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      Waist Circumference and Abdominal Volume Index Can Predict Metabolic Syndrome in Adolescents, but only When the Criteria of the International Diabetes Federation are Employed for the Diagnosis

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          Abstract

          We previously reported, using the diagnostic criteria of the International Diabetes Federation (IDF), that waist circumference (WC) and abdominal volume index (AVI) were capable of predicting metabolic syndrome (MetS) in adolescents. This study was aimed at confirming this finding when other diagnostic criteria are used. A cross-sectional study was performed on 981 Spanish adolescents (13.2 ± 1.2 years). MetS was diagnosed by eight different criteria. Ten anthropometric indexes were calculated and receiver-operator curves (ROC) were created to determine their discriminatory capacity for MetS. Of all diagnostic criteria, the ones proposed by the IDF showed the highest mean values for weight, WC and systolic blood pressure in boys and girls with MetS, and the lowest for glucose and triglycerides in boys. ROC analysis showed that only WC, AVI and body roundness index (BRI) achieved area under the curve (AUC) values above 0.8 in boys, and that fat content, body mass index (BMI), WC, AVI, BRI and pediatric body adiposity index (BAIp) showed AUC values above 0.8 in girls. Importantly, this occurred only when diagnosis was carried out using the IDF criteria. We confirm that WC and AVI can predict MetS in adolescents but only when the IDF’s diagnostic criteria are employed.

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          A New Body Shape Index Predicts Mortality Hazard Independently of Body Mass Index

          Background Obesity, typically quantified in terms of Body Mass Index (BMI) exceeding threshold values, is considered a leading cause of premature death worldwide. For given body size (BMI), it is recognized that risk is also affected by body shape, particularly as a marker of abdominal fat deposits. Waist circumference (WC) is used as a risk indicator supplementary to BMI, but the high correlation of WC with BMI makes it hard to isolate the added value of WC. Methods and Findings We considered a USA population sample of 14,105 non-pregnant adults ( ) from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 with follow-up for mortality averaging 5 yr (828 deaths). We developed A Body Shape Index (ABSI) based on WC adjusted for height and weight: ABSI had little correlation with height, weight, or BMI. Death rates increased approximately exponentially with above average baseline ABSI (overall regression coefficient of per standard deviation of ABSI [95% confidence interval: – ]), whereas elevated death rates were found for both high and low values of BMI and WC. ( – ) of the population mortality hazard was attributable to high ABSI, compared to ( – ) for BMI and ( – ) for WC. The association of death rate with ABSI held even when adjusted for other known risk factors including smoking, diabetes, blood pressure, and serum cholesterol. ABSI correlation with mortality hazard held across the range of age, sex, and BMI, and for both white and black ethnicities (but not for Mexican ethnicity), and was not weakened by excluding deaths from the first 3 yr of follow-up. Conclusions Body shape, as measured by ABSI, appears to be a substantial risk factor for premature mortality in the general population derivable from basic clinical measurements. ABSI expresses the excess risk from high WC in a convenient form that is complementary to BMI and to other known risk factors.
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            Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey.

            Metabolic syndrome (MetS) is defined by the Third Report of the Adult Treatment Panel (ATP III) using criteria easily applied by clinicians and researchers. There is no standard pediatric definition. We defined pediatric MetS using criteria analogous to ATP III as > or =3 of the following: (1) fasting triglycerides > or =1.1 mmol/L (100 mg/dL); (2) HDL or =6.1 mmol/L (110 mg/dL); (4) waist circumference >75th percentile for age and gender; and (5) systolic blood pressure >90th percentile for gender, age, and height. MetS prevalence in US adolescents was estimated with the Third National Health and Nutritional Survey 1988 to 1994. Among 1960 children aged > or =12 years who fasted > or =8 hours, two thirds had at least 1 metabolic abnormality, and nearly 1 in 10 had MetS. The racial/ethnic distribution was similar to adults: Mexican-Americans, followed by non-Hispanic whites, had a greater prevalence of MetS compared with non-Hispanic blacks (12.9%, [95% CI 10.4% to 15.4%]; 10.9%, [95% CI 8.4% to 13.4%]; and 2.5%, [95% CI 1.3% to 3.7%], respectively). Nearly one third (31.2% [95% CI 28.3% to 34.1%]) of overweight/obese adolescents had MetS. Our definition of pediatric MetS, designed to be closely analogous to ATP III, found MetS is common in adolescents and has a similar racial/ethnic distribution to adults in this representative national sample. Because childhood MetS likely tracks into adulthood, early identification may help target interventions to improve future cardiovascular health.
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              A simple model-based index of abdominal adiposity

              R. Valdez (1991)
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                18 June 2019
                June 2019
                : 11
                : 6
                : 1370
                Affiliations
                [1 ]Instituto de la Grasa-CSIC, Campus Universidad Pablo de Olavide, Edificio 46, 41013 Seville, Spain; perona@ 123456ig.csic.es
                [2 ]Department of Nursing, University of Granada, Av. Ilustración, 60, 18016 Granada, Spain; anfeapa@ 123456ugr.es (Á.F.-A.); macoro@ 123456ugr.es (M.C.-R.); emigoji@ 123456ugr.es (E.G.-J.)
                [3 ]Department of Health Sciences, Public University of Navarra, Navarrabiomed- IdiSNA, Pamplona, 31006 Navarra, Spain; robin640@ 123456hotmail.com
                Author notes
                [* ]Correspondence: jschmidt@ 123456ugr.es ; Tel.: +34-958-243-495; Fax: +34-958-243-495
                Author information
                https://orcid.org/0000-0002-1298-8349
                https://orcid.org/0000-0001-9165-4349
                https://orcid.org/0000-0003-3075-6960
                https://orcid.org/0000-0001-5103-6028
                Article
                nutrients-11-01370
                10.3390/nu11061370
                6627132
                31216719
                49d51fec-3873-4d53-b48a-5952e1ab066f
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 27 May 2019
                : 14 June 2019
                Categories
                Article

                Nutrition & Dietetics
                anthropometric indexes,diagnosis criteria,metabolic syndrome,adolescents,obesity

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