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The present study aimed to investigate whether the visceral adiposity index (VAI) is an effective predictor to identify unhealthy metabolic phenotype by comparing normal-weight and overweight individuals.
Design
A population-based cross-sectional study. Data were collected by interviews, anthropometric evaluation, dietetic, clinical and laboratory tests. The area under the receiver-operating characteristic curve (AUC) and prevalence ratio (PR), obtained from Poisson regression, were used to compare the predictive capacity of the obesity indicators evaluated (VAI, BMI, waist and neck circumference, waist-to-height and waist-to-hip ratios) and their association with the unhealthy metabolic phenotype. All analyses were stratified by sex and by nutritional status.
Setting
Viçosa, Minas Gerais, Brazil.
Participants
A total of 854 Brazilian adults (20–59 years old) of both sexes.
Results
VAI was the best predictor for unhealthy metabolic phenotype among men (AUC = 0·865) and women (AUC = 0·843) at normal weight. VAI also had the best predictive capacity among overweight women (AUC = 0·903). Among overweight men, its accuracy (AUC = 0·830) was higher than that of waist-to-hip ratio. In the adjusted regression models, VAI was the indicator most strongly associated with the unhealthy metabolic phenotype, especially among those with normal weight (PR = 6·74; 95 % CI 3·15, 14·42 for men; PR = 7·14; 95 % CI 3·79, 13·44 for women).
Conclusions
VAI has better predictive capacity in detecting unhealthy metabolic phenotype than conventional anthropometric indicators, regardless of nutritional status and sex.
To evaluate agreement of the body adiposity index (BAI) and paediatric body adiposity index (BAIp) in estimating body fat compared with dual-energy X-ray absorptiometry (DXA) and to propose cut-off points for these indices to classify excess adiposity in Brazilian children and adolescents.
Design
Cross-sectional study. Measures of weight, height, hip circumference, BMI and body fat percentage (%BF) assessed by DXA were taken, and BAI and BAIp were calculated. The Bland–Altman plot was used to estimate agreement between the methods, and the receiver-operating characteristic curve to determine the cut-off points for BAI and BAIp per age and sex in comparison with DXA.
Setting
Viçosa, Minas Gerais, Brazil.
Subjects
Children and adolescents aged 8–19 years (n 1049).
Results
Of the children and adolescents, 52·4 % were girls. BAI and BAIp had satisfactory performance by the receiver-operating characteristic curve, except for the 18–19 years age group, whose BAIp had better predictive capacity than BAI. The agreement analysis showed that BAI overestimated %BF by 2·64 %, on average, using DXA; while BAIp underestimated %BF by 3·37 %.
Conclusions
BAI and BAIp showed low agreement with the body fat obtained by DXA, requiring caution when interpreting body composition data in children and adolescents.
To evaluate the ability of anthropometric measurements to identify excess android fat and to propose cut-off points for excess central adiposity in children, according to age and sex.
Design
A cross-sectional study with children from a municipality of Minas Gerais, Brazil. Receiver-operating characteristic curve analyses were performed to evaluate waist circumference (WC), waist-to-height ratio (WHtR) and conicity index (C-index) in estimating excess android fat by dual energy X-ray absorptiometry (DXA).
Setting
Viçosa, Minas Gerais, Brazil.
Subjects
Children aged 4–9 years (n 788).
Results
Overweight prevalence was 29·1 % and android fat percentage was higher among girls. All central fat measurements were able to discriminate excess android fat in the age groups evaluated, especially WC and WHtR, with cut-off points showing good sensitivity and specificity overall.
Conclusions
Because these methods are easy to obtain and inexpensive, it is possible to use WC, WHtR and C-index in population surveys to evaluate central obesity. The proposed cut-off points showed satisfactory values of sensitivity and specificity and can be used in epidemiological studies.
To evaluate the effectiveness of anthropometric measures and physical activity level in the prediction of metabolic syndrome (MetS) in children.
Design
Cross-sectional study with children from public and private schools. Children underwent an anthropometric assessment, blood pressure measurement and biochemical evaluation of serum for determination of TAG, HDL-cholesterol and glucose. Physical activity level was calculated and number of steps per day obtained using a pedometer for seven consecutive days.
Setting
Viçosa, south-eastern Brazil.
Subjects
Boys and girls (n 187), mean age 9·90 (sd 0·7) years.
Results
Conicity index, sum of four skinfolds, physical activity level and number of steps per day were accurate in predicting MetS in boys. Anthropometric indicators were accurate in predicting MetS for girls, specifically BMI, waist circumference measured at the narrowest point and at the level of the umbilicus, four skinfold thickness measures evaluated separately, the sum of subscapular and triceps skinfold thickness, the sum of four skinfolds and body fat percentage.
Conclusions
The sum of four skinfolds was the most accurate method in predicting MetS in both genders.
To examine the relative contribution for the prediction of hypertension by waist circumference (WC), waist:stature ratio (WSR) or waist:hip ratio (WHR) with that by BMI, to ascertain if WC, WSR or WHR enhances the prediction of hypertension by BMI.
Design
Population-based, cross-sectional study. A change of ≥10 % in the prevalence ratio of BMI (PR) or the area under the receiver-operating characteristic curve (AUC) when WC, WSR or WHR was added to a model with BMI was used as the criterion for significant contribution to the prediction of hypertension by BMI. For greater contributions (≥10 %) these waist measures were considered as better predictors.
Setting
Nine provinces in China.
Subjects
Chinese adults aged 18 to 65 years (n 7336) who participated in the 2004 China Health and Nutrition Survey.
Results
The prevalence of hypertension (17 % and 23 % for women and men, respectively) was significantly related to increased BMI, WC, WSR and WHR (P for trend <0·001). Although there was a better model fit when WC, WSR or WHR was added to a model with BMI (P < 0·05; likelihood ratio test), the changes in PR and AUC were <10 % and <5 %, respectively. The sex-specific AUC for the prediction of hypertension by BMI (of 0·7–0·8) was similar to that by WC, WSR or WHR.
Conclusions
The waist indices do not perform better than BMI or markedly enhance the prediction of increased hypertension risk by BMI in Chinese adults.
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