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      Neck circumference as a new anthropometric indicator for prediction of insulin resistance and components of metabolic syndrome in adolescents: Brazilian Metabolic Syndrome Study Translated title: Circunferencia del cuello como un nuevo indicador antropométrico para predicción de resistencia a la insulina y componentes del síndrome metabólico en adolescentes: Brazilian Metabolic Syndrome Study - BRAMS

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          Abstract

          OBJECTIVE:

          To evaluate the correlation between neck circumference and insulin resistance and components of metabolic syndrome in adolescents with different adiposity levels and pubertal stages, as well as to determine the usefulness of neck circumference to predict insulin resistance in adolescents.

          METHODS:

          Cross-sectional study with 388 adolescents of both genders from ten to 19 years old. The adolescents underwent anthropometric and body composition assessment, including neck and waist circumferences, and biochemical evaluation. The pubertal stage was obtained by self-assessment, and the blood pressure, by auscultation. Insulin resistance was evaluated by the Homeostasis Model Assessment-Insulin Resistance. The correlation between two variables was evaluated by partial correlation coefficient adjusted for the percentage of body fat and pubertal stage. The performance of neck circumference to identify insulin resistance was tested by Receiver Operating Characteristic Curve.

          RESULTS:

          After the adjustment for percentage body fat and pubertal stage, neck circumference correlated with waist circumference, blood pressure, triglycerides and markers of insulin resistance in both genders.

          CONCLUSIONS:

          The results showed that the neck circumference is a useful tool for the detection of insulin resistance and changes in the indicators of metabolic syndrome in adolescents. The easiness of application and low cost of this measure may allow its use in Public Health services.

          Translated abstract

          OBJETIVO:

          Evaluar la correlación de la circunferencia del cuello con resistencia a la insulina y con los componentes del síndrome metabólico en adolescentes con distintos niveles de adiposidad y estadios puberales, así como determinar la utilidad de la circunferencia del cuello como un parámetro en la predicción de resistencia a la insulina en adolescentes.

          MÉTODOS:

          Estudio transversal en el que se evaluó a 388 adolescentes de ambos sexos, de los 10 a los 19 años. Los adolescentes fueron sometidos a evaluación antropométrica y de composición corporal, incluyendo circunferencias del cuello y de la cintura, y la evaluación bioquímica. El estadio puberal se obtuvo mediante autoevaluación y la presión arterial, por el método de ausculta. Se evaluó la resistencia a la insulina por el Homeostasis Model Assessment-Insulin Resistence. La correlación entre dos variables fue evaluada con el coeficiente de corrrelación parcial ajustado para el porcentaje de grasa corporal y el estadio puberal. El desempeño de la circunferencia del cuello para identificar resistencia a la insulina fue evaluado por la Receiver Operating Characteristic Curve y se consideró p<0,05.

          RESULTADOS:

          Después del ajuste para el porcentaje de grasa corporal y estadio puberal, la circunferencia del cuello se correlacionó con la circunferencia de la cintura, presión arterial, triglicéridos y marcadores de resistencia a la insulina en ambos sexos.

          CONCLUSIONES:

          Los resultados demostraron que la circunferencia del cuello es una herramienta útil para detectar la resistencia a la insulina y la alteración en los indicadores de síndrome metabólico en adolescentes. La facilidad de aplicación y el bajo costo pueden hacer su uso viable en servicios de Salud Pública.

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          Most cited references29

          • Record: found
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          VI Diretrizes Brasileiras de Hipertensão

          (2010)
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            2000 CDC Growth Charts for the United States: methods and development.

            This report provides detailed information on how the 2000 Centers for Disease Control and Prevention (CDC) growth charts for the United States were developed, expanding upon the report that accompanied the initial release of the charts in 2000. The growth charts were developed with data from five national health examination surveys and limited supplemental data. Smoothed percentile curves were developed in two stages. In the first stage, selected empirical percentiles were smoothed with a variety of parametric and nonparametric procedures. In the second stage, parameters were created to obtain the final curves, additional percentiles and z-scores. The revised charts were evaluated using statistical and graphical measures. The 1977 National Center for Health Statistics (NCHS) growth charts were revised for infants (birth to 36 months) and older children (2 to 20 years). New body mass index-for-age (BMI-for-age) charts were created. Use of national data improved the transition from the infant charts to those for older children. The evaluation of the charts found no large or systematic differences between the smoothed percentiles and the empirical data. The 2000 CDC growth charts were developed with improved data and statistical procedures. Health care providers now have an instrument for growth screening that better represents the racial-ethnic diversity and combination of breast- and formula-feeding in the United States. It is recommended that these charts replace the 1977 NCHS charts when assessing the size and growth patterns of infants, children, and adolescents.
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                Author and article information

                Journal
                Rev Paul Pediatr
                Rev Paul Pediatr
                Revista Paulista de Pediatria
                Sociedade de Pediatria de São Paulo
                0103-0582
                1984-0462
                June 2014
                June 2014
                : 32
                : 2
                : 221-229
                Affiliations
                [1 ]Faculdade de Ciências Médicas da Unicamp; Laboratório de Investigação em Metabolismo e Diabetes (Limed) - Gatrocentro-Unicamp, Campinas, SP, Brasil
                [1 ] Faculdade de Ciências Médicas da Unicamp; Laboratório de Investigação em Metabolismo e Diabetes (Limed) - Gatrocentro-Unicamp, Campinas, SP, Brasil
                Author notes
                Endereço para correspondência: Cleliani de Cassia da Silva Rua Carlos Chagas, 420 - Cidade Universitária CEP 13083-878 - Campinas/SP E-mail: ccsnutri@ 123456yahoo.com.br

                Conflito de interesse: nada a declarar

                Endereço para correspondência: Cleliani de Cassia da Silva Rua Carlos Chagas, 420 - Cidade Universitária CEP 13083-878 - Campinas/SP E-mail: ccsnutri@ 123456yahoo.com.br

                Conflito de interesse: nada a declarar

                Fonte financiadora: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), processo nº 563664/2010-0, e Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes)

                Article
                10.1590/0103-0582201432210713
                4183009
                25119754
                673d043f-37dd-4746-8846-dfd0f7711254

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 July 2013
                : 28 October 2013
                Page count
                Figures: 2, Tables: 3, References: 30, Pages: 9
                Categories
                Original Article

                insulin resistance,metabolic syndrome x,adolescent,adiposity,resistência à insulina,síndrome x metabólica,adolescente,adiposidade

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