title: Metabolic syndrome and insulin resistance in obese adolescents.
abstract: OBJECTIVE
  To verify the prevalence of metabolic syndrome and insulin resistance in obese adolescents and its relationship with different body composition indicators.
  
  
  METHODS
  A cross-sectional study comprising 79 adolescents aged ten to 18 years old. The assessed body composition indicators were: body mass index (BMI), body fat percentage, abdominal circumference, and subcutaneous fat. The metabolic syndrome was diagnosed according to the criteria proposed by Cook et al. The insulin resistance was determined by the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) index for values above 3.16. The analysis of ROC curves was used to assess the BMI and the abdominal circumference, aiming to identify the subjects with metabolic syndrome and insulin resistance. The cutoff point corresponded to the percentage above the reference value used to diagnose obesity.
  
  
  RESULTS
  The metabolic syndrome was diagnosed in 45.5% of the patients and insulin resistance, in 29.1%. Insulin resistance showed association with HDL-cholesterol (p=0.032) and with metabolic syndrome (p=0.006). All body composition indicators were correlated with insulin resistance (p<0.01). In relation to the cutoff point evaluation, the values of 23.5 and 36.3% above the BMI reference point allowed the identification of insulin resistance and metabolic syndrome. The best cutoff point for abdominal circumference to identify insulin resistance was 40%.
  
  
  CONCLUSIONS
  All body composition indicators, HDL-cholesterol and metabolic syndrome showed correlation with insulin resistance. The BMI was the most effective anthropometric indicator to identify insulin resistance.
authors.affiliation: Faculdade de Ciencias Medicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Amanda Oliva
authors.initials: AO
authors.lastname: Gobato
authors.affiliation: Faculdade de Ciencias Medicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Ana Carolina J
authors.initials: AC
authors.lastname: Vasques
authors.affiliation: Faculdade de Ciencias Medicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Mariana Porto
authors.initials: MP
authors.lastname: Zambon
authors.affiliation: Faculdade de Ciencias Medicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Antonio de Azevedo
authors.initials: Ade A
authors.lastname: Barros Filho
authors.affiliation: Faculdade de Ciencias Medicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Hessel
mesh_terms: D000293:Adolescent; D001823:Body Composition; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism*; D009765:Obesity / Q000150:complications / Q000378:metabolism*; D015995:Prevalence