title: Umbilical waist-to-height ratio and trunk fat mass index (DXA) as markers of central adiposity and insulin resistance in Argentinean children with a family history of metabolic syndrome.
abstract: Central adiposity is increasing in childhood. To find a simple index of central fatness that accurately predicts insulin resistance we studied 55 obese children and 53 siblings, aged 6-16 years. We recorded the family metabolic score, calculated clinical and DXA-derived fat distribution indexes and HOMA-IR. Umbilical waist-to-height ratio (W-to-Ht) had the best combination of ROC area (0.99, IC95: 0.93 to 1.0), Youden's index (0.976), coefficient of variation (4.9) and correlation with HOMA-IR (r = 0.58, p < 0.0001); it also correlated (p < 0.001) with BMI (r = 0.95) and DXA-trunk fat mass index (r = 0.93). It was the best predictor of insulin resistance in a multiple regression model (p < 0.0001). Odds ratios for insulin resistance were 9.33 when the family score was >10 (p < 0.01) and 14.35 when umbilical W-to-Ht was >0.54 (p < 0.0001). Umbilical W-to-Ht, a simple marker of central adiposity, strongly relates to children's DXA-trunk fat mass index and insulin resistance.
authors.affiliation: Service of Pediatric Endocrinology and Adolescent Medicine, Pediatric Hospital "Humberto Notti", Universidad Nacional de Cuyo, Mendoza, Argentina. zelmira@uolsinectis.com.ar
authors.forename: Zelmira
authors.initials: Z
authors.lastname: Guntsche
authors.forename: Enrique M
authors.initials: EM
authors.lastname: Guntsche
authors.forename: Fernando D
authors.initials: FD
authors.lastname: Saraví
authors.forename: Lía M
authors.initials: LM
authors.lastname: Gonzalez
authors.forename: Carina
authors.initials: C
authors.lastname: Lopez Avellaneda
authors.forename: Elsa
authors.initials: E
authors.lastname: Ayub
authors.forename: Silvana
authors.initials: S
authors.lastname: Coll
authors.forename: Susana
authors.initials: S
authors.lastname: Astor
authors.forename: Laura
authors.initials: L
authors.lastname: Cestino
mesh_terms: D050153:Abdominal Fat; D015502:Absorptiometry, Photon; D000293:Adolescent; D000886:Anthropometry / Q000379:methods; D001118:Argentina / Q000453:epidemiology; D015415:Biomarkers; D001823:Body Composition; D001827:Body Height; D015992:Body Mass Index; D002648:Child; D042241:Early Diagnosis; D005192:Family Health; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome; D056128:Obesity, Abdominal / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D055105:Waist Circumference
chemical_list: D015415:Biomarkers