Identification of neck circumference cut-off points for insulin resistance as a marker in adolescents
Palabras clave:
Adolescent, Anthropometry, Insulin resistance, NeckResumen
Objective
To identify cut-off points of neck circumference measurement to predict insulin resistance in adolescents.
Methods
Cross-sectional analysis with data derived from the Study of Cardiovascular Risks in Adolescents, nationwide, multicenter, school-based survey. We evaluated 901 adolescents, aged 12 to 17, from public and private schools in two cities of Sergipe state in Brazil. We measured demographic, anthropometric, and biochemical data, and insulin resistance using Homeostasis Model Assessment-Insulin Resistance. We used multiple linear regression and logistic analysis to evaluate the association between dependent variables (biochemical) and independent variables (anthropometric) controlled by body mass index, age, gender, and Tanner’s stage. We used the Receiver operating characteristic curve to determine cut-off points of neck circumference that can identify insulin resistance.
Results
The multiple linear regression analysis showed a positive association between neck circumference measurement with fasting glycemia and glycated hemoglobin (p<0.001) and a negative association with insulin (p<0.024). Furthermore, in logistic regression, the measurement of neck circumference was the only anthropometric indicator positively correlated with homeostasis model assessment-insulin resistance. The cut-off points of neck circumference for predicting insulin resistance were: 30.55cm for female pubertal and 32.10cm for post-pubertal adolescents; 35.90cm for male pubertal adolescents and 36.65cm for post-pubertal adolescents.
Conclusion
The measurement of neck circumference is a simple, practical anthropometric indicator and can be used as a screening tool to identify insulin resistance in adolescents.
Citas
Joshipura K, Muñoz-Torres F, Vergara J, Palacios C, Pérez CM. Neck circumference may be a better alternative to standard anthropometric measures. J Diabetes Res. 2016;2016:8.
Santos D, Contarato AAPF, Kroll C, Bertoli M, Czarnobay SA, Figueirêdo KBW, et al. Neck circumference as a complementary measure to identify excess body weight in children aged 13-24 months. Rev Bras Saúde Mater Infant. 2015;15(3):301-7.
Ferretti RDL, Cintra IDP, Passos MAZ, Ferrari GLDM, Fisberg M. Elevated neck circumference and associated factors in adolescents. Bmc Public Health. 2015;15(208):1-10.
Pandzic Jaksic V, Grizelj D, Livun A, Boscic D, Ajduk M, Kusec R, et al. Neck adipose tissue-tying ties in metabolic disorders. Horm Mol Biol Clin Investig. 2018;33(2):1-9.
Palhares HMC, Zaidan PC, Dib FCM, Silva AP, Resende DCS, Borges MF. Associação entre acantose nigricans e outros fatores de risco cardiometabólico em crianças e adolescentes com sobrepeso e obesidade. Rev Paul Pediatr. 2018;36(3):301-8.
Mutsert R, Gast K, Widya R, Koning E, Jazet I, Lamb H, et al. Associations of abdominal subcutaneous and visceral fat with insulin resistance and secretion differ between men and women: the Netherlands epidemiology of obesity study. Metab Syndr Relat Disord. 2018;16(1):54-63.
Caprio S, Perry R, Kursawe R. Adolescent obesity and insulin resistance: roles of ectopic fat accumulation and adipose inflammation. Gastroenterology. 2017;152(7):1638-46. https://doi.org/10.1053/j.gastro.2016.12.051
Kelsey MM, Zeitler PS. Insulin resistance of puberty. Curr Diab Rep. 2016;16(7). https://doi.org/10.1007/s11892-016-0751-5
Andrade MIS. Consumo alimentar de micronutrientes antioxidantes e resistência à insulina em adolescentes brasileiros [tese]. Universidade Federal de Pernambuco; 2019.
Fantin F, Comellato G, Rossi AP, Grison E, Zoico E, Mazzali G, et al. Relationship between neck circumference, insulin resistance and arterial stiffness in overweight and obese subjects. Eur J Prev Cardiol. 2017;24(14):1532-40.
Assyov Y, Gateva A, Tsakova A, Kamenov Z. A comparison of the clinical usefulness of neck circumference and waist circumference in individuals with severe obesity. Endocr Res. 2017;42(1):6-14. https://doi.org/10.3109/07435800.2016.1155598
Vasconcellos MTL, Silva PLN, Szklo M, Kuschnir MCC, Klein CH, Abreu GDA, et al. Desenho da amostra do Estudo do Risco Cardiovascular em Adolescentes (ERICA). Cad Saúde Pública. 2015;31(5):1-10.
Bloch KV, Szklo M, Kuschnir MCC, Abreu GA, Barufaldi LA, Klein CH, et al. The study of cardiovascular risk in adolescents ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in Brazilian adolescents. Bmc Public Health. 2015;15(1):1-10.
Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Org. 2007;85(9):660-7.
Habicht J-P. Estandarizacion de metodos epidemiologicos cuantitativos sobre el terreno. Bol Sanit Panam. 1974;76(5):375-84.
Andrade MIS. Homa-Ir e fatores de risco cardiometabólico e consumo alimentar de adolescentes [dissertação]. Universidade Federal de Pernambuco; 2016.
Tanner JM. Growth at adolescence. 2nd ed. Oxford: Blackiwell; 1962.
Gobato AO, Carolina A, Vasques J, Zambon MP, Azevedo A, Filho B, et al. Síndrome metabólica e resistência à insulina em adolescentes obesos Metabolic syndrome and insulin resistance in obese adolescents. Rev Paul Pediatr. 2014;32(1):55-62.
Volaco A, Martins C, Soares J, Cavalcanti A, Moyses S, Filho R, et al. Neck circumference and its correlation to other anthropometric parameters and finnish diabetes risk score (FINDRISC). Curr Diabetes Rev. 2018;14(5):464-71.
Silva CC, Zambon MP, Vasques ACJ, Rodrigues AMB, Camilo DF, Antonio MÂRGM, et al. Circunferência do pescoço como um novo indicador antropométrico para predição de resistência à insulina e componentes da síndrome metabólica em adolescentes: Brazilian Metabolic Syndrome Study. Rev Paul Pediatr. 2014;32(2):221-9.
Guimarães MR, Alves A, Santos D, Fernanda T, Moura R, Rocha MR, et al. Alterações clínicas, metabólicas e resistência à insulina entre adolescentes. Acta Paul Enferm. 2019;32(6):608-16.
Gomez-Arbelaez D, Camacho PA, Cohen DD, Saavedra-Cortes S, Lopez-Lopez C, Lopez-Jaramillo P. Neck circumference as a predictor of metabolic syndrome, insulin resistance and low-grade systemic inflammation in children: The ACFIES study. Bmc Pediatr. 2016;16(1):1-9.
Costa CS, Rauber F, Leffa PS, Sangalli CN, Campagnolo PDB, Vitolo MR. Ultra-processed food consumption and its effects on anthropometric and glucose profile: a longitudinal study during childhood. Nutr Metab Cardiovasc Dis. 2018;29(2):177-84. https://doi.org/10.1016/j.numecd.2018.11.003
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Derechos de autor 2022 Ingrid Ribeiro da Cruz Melo, Mácia Ferreira Cândido de Souza, Íkaro Daniel de Carvalho Barreto, Danielle Góes da Silva, Ricardo Queiroz Gurgel
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
