Adiposity indices in the prediction of insulin resistance in prepubertal Colombian children.
OBJECTIVE
To compare BMI with abdominal skinfold thickness (ASF), waist circumference and waist-to-height ratio in the prediction of insulin resistance (IR) in prepubertal Colombian children.


METHODS
We calculated age- and sex-specific Z-scores for BMI, ASF, waist circumference, waist-to-height ratio and three other skinfold-thickness sites. Logistic regression with stepwise selection (P = 0·80 for entry and P = 0·05 for retention) was performed to identify predictors of IR and extreme IR, which were determined by age- and sex-specific Z-scores to identify the ≥ 90th and ≥ 95th percentile of homeostasis model assessment (HOMAIR), respectively. We used receiver operating characteristic curves to compare the area under the curve between models.


METHODS
Bucaramanga, Colombia.


METHODS
Children (n 1261) aged 6-10 years in Tanner stage 1 from a population-based study.


RESULTS
A total of 127 children (seventy girls and fifty-seven boys) were classified with IR, including sixty-three children (thirty-three girls and thirty boys) classified with extreme IR. Only ASF and BMI Z-scores were retained as predictors of IR by stepwise selection. Adding ASF Z-score to BMI Z-score improved the area under the curve from 0·794 (95 % CI 0·752, 0·837) to 0·811 (95 % CI 0·770, 0·851; P for contrast = 0·01). In predicting extreme IR, the addition of ASF Z-score to BMI Z-score improved the area under the curve from 0·837 (95 % CI 0·790, 0·884) to 0·864 (95 % CI 0·823, 0·905; P for contrast = 0·01).


CONCLUSIONS
ASF Z-score predicted IR independent of BMI Z-score in our population of prepubertal children. ASF and BMI Z-scores together improved IR risk stratification compared with BMI Z-score alone, opening new perspectives in the prediction of cardiometabolic risk in prepubertal children.
Division of Epidemiology and Community Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454 USA. muel0266@umn.edu
Noel T
NT
Mueller
Mark A
MA
Pereira
Adriana
A
Buitrago-Lopez
Diana C
DC
Rodríguez
Alvaro E
AE
Duran
Alvaro J
AJ
Ruiz
Christian F
CF
Rueda-Clausen
Cristina
C
Villa-Roel
D000005:Abdomen; D050154:Adiposity; D019540:Area Under Curve; D015992:Body Mass Index; D002648:Child; D003105:Colombia / Q000453:epidemiology; D005260:Female; D044882:Glucose Metabolism Disorders / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000150:complications*; D011627:Puberty; D012372:ROC Curve; D012885:Skinfold Thickness