Hypertriglyceridemic Waist Phenotype Indicates Insulin Resistance in Adolescents According to the Clamp Technique in the BRAMS Study

Hypertriglyceridemic Waist Phenotype Indicates Insulin Resistance in Adolescents According to the Clamp Technique in the BRAMS Study

Author Barreiro-Ribeiro, Francieli Google Scholar
Junqueira Vasques, Ana Carolina Google Scholar
da Silva, Cleliani de Cassia Google Scholar
Zambon, Mariana Porto Google Scholar
De Bernardi Rodrigues, Ana Maria Google Scholar
Camilo, Daniella Fernandes Google Scholar
de Goes Monteiro Antonio, Maria Angela Reis Google Scholar
Dâmaso, Ana Raimunda Autor UNIFESP Google Scholar
da Silveira Campos, Raquel Munhoz Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Mello, Marco Tulio de Autor UNIFESP Google Scholar
Geloneze, Bruno Google Scholar
Abstract Objective: This study aimed to identify cutoff points for detecting hypertriglyceridemic waist phenotype (HTWP) in adolescents and to investigate the association of the HTWP with insulin resistance (IR) and metabolic syndrome components. Methods: A multicentric cross-sectional study of 861 adolescents (10-19 years of age, 504 girls) was conducted. Pubertal stage, anthropometric, and laboratory parameters were assessed. IR was assessed by Homeostasis Model Assessment for Insulin Resistance (HOMA1-IR) index and hyperglycemic clamp (n = 80). HTWP was defined by the presence of increased plasma triglycerides (TGs) and increased waist circumference (WC) according to cutoff points obtained in ROC curve analysis given the HOMA1-IR index as a reference method. Results: Cutoffs for WC and TGs, with a higher sum of sensitivity (S) and specificity (E), were, respectively: >84cm (S:65.1%, E:71.9%) and >87mg/dL (S:65.1%, E:73.4%) in pubertal girls

>88.5cm (S:80.2%, E:60.2%) and >78mg/dL (S:60.5%, E:53.2%) in postpubertal girls

>94cm (S:73.1%, E:83.1%) and >79mg/dL (S:61.5%, E:60.2%) in pubertal boys

and >99cm (S:81.3%, E:78.7%) and >86mg/dL in postpubertal boys (S:68.1%, E:60.7%). HTWP frequency was 27.5%. In the phenotype presence, after adjustment for age and pubertal stage, blood pressure and fasting glucose levels were elevated and high-density lipoprotein cholesterol was lower (p<0.001). Adolescents with the HTWP showed more IR, evaluated both by the HOMA1-IR and by the clamp test (p<0.003). Conclusion: The findings suggest HTWP as an IR status in adolescents. Cutoff point standardization for gender and pubertal stage, combined with the ease of application of the method, may allow their use for screening adolescents who would most benefit from lifestyle changes.
xmlui.dri2xhtml.METS-1.0.item-coverage New Rochelle
Language English
Sponsor Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Grant number CNPq: 563664/2010-0
CAPES: 01-P-4346-2015
Date 2016
Published in Childhood Obesity. New Rochelle, v. 12, n. 6, p. 446-454, 2016.
ISSN 2153-2168 (Sherpa/Romeo, impact factor)
Publisher Mary Ann Liebert, Inc
Extent 446-454
Origin http://dx.doi.org/10.1089/chi.2016.0180
Access rights Closed access
Type Article
Web of Science ID WOS:000388194200006
URI https://repositorio.unifesp.br/handle/11600/56667

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