title: Lower waist circumference in mildly-stunted adolescents is associated with elevated insulin concentration.
abstract: OBJECTIVE
  Augmented waist circumference (WC) is associated with non-communicable diseases and could represent a valuable marker in screening for metabolic dysfunctions in subjects with insufficient linear growth. The objective of the present study was to determine whether biochemical and hemodynamic parameters and waist circumference vary between mildly-stunted and non-stunted adolescents from impoverished communities of São Paulo, Brazil.
  
  
  METHODS
  The cross-sectional study involved 206 subjects, aged between 9 and 19 years and living in impoverished areas of São Paulo, Brazil. The sample population was divided according to height-for-age Z-score (HAZ) into stunted (-1 > HAZ ≥ -2) and non-stunted (HAZ ≥ -1) groups, and was sub-divided according to gender. Logistic regression analysis was employed to compare individuals with elevated (> 75th percentile) insulin concentrations. The receiver operating characteristic curves were constructed to determine WC cut-off points that could be used to identify stunted and non-stunted individuals with elevated insulin concentrations.
  
  
  RESULTS
  WC cut-off points of 58.25cm and 67.2cm allowed for correct classification of 90.7% of stunted and 88.7% of non-stunted individuals in the studied population. While the sensitivity of the model was high for stunted and non-stunted subjects (98.8% and 97.2%, respectively), the specificity was modest (57.1% and 41.2%, respectively).
  
  
  CONCLUSIONS
  The results presented herein suggest that an increase in plasma insulin is one of the primary metabolic modifications in stunted individuals, and that this alteration could be identified at a lower WC cut-off point than in non-stunted counterparts.
authors: Universidade Federal de Alagoas (UFAL), Maceió, AL, Brazil. Electronic address: anagrotticlemente@gmail.com.
authors: Ana Paula Grotti
authors: AP
authors: Clemente
authors: Ciências Aplicadas à Pediatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors: Carla Danusa da Luz
authors: CD
authors: Santos
authors: Programa de Pós-Graduação em Endocrinologia Clínica, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors: Vinicius J B
authors: VJ
authors: Martins
authors: Programa de Pós-Graduação em Endocrinologia Clínica, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors: Maria Paula
authors: MP
authors: Albuquerque
authors: Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors: Mariana B
authors: MB
authors: Fachim
authors: Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors: Ana Lydia
authors: AL
authors: Sawaya
mesh_terms: D000293:Adolescent; D062186:Arterial Pressure / Q000502:physiology; D001786:Blood Glucose / Q000032:analysis; D001827:Body Height; D015992:Body Mass Index; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood* / Q000276:immunology; D008297:Male; D011203:Poverty; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012737:Sex Factors; D055105:Waist Circumference / Q000502:physiology*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Altura; Circunferência da cintura; Height; Insulin; Insulina; Waist circumference