Waist-to-height ratio is as reliable as biochemical markers to discriminate pediatric insulin resistance

J Pediatr (Rio J). 2019 Jul-Aug;95(4):428-434. doi: 10.1016/j.jped.2018.04.004. Epub 2018 May 7.

Abstract

Objective: Given the importance of incorporating simple and low-cost tools into the pediatric clinical setting to provide screening for insulin resistance, the present study sought to investigate whether waist-to-height ratio is comparable to biochemical markers for the discrimination of insulin resistance in children and adolescents.

Methods: This cross-sectional study involved students from nine public schools. In total, 296 children and adolescents of both sexes, aged 8-14 years, composed the sample. Waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio were determined according to standard protocols. Insulin resistance was defined as homeostatic model assessment for insulin resistance with cut-off point ≥ 3.16.

Results: Age, body mass index, frequency of overweight, waist circumference, waist-to-height ratio, insulin, glucose, homeostatic model assessment for insulin resistance, triglycerides, triglycerides/glucose index, and triglycerides-to-HDL-C were higher among insulin resistant boys and girls. Moderate correlation of all indicators (waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio) with homeostatic model assessment for insulin resistance was observed for both sexes. The areas under the receiver operational characteristic curves ware similar between waist-to-height ratio and biochemical markers.

Conclusion: The indicators provided similar discriminatory power for insulin resistance. However, taking into account the cost-benefit ratio, we suggest that waist-to-height ratio may be a useful tool to provide screening for insulin resistance in pediatric populations.

Keywords: Adolescentes; Adolescents; Children; Crianças; Insulin resistance; Razão cintura-altura; Razão triglicérides-HDL-C; Resistência à insulina; Triglycerides-to-HDL-C ratio; Triglycerides/glucose index; Waist-height ratio; Índice de triglicerídeos/glicose.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Biomarkers / analysis*
  • Blood Glucose / analysis*
  • Body Mass Index
  • Brazil
  • Child
  • Cholesterol, HDL / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Insulin Resistance / physiology*
  • Lipoproteins, HDL / blood
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / physiopathology*
  • Overweight / blood
  • Overweight / physiopathology
  • Triglycerides / blood
  • Waist Circumference / physiology*
  • Waist-Height Ratio*

Substances

  • Biomarkers
  • Blood Glucose
  • Cholesterol, HDL
  • HDL-triglyceride
  • Lipoproteins, HDL
  • Triglycerides