools of the Fonseca neighborhood, in Niterói, between 2003 and 2004. A subject was defined as hypertensive if he/she had systolic and diastolic pressures above the 95th percentile for sex, age and height. A questionnaire was applied and Body Mass Index (BMI) and waist circumference (WC) measurements were made. RESULTS: A statistically significant correlation was observed between hypertension and the cutoff points considered unfavorable, both for BMI and WC. The greatest association was with the cutoff point proposed for the Brazilian population. As to the BMI sensitivity used for American Black or White populations or for the Brazilian population, we found 52.4% to 57.1% and 52.4%, respectively. And BMI specificity was 69.3%, 70.0% and 80.88%, respectively. The sensitivity found in our sample, relative to the cutoff points for WC proposed for all American ethnic groups, was also low (45.0%) and specificity was a little higher (77.6% and 74.5%, respectively). CONCLUSION: Existing American WC measurements showed low sensitivity and specificity for hypertension in our population. As to BMI, the available cutoff points also showed a low level of sensitivity. There is a need to establish body fat cutoff points that can provide a better prediction of cardiovascular risk.

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Proposal of cut points for the indication of abdominal obesity among adolescents

Different measurements of the sagittal abdominal diameter and waist perimeter in the prediction of HOMA-IR

Effects of aerobic and anaerobic exercise on cardiac risk variables in overweight adults

Body mass index and waist circumference as markers of arterial hypertension in adolescents

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