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Cut-off points in the waist:height ratio for the prediction of insulin resistance, second stage of sexual maturation in Brazilian adolescents

Published online by Cambridge University Press:  08 March 2022

Pamela Rodrigues Martins Lins Open the ORCID record for Pamela Rodrigues Martins Lins [Opens in a new window] ,
Adélia da Costa Pereira de Arruda Neta Open the ORCID record for Adélia da Costa Pereira de Arruda Neta [Opens in a new window]  and
Rodrigo Pinheiro de Toledo Vianna
Pamela Rodrigues Martins Lins*
Affiliation:
Department of Nutrition, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
Adélia da Costa Pereira de Arruda Neta
Affiliation:
Department of Nutrition, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
Rodrigo Pinheiro de Toledo Vianna
Affiliation:
Department of Nutrition, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
*
*Corresponding author: Pamela Rodrigues Martins Lins, email martins.pamela@gmail.com
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Abstract

The objective of this study was verify the best waist:height ratio (WHtR) cut-off points for the prediction of insulin resistance (IR) according to stage of sexual maturation in Brazilian adolescents. Data were analysed from 37 759 adolescents between 12 and 17 years of age, of both sexes, participating in the ERICA study on cardiovascular risk factors in adolescents (‘Estudo de Riscos Cardiovasculares em Adolescentes – ERICA’). The following variables were included sex, age and sexual maturity according to the Tanner stage, waist circumference, height, WHtR, fasting insulin and fasting blood sugar so as to obtain the homeostasis model assessment-estimated insulin resistance (HOMA-IR). We constructed an Receiver Operating characteristic (ROC) curve for each group in order to determine the best WHtR cut-off points for the sample stratified by sex and stratified by sex and sexual maturation stage. The female sex corresponded to 60% of the sample, with a mean age of 14·7 years (sd ± 0·08 years) and 13·1 % had IR. The prediction of IR through the WHtR indicator was better for boys, where all the areas under the ROC curve were superior to 0·70. When stratifying by sex alone, the best WHtR cut-off points found were equal to 0·45 for girls and 0·44 for boys. When stratifying by Tanner maturation stages, the cut-off points were reduced with advancing sexual maturation in the male group, while the opposite occurred in the female group. Among Brazilian adolescents, WHtR is a good predictor of IR evaluated by HOMA-IR, but different cut-off points should be adopted according to sex and sexual maturation stage.

Keywords

Waist heightInsulin resistanceSexual maturationAdolescents
Type
Research Article
Information
British Journal of Nutrition , Volume 130 , Issue 2 , 28 July 2023 , pp. 353 - 359
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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