Circunferencia de cintura en cuatro sitios y su relación con indicadores de obesidad en escolares de 6 a 11 años
DOI:
https://doi.org/10.29059/cienciauat.v13i2.1057Palabras clave:
circunferencia de cintura, obesidad infantil, antropometría, escolaresResumen
La circunferencia de cintura abdominal (CC) se utiliza para evaluar obesidad infantil; para su medición, se emplean diferentes lugares pero aún no se ha demostrado la similitud o diferencia entre los valores obtenidos en cada zona. El objetivo de este trabajo fue identificar el sitio de medición de la CC que mejor determine obesidad infantil, contrastada con indicadores de obesidad. Se midió la CC en cuatro lugares: 1) circunferencia mínima (CM); 2) circunferencia umbilical (CU); 3) circunferencia en el punto medio (CPM); y 4) circunferencia por arriba del borde superior de la cresta ilíaca (CCI); se determinaron la endomorfia (Endo), la suma proporcional de seis pliegues (SP6P) y el índice de masa corporal (IMC), como indicadores de sobrepeso u obesidad en 107 escolares de 6 a 11 años de edad. En niñas la CCI fue más alta que CM y CPM (P = 0.001 y 0.049 respectivamente) y CU mayor que CM (P = 0.025). Todos los sitios de medición de CC correlacionaron bien con los indicadores de obesidad (P = 0.001). La CCI fue el mejor lugar de medición de la CC para predecir sobrepeso u obesidad representada por Endo, SP6P e IMC (P = 0.001), por lo que es el sitio que mejor predice obesidad en edad escolar y parece evidenciar la presencia de dimorfismo sexual en niñas; debido a ello, los sitios de medición de circunferencia de cintura no deben ser intercambiables, ya que esta identificación ayudaría a generar un mejor diagnóstico de obesidad y riesgo cardiometabólico en niños y niñas en etapa de la pubertad.
Citas
Agarwal, S. K., Misra, A., Aggarwal, P., Bardia, A., Goel, R., Vikram, N. K., …, and Pandey, R. (2009). Waist circumference measurement by site, posture, respiratory phase, and meal time: implications for methodology. Obesity. 17(5): 1056-1061. DOI: https://doi.org/10.1038/oby.2008.635
Andaki, A. C., Tinoco, A. L., Mendes, E. L., Júnior, R. A., Hills, A. P., and Amorim, P. R. (2012). Different waist circumference measurements and prediction of cardiovascular risk factors and metabolic syndrome in children. Obesity Research & Clinical Practice. 6(2): 149-157. DOI: https://doi.org/10.1016/j.orcp.2011.07.006
Bosy-Westphal, A., Booke, C. A., Blöcker, T., Kossel, E., Goele, K., Later, W., …, and Müler, M. (2010). Measurement site for waist circumference affects its accuracy as an index of visceral and abdominal subcutaneous fat in a Caucasian population. The Journal of Nutrition. 140(5): 954-961. DOI: https://doi.org/10.3945/jn.109.118737
Brambilla, P., Bedogni, G., Heo, M., and Pietrobelli, A. (2013). Waist circumference-to-height ratio predicts adiposity better than body mass index in children and adolescents. International Journal of Obesity. 37(7): 943-946. DOI: https://doi.org/10.1038/ijo.2013.32
De-Oliveira, A., Cocate, P. G., Hermsdorff, H., Bressan, J., de-Silva, M. F., Rodrigues, J. A., and Natali, A. J. (2014). Waist circumference measures: cutoff analyses to detect obesity and cardiometabolic risk factors in a Sout-heast Brazilian middle-aged men population-a cross-sectional study. Lipids in health and Disease. 13(1): 141. DOI: https://doi.org/10.1186/1476-511X-13-141
Eisenmann, J. C. (2005). Waist circumference percentiles for 7-to 15-year-old Australian children. Acta Paediatrica. 94(9): 1182-1185. DOI: https://doi.org/10.1080/08035250510029352
Fernández, J. R., Redden, D. T., Pietrobelli, A., and Allison, D. B. (2004). Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. The Journal of Pediatrics. 145(4): 439-44. DOI: https://doi.org/10.1016/j.jpeds.2004.06.044
Fryar, C. D., Gu, Q., Ogden, C. L., and Flegal, K. M. (2016). Anthropometric reference data for children and adults: United States, 2011-2014. Vital & Health Statistics. Series 3, Analytical and Epidemiological Studies. 3(39): 1-38.
Fujikawa, R., Ito, C., and Mitama, A. (2012). Association between visceral fat area and waist circumference measured at different sites. Diabetology International. 3(3): 140-145. DOI: https://doi.org/10.1007/s13340-012-0070-2
Griffiths, C., Gately, P., Marchant, P., and Cooke, C. (2013). A five year longitudinal study investigating the prevalence of childhood obesity: comparison of BMI and waist circumference. Public Health. 127(12): 1090-1096. DOI: https://doi.org/10.1016/j.puhe.2013.09.020
Harrington, D. M., Staiano, A. E., Broyles, S. T., Gupta, A. K., and Katzmarzyk, P. T. (2013). Waist circumference measurement site does not affect relationships with visceral adiposity and cardiometabolic risk factors in children. Pediatric Obesity. 8(3): 199-206. DOI: https://doi.org/10.1111/j.2047-6310.2012.00106.x
Heath, B. H. and Carter, J. (1967). A modified somato type method. American Journal of Physical Anthropology. 27(1): 57-74. DOI: https://doi.org/10.1002/ajpa.1330270108
Hitze, B., Bosy-Westphal, A., Bielfeldt, F., Settler, U., Mönig, H., and Müller, M. J. (2008). Measurement of waist circumference at four different sites in children, adolescents, and young adults: concordance and correlation with nutritional status as well as cardiometabolic risk factors. Obesity Facts. 1(5): 243-249. DOI: https://doi.org/10.1159/000157248
Johnson, S. T., Kuk, J. L., Mackenzie, K. A., Huang, T. T., Rosychuk, R. J., and Ball, G. D. (2010). Metabolic risk varies according to waist circumference measurement site in overweight boys and girls. The Journal of Pediatrics. 156(2): 247-252. DOI: https://doi.org/10.1016/j.jpeds.2009.08.010
Klünder-Klünder, M. and Flores-Huerta, S. (2011). Waist circumference values according to height percentiles: a proposal to evaluate abdominal obesity in Mexican children and adolescents between 6 and 16 years of age. Archives of Medical Research. 42(6): 515-522. DOI: https://doi.org/10.1016/j.arcmed.2011.09.004
López-González, D., Miranda-Lora, A., Klünder-Klünder, M., Queipo-García, G., Bustos-Esquivel, M., Paez-Villa, M., …, and Garibay-Nieto, M. D. (2016). Diagnostic performance of waist circumference measurements for predicting cardiometabolic risk in mexican children. Endocrine Practice. 22(10): 1170-1176. DOI: https://doi.org/10.4158/EP161291.OR
Ma, L., Cai, L., Deng, L., Zhu, Y., Ma, J., Jing, J., and Chen, Y. (2016). Waist circumference is better than other anthropometric indices for predicting cardiovascular disease risk factors in Chinese children—a cross-sectional study in Guangzhou. Journal of Atherosclerosis and Thrombosis. 23(3): 320-329. DOI: https://doi.org/10.5551/jat.31302
McCarthy, H., Jarrett, K., and Crawley, H. (2001). Original communications-The development of waist circumference percentiles in British children aged 5.0-16.9 years. European Journal of Clinical Nutrition. 55(10): 902-907. DOI: https://doi.org/10.1038/sj.ejcn.1601240
Monzani, A., Rapa, A., Prodam, F., Fuiano, N., Diddi, G., Petri, A., ..., and Bona, G. (2016). High discrepancy in abdominal obesity prevalence according to different waist circumference cut-offs and measurement methods in children: need for age-risk-weighted standardized cut-offs? PloS One. 11(1): e0146579. DOI: https://doi.org/10.1371/journal.pone.0146579
OMS, Organización Mundial de la Salud (2011). Waist circumference and waist-hip ratio. [En línea]. Disponible en: http://apps.who.int/iris/bitstream/10665/44583/1/9789241501491_eng.pdf. Fecha de consulta: 13 de septiembre de 2017.
Patry-Parisien, J., Shields, M., and Bryan, S. (2012). Comparison of waist circumference using the World Health Organization and National Institutes of Health protocols. Health Reports. 23(3): 53-60.
Pettitt, D. J., Talton, J. W., Liese, A. D., Liu, L. L., Crimmins, N., West, N. A., ..., and Kahn, H. (2012). Comparison of two waist circumference measurement protocols: the SEARCH for diabetes in youth study. Pediatric Obesity. 7(6): e81-e85. DOI: https://doi.org/10.1111/j.2047-6310.2012.00088.x
Ross, R., Berentzen, T., Bradshaw, A. J., Janssen, I., Kahn, H. S., Katzmarzyk, P. T., ..., and Després, J. P. (2008). Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference? Obesity Reviews. 9(4): 312-325. DOI: https://doi.org/10.1111/j.1467-789X.2007.00411.x
Ross, W. D. y Marfell-Jones, M. J. (2005). Cineantropometría. En J. D. MacDougall, H. A. Wenger y H. J. Green (Eds.), Evaluación fisiológica del deportista (pp. 277-380). Barcelona: Ediciones Paidotribo.
Rudolf, M. C., Walker, J., and Cole, T. J. (2007). What is the best way to measure waist circumference? International Journal of Pediatric Obesity. 2(1): 58-61. DOI: https://doi.org/10.1080/17477160601095177
Sabin, M. A., Wong, N., Campbell, P., Lee, K. J., Mc Callum, Z., and Werther, G. A. (2014). Where should we measure waist circumference in clinically overweight and obese youth? Journal of Paediatrics and Child health. 50(7): 519-524. DOI: https://doi.org/10.1111/jpc.12626
Sant’Anna, M. D., Tinoco, A. L., Rosado, L. E., Sant’Ana, L. F., Mello, A. D., Brito, I. S., ..., and Santos, T. F. (2009). Body fat assessment by bioelectrical impedance and its correlation with different anatomical sites used in the measurement of waist circumference in children. Journal de Pediatria. 85(1): 61-66. DOI: https://doi.org/10.2223/JPED.1871
Sarli, R. and Shariatpanahi, Z. V. (2016). Comparison of waist circumference measured at four sites in healthy Iranian adults. Malaysian Journal of Nutrition. 22(2): 182-189.
Savva, S., Tornaritis, M., Savva, M., Kourides, Y., Panagi, A., Silikiotou, N., ..., and Kafatos, A. (2000). Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. International Journal of Obesity. 24(11): 1453-1458. DOI: https://doi.org/10.1038/sj.ijo.0801401
Shephard, R. J., Labarre, R., Jéquier, J. C., Lavallee, H., Rajic, M., and Volle, M. (1985). The “unisex phantom,” sexual dimorphism. American Journal of Physical Anthropology. 67(4): 403-412. DOI: https://doi.org/10.1002/ajpa.1330670412
Schröder, H., Ribas, L., Koebnick, C., Funtikova, A., Gomez, S. F., Fito, M., ..., and Serra-Majem, L. (2014). Prevalence of abdominal obesity in Spanish children and adolescents. Do we need waist circumference measurements in pediatric practice? PLoS One. 9(1): e87549. DOI: https://doi.org/10.1371/journal.pone.0087549
Shi, W., Neubeck, L., and Gallagher, R. (2016). Measurement matters: A systematic review of waist measurement sites for determining central adiposity. Collegian. 24(5): 513-523. DOI: https://doi.org/10.1016/j.colegn.2016.08.009
Spolidoro, J. V., Pitrez-Filho, M. L., Vargas, L. T., Santana, J. C., Pitrez, E., Hauschild, J. A., ..., and Piva, J. P. (2013). Waist circumference in children and adolescents correlate with metabolic syndrome and fat deposits in young adults. Clinical Nutrition. 32(1): 93-97. DOI: https://doi.org/10.1016/j.clnu.2012.05.020
Stewart, A., Marfell-Jones, M. O. T., and Ridder, H. D. (2011). Protocolo internacional para la valoración antropométrica. Lower Hutt, New Zealand: International Society for the Advancement of Kinanthropometry. 101 Pp.
Verweij, L. M., Terwee, C. B., Proper, K. I., Hulshof, C. T., and Van-Mechelen, W. (2013). Measurement error of waist circumference: gaps in knowledge. Public health nutrition. 16(2): 281-288. DOI: https://doi.org/10.1017/S1368980012002741
Wang, J., Thornton, J. C., Bari, S., Williamson, B., Gallagher, D., Heymsfield, S. B., …, and Pi-Sunyer, F. X. (2003). Comparisons of waist circumferences measured at 4 sites. American Society for Clinical Nutrition. 77(2): 379-84. DOI: https://doi.org/10.1093/ajcn/77.2.379
Ward, R., Ross, W., Leyland, A., and Selbie, S. (1989). The advanced O-Scale physique assessment system. Burnaby, Vancouver: Kinemetrix Inc. 87 Pp.
Wimonpeerapattana, W. and Yamborisut, U. (2013). Receiver operating characteristic (ROC) curves to identify waist circumference cut-off points for predicting the overweight and obese school children. Research Journal. 18(5): 861-868.
Yang, C. and Wang, L. (2017). Comparisons of waist circumference measurements at five different anatomical sites in Chinese children. BioMed Research International. 1-8. DOI: https://doi.org/10.1155/2017/7678613
