Tendência secular do estado nutricional, capacidade preditiva e pontos de corte de índices antropométricos para identificar adiposidade corporal e risco cardiometabólico em adolescentes
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2019-02-19
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Universidade Federal de Viçosa
Resumo
A adolescência é um período de vulnerabilidade para ocorrência de excesso de peso. A obesidade, sendo a doença crônica não transmissível mais prevalente também entre crianças e adolescentes, está relacionada a ocorrência de complicações na vida adulta, inclusive o desenvolvimento de doenças cardiometabólicas. A antropometria é um método eficaz para avaliar a situação nutricional de indivíduos, sendo que os índices antropométricos utilizados na avaliação do excesso de peso podem ter bom desempenho na identificação de risco cardiometabólico. Sendo assim, esse estudo teve como objetivo avaliar a tendência secular do estado nutricional, a capacidade preditiva e pontos de corte de índices antropométricos (IMC, RCE, RCQ, ICo, IAC e BRI) para identificar adiposidade corporal e risco cardiometabólico em adolescentes, de acordo com o sexo e fase da adolescência. Realizou-se estudo transversal com 2369 adolescentes. Utilizou-se dados secundários de pesquisas realizadas nos anos de 2002 a 2017, em Viçosa-MG, aprovadas pelo Comitê de Ética em Pesquisa com Seres Humanos da UFV. Avaliou-se medidas antropométricas e de composição corporal, e calculou-se os índices antropométricos, Índice de Massa Corporal (IMC), Relação Cintura/Estatura (RCE), Relação Cintura/Quadril (RCQ), Índice de Conicidade (ICo), Índice de Adiposidade Corporal (IAC) e Body Roudness Index (BRI) foram calculados. Avaliou-se a pressão arterial e parâmetros bioquímicos. O risco cardiometabólico foi identificado avaliando-se o número de fatores de risco, hipertensão arterial, dislipidemia, resistência à insulina e diabetes, agrupados da seguinte forma: presença de um, dois e três ou mais fatores de risco. As análises estatísticas foram realizadas nos softwares Statistical Package for the Social Sciences (SPSS) for Windows, versão 20.0 e MedCalc versão 9.3 e adotou-se como nível de significância estatística p<0,05. A maioria dos adolescentes era do sexo feminino (69,3%) e 41,1% tinha idade de 14 a 16 anos. A maioria estava eutrófica, mas 22,7% com sobrepeso/obesidade, e 1,3% com baixa estatura para idade. A maior proporção de adolescentes com obesidade (53,1%) foi observada na fase inicial da adolescência (p<0,05). Ao longo dos anos houve diminuição na prevalência de eutrofia e aumento nas prevalências de sobrepeso e obesidade. A análise das curvas ROC permitiram determinar pontos de corte para os índices avaliados, para determinar excesso de gordura corporal, de acordo com o sexo e fase da adolescência. Adolescentes com excesso de gordura corporal apresentaram prevalências superiores de fatores de risco cardiometabólico em relação aos eutróficos. Os indicadores analisados apresentaram melhor desempenho para predizer fatores de risco quando agrupados em três ou mais. Após a análise dos 15 anos, observou-se mudanças importantes no estado nutricional dos adolescentes, demonstrando que esta população está passando pela transição nutricional, com diminuição na prevalência de eutrofia e aumento nas prevalências de sobrepeso e obesidade. Confirmando a necessidade da avaliação antropométrica e acompanhamento da situação nutricional nesta faixa etária. Devido às limitações do IMC, é aconselhável a sua complementação na avaliação nutricional, com outros índices que garantam a estimativa adequada do percentual de gordura corporal e do rsico cardiometabólico. A RCE e o IAC são alternativas de fácil obtenção. O IAC, diferente da RCE, fornece uma estimativa direta do percentual de gordura corporal total, de forma que estes índices podem ser utilizados em conjunto para uma avaliação mais completa do estado nutricional.
Adolescence is a period of vulnerability to the occurrence of overweight. Obesity, being the chronic noncommunicable disease more prevalent also among children and adolescents, is related to the occurrence of complications in adult life, including the development of cardiometabolic diseases. Anthropometry is an effective method to evaluate the nutritional status of individuals, and the anthropometric indices used in the evaluation of excess weight may perform well in the identification of cardiometabolic risk. The objective of this study was to evaluate the nutritional status, predictive capacity and cutoff points of the anthropometric indices (BMI, ECR, WHR, ICo, IAC and BRI) to identify body adiposity and cardiometabolic risk in adolescents. According to sex and stage of adolescence. A cross-sectional study was conducted with 2,369 adolescents. Secondary research data from 2002 to 2017, in Viçosa-MG, were approved by the Research Ethics Committee with Human Beings of UFV. The body mass index (BMI), waist-to-height ratio (ECR), waist-hip ratio (WHR), conicity index (ICo), Body Addiction index (IAC) and body change index (BMI) were calculated. Blood pressure and biochemical parameters were evaluated. Cardiometabolic risk was identified by the number of risk factors, arterial hypertension, dyslipidemia, insulin resistance and diabetes, grouped as follows: presence of one, two and three or more risk factors. Statistical analyzes were performed using the Statistical Package for the Social Sciences (SPSS) for Windows, version 20.0 and MedCalc version 9.3, and were adopted as a statistical significance level of p <0.05. The majority of adolescents were female (69.3%) and 41.1% were between 14 and 16 years of age. The majority were eutrophic, but 22.7% were overweight / obese and 1.3%, short stature for age. The highest proportion of adolescents with obesity (53.1%) was observed in the early adolescence phase (p <0.05). Over the years, there was a decrease in the prevalence of eutrophication and an increase in the prevalence of overweight and obesity. The analysis of the ROC curves allowed to determine the cutoff points for the indices evaluated, to determine the excess body fat, according to the sex and the phase of the adolescence. Adolescents with excess body fat presented higher prevalences of cardiometabolic risk factors in relation to eutrophic ones. The analyzed indicators presented better performance to predict risk factors when grouped in three or more. After the analysis of the 15 years, important changes were observed in the nutritional status of the adolescents, demonstrating that this population is in nutritional transition, with a decrease in the prevalence of eutrophy and an increase in the prevalence of overweight and obesity. Confirming the need for anthropometric evaluation and monitoring of nutritional status in this age group. Due to the limitations of the BMI, it is recommended to complement it in the nutritional assessment, with other indexes that guarantee the adequate estimation of the body fat percentage and the cardiometabolic risk. The RCE and the IAC are easy to obtain alternatives. IAC, in addition to ECR, provides a direct estimate of the percentage of total body fat, so that these indexes can be used together for a more complete assessment of nutritional status.
Adolescence is a period of vulnerability to the occurrence of overweight. Obesity, being the chronic noncommunicable disease more prevalent also among children and adolescents, is related to the occurrence of complications in adult life, including the development of cardiometabolic diseases. Anthropometry is an effective method to evaluate the nutritional status of individuals, and the anthropometric indices used in the evaluation of excess weight may perform well in the identification of cardiometabolic risk. The objective of this study was to evaluate the nutritional status, predictive capacity and cutoff points of the anthropometric indices (BMI, ECR, WHR, ICo, IAC and BRI) to identify body adiposity and cardiometabolic risk in adolescents. According to sex and stage of adolescence. A cross-sectional study was conducted with 2,369 adolescents. Secondary research data from 2002 to 2017, in Viçosa-MG, were approved by the Research Ethics Committee with Human Beings of UFV. The body mass index (BMI), waist-to-height ratio (ECR), waist-hip ratio (WHR), conicity index (ICo), Body Addiction index (IAC) and body change index (BMI) were calculated. Blood pressure and biochemical parameters were evaluated. Cardiometabolic risk was identified by the number of risk factors, arterial hypertension, dyslipidemia, insulin resistance and diabetes, grouped as follows: presence of one, two and three or more risk factors. Statistical analyzes were performed using the Statistical Package for the Social Sciences (SPSS) for Windows, version 20.0 and MedCalc version 9.3, and were adopted as a statistical significance level of p <0.05. The majority of adolescents were female (69.3%) and 41.1% were between 14 and 16 years of age. The majority were eutrophic, but 22.7% were overweight / obese and 1.3%, short stature for age. The highest proportion of adolescents with obesity (53.1%) was observed in the early adolescence phase (p <0.05). Over the years, there was a decrease in the prevalence of eutrophication and an increase in the prevalence of overweight and obesity. The analysis of the ROC curves allowed to determine the cutoff points for the indices evaluated, to determine the excess body fat, according to the sex and the phase of the adolescence. Adolescents with excess body fat presented higher prevalences of cardiometabolic risk factors in relation to eutrophic ones. The analyzed indicators presented better performance to predict risk factors when grouped in three or more. After the analysis of the 15 years, important changes were observed in the nutritional status of the adolescents, demonstrating that this population is in nutritional transition, with a decrease in the prevalence of eutrophy and an increase in the prevalence of overweight and obesity. Confirming the need for anthropometric evaluation and monitoring of nutritional status in this age group. Due to the limitations of the BMI, it is recommended to complement it in the nutritional assessment, with other indexes that guarantee the adequate estimation of the body fat percentage and the cardiometabolic risk. The RCE and the IAC are easy to obtain alternatives. IAC, in addition to ECR, provides a direct estimate of the percentage of total body fat, so that these indexes can be used together for a more complete assessment of nutritional status.
Descrição
Palavras-chave
Adolescentes - Nutrição, Antropometria, Composição corporal
Citação
MORAIS, Núbia de Souza de. Tendência secular do estado nutricional, capacidade preditiva e pontos de corte de índices antropométricos para identificar adiposidade corporal e risco cardiometabólico em adolescentes. 2019. 125 f. Dissertação (Mestrado em Ciência da Nutrição) - Universidade Federal de Viçosa, Viçosa. 2019.