Invarianza factorial por sexo y puntos de corte del cuestionario de control de la imagen corporal en fotografías en población mexicana / Factorial invariance by sex and cut-off points of the body image control questionnaire in photographs in Mexican population

RESUMEN La imagen corporal varía a lo largo de la vida. Los cambios físicos que conlleva la adolescencia, pueden influir en el desarrollo de conductas de riesgo para trastornos alimentarios. Aunque los factores sociales y culturales afectan la imagen corporal, las formas de interacción modernas, mediante el uso de tecnología, en particular las redes sociales, permiten controlar la autopresentación de la imagen corporal en las fotografías que son publicadas, lo que podría servir como indicador de conductas de riesgo alimentarias. El objetivo de este trabajo fue establecer la asociación de conductas alimentarias de riesgo con el control de la imagen corporal en fotografías, para analizar su invarianza factorial por sexo y proponer puntos de corte en población mexicana. La muestra estuvo conformada por 1 155 adolescentes (51.3 % hombres y 48.7 % mujeres), con una media de edad de 15.18 años. Se utilizó el cuestionario en español sobre el control de la imagen corporal en fotografías denominado BICP-S, además del cuestionario de conductas alimentarias de riesgo (CAR). Los resultados evidenciaron una relación entre las conductas alimentarias de riesgo y el control de la imagen en fotografías. La estructura factorial del BICP-S varía en función del sexo, por lo que se proponen diferentes puntos de corte del cuestionario, en donde aquellas ubicadas en el percentil 85 indican riesgo acerca de las preocupaciones por la imagen corporal en mujeres, mientras que en hombres se establece en el percentil 92, con una alta confiabilidad en el control de la imagen en ambos sexos (α > 0.90). El cuestionario tiene utilidad clínica para la detección de jóvenes con serias preocupaciones en torno a la imagen corporal que, de continuar, pueden constituirse en un factor de riesgo para trastornos de la conducta alimentaria.

ABSTRACT Body varies throughout life. Physical changes that take place during teenage years may influence the development of risky behaviors related to eating disorders. Although social and cultural factors affect body image, modern forms of interaction with technology, particularly social networks, allow controlling the self-presentation of body image in the photographs that are published, which could serve as an indicator of risky eating behaviors. The aim of this study was to establish the association of risky eating behaviors with the body image control in photographies, to analyze the factorial invariance by sex and to propose cut-off points in the Mexican population. The sample consisted of 1 155 adolescents (51.3 % males and 48.7 % females), with a mean age of 15.18 years. The BICP-S was used, in addition to the risky eating behaviors questionnaire (CAR). The results showed a relationship between risky eating behaviors and image control in photographs. The factorial structure of the BICP-S varies according to sex, so different cut-off points of the questionnaire are proposed, where those located at the 85th percentile indicate risk about body image concerns in women, while in men it is established at the 92nd percentile, with a high reliability in image control in both groups (α > 0.90). It is concluded that the questionnaire has clinical utility for the detection of at-risk youth who may have serious body image concerns, which if continued can be a risk factor for eating disorders.

Propuesta de Valores de Referencia para el Cuestionario de Evaluación del Apego Adulto: Experiences in Close Relationships (ECR-12), en población adulta chilena / Reference values for the Adult Attachment Assessment Questionnaire: Experiences in Close Relationships (ECR-12) in the Chilean Adult Population

El cuestionario de Experiencias en Relaciones Cercanas (ECR) es un instrumento de auto-reporte ampliamente utilizado para evaluar el apego en la adultez, a partir de dos dimensiones: la ansiedad y la evitación asociadas al apego. Este instrumento ha sido adaptado en múltiples contextos, incluyendo el chileno, del cual existe una versión abreviada (ECR-12), objeto de análisis del presente estudio. Si bien existe consenso en que la seguridad en el apego es mejor descrita en términos dimensionales, hay ámbitos, como en la práctica clínica donde contar con valores de referencia podría ser de utilidad. El objetivo de este estudio es proveer valores de referencia para la interpretación de los valores del ECR-12 en el contexto chileno. Para ello, una muestra de 6779 participantes respondió el ECR-12. Se utilizó el método de puntuación z con normalización para obtener los valores de referencia. Los análisis realizados evidenciaron la necesidad de construir baremos diferenciados por edad. Así, para el grupo de 29 años o menos, el punto de corte en la dimensión de ansiedad es de un promedio igual o superior a 4.4 puntos, y para la evitación, el punto de corte es de un promedio igual o superior a 2.5. En cambio, para el grupo de 30 años o más, el punto de corte en la dimensión de ansiedad es de un promedio igual o superior a 4.2, y para la evitación, es de un promedio igual o superior a 2.9. Estos hallazgos pueden ser relevantes no sólo para identificar a personas que puedan presentar niveles sustancialmente altos de ansiedad y/o evitación en el apego, sino, también puede constituirse como una herramienta clínica complementaria en contextos terapéuticos.

The Experiences in Close Relationships (ECR) questionnaire is a widely used self-report measure to assess adult attachment, based on two dimensions: attachment anxiety and attachment avoidance. This instrument has been adapted in multiple contexts, including the Chilean, for which there is an abbreviated version (ECR-12), that is the object of analysis in the present study. Although there is consensus that attachment security is best described in dimensional terms, there are areas, such as clinical practice, where having reference values could be useful. The aim of this study is to provide reference values for the interpretation of ECR-12 scores in the Chilean context. To do this, a sample of 6779 participants was evaluated using the ECR-12. The z-score normalization method was used to obtain the reference values. The analyzes carried out showed the need to build scales differentiated by age. Thus, for the group of 29 years or less, the cut-off point in the anxiety dimension is an average equal to or greater than 4.4 points, and for avoidance, the cut-off point is an average equal to or greater than 2.5. On the other hand, for the group aged 30 or older, the cut-off point in the anxiety dimension is an average equal to or greater than 4.2, and for avoidance, it is an average equal to or greater than 2.9. These findings can be relevant not only for identifying people who may present substantially high levels of anxiety and/or avoidance in attachment, but also as a complementary clinical tool in therapeutic contexts.

The cut-off points of body mass index and waist circumference for predicting metabolic risk factors in Chinese adults / 中华流行病学杂志

Objective@#To assess the association of BMI and waist circumference (WC) with metabolic risk factors, and confirm the appropriate cut-off points of BMI and WC among Chinese adults.@*Methods@#After excluding participants with missing or extreme measurement values, as well as individuals with self-reported histories of cancer, a total of 501 201 adults in baseline and 19 201 adults in the second re-survey from the China Kadoorie Biobank were included. The associations of BMI and WC with metabolic risk factors were estimated. Receiver operating characteristic (ROC) analyses were conducted to assess the appropriate cut-off values of BMI and WC to predict the risk of hypertension, diabetes, dyslipidemia and clustering of risk factors.@*Results@#The prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all presented ascending trends with the increasing levels of BMI or WC. Defined as the points on the ROC curve where Youden’s index reached the highest, the appropriate overweight cut-off points of BMI were around 24.0 kg/m2 both in men and women, and the points of WC were around 85 cm in men and 80 to 85 cm in women. With specificity 90% for identification of risk factors, the appropriate obese cut-off points of BMI were around 28.0 kg/m2 both in men and women, with the range of 27.0 to 28.9 kg/m2.@*Conclusions@#The cut-off points for overweight and obesity recommended by Coorperative Meta-analysis Group of China Obesity Task Force was verified in the large sample survey conducted more recently. The cut-off points of BMI were 24.0 and 28.0 kg/m2 for overweight and obesity, and the cut-off point of WC was 85 cm in men and 80 to 85 cm in women for central obesity.

Study on the prevalence rate and optimal waist circumference cut-off points of obesity for the components of metabolic syndrome in Uygur from Xinjiang / 中华内分泌代谢杂志

Objective To investigate the prevalence of metabolic syndrome and appropriate cut-off point of waist circumference of abdominal obesity for components of metabolic syndrome in Uygur population in Xinjiang. Methods A questionnaire-based survey, physical examination, and blood testing were conducted according to cluster random sampling in Uygur residents above 18 years old in Xinjiang.There were 3 542 samples collected,based on the International Diabetes Federation(IDF)standard of metabolic syndrome, the relativities of clustering of metabolic syndrome components and different strata of waist circumference for Uygur were analyzed,and looking for the appropriate cut-off points for identifying two or more components of metabolic syndrome within the shortest distance of receiver operating characteristic(ROC)curve.Results According to IDF standard,the waist circumference(85 cm for men,82 cm for women)corresponded to the shortest distance in ROC curve,at these cut-offs of abdominal obesity for component of metabolic syndrome,the prevalences of metabolic syndrome were 21.3%,19.5%in men, while 23.0%in women,the prevalence of women was higher than that of men(P<0.05).The prevalences of≥1,≥2 components of metabolic syndrome were shown an increasing trend with the increasing size of waist circumference, and the odds ratio of clustering of metabolic syndrome components were also increased significantly.Conclusion The prevalence of metabolic syndrome among Xinjiang Uygur population was higher than that of national level.The cut-off points of waist circumference(85 cm for men,82 cm for women)combining other components definition of IDF standard were recommended for identifying metabolic syndrome of Uygurs.

Using ROC curve to evaluate cut-off points of Psychological Distress Scale of Cancer Patients / 中国实用护理杂志

Objective To determine the cut-off points of Psychological Distress Scale of Cancer Patients by using the ROC curve, in order to provide reference for clinical application of it. Methods A questionnaire containing both the Psychological Distress Scale of Cancer Patients and Symptom Checklist-90 (SCL-90) were filled by 364 cancer patients in Beijing Cancer Hospital. Later the cut-off points of the four latitudes of the Scale were evaluated by ROC curve through comparing the two scales. Results By using the latitudes of the SCL-90 scale as a reference, the areas of all the four latitudes of the Scale were:anxiety (0.815, P<0.01); depression (0.790, P<0.01); interpersonal disability (0.829, P<0.01);suspiciousness (0.670, P<0.01) respectively. The following cut-off points could result in the most ideal sensitivity and specificity: 11 for anxiety; 14 for depression; 7 for interpersonal disability and 4 for suspiciousness. Conclusions The Psychological Distress Scale of Cancer Patients can provide great values to the diagnosis of psychological problems related with anxiety, depression, and interpersonal disability, while low valuable reference for diagnosis of suspiciousness. It can provide good diagnosis value which contributes to evaluation of psychological problems of cancer patients.

ELF (Enhanced Liver Fibrosis) como marcador não invasivo de fibrose hepática na hepatite C crônica / ELF (Enhanced Liver Fibrosis) as a non invasive predictor of liver fibrosis in hepatitis C

A fibrose hepática é o aspecto mais relevante e o mais importante determinante de morbimortalidade na hepatite C crônica (HCC). Historicamente, a biópsia hepática é o método de referência para avaliação da fibrose causada pela HCC, apesar de apresentar limitações. O estudo de marcadores não invasivos, que possam obviar a necessidade da biópsia, é uma área de constante interesse na hepatologia. Idealmente, a avaliação da fibrose hepática deveria ser acurada, simples, prontamente disponível, de baixo custo e informar sobre o prognóstico da patologia. Os marcadores não invasivos mais estudados são a elastografia hepática transitória (EHT) e os laboratoriais. A EHT já foi extensamente validada na HCC e está inserida na rotina de avaliação destes pacientes. Dentre os laboratoriais, existem diversos testes em continua experimentação e, até o momento, nenhum foi integrado à prática clínica no Brasil, embora já aplicados rotineiramente em outros países. O Enhanced Liver Fibrosis (ELF), um teste que dosa no soro ácido hialurônico, pró-peptídeo amino-terminal do colágeno tipo III e inibidor tissular da metaloproteinase 1, tem se mostrado bastante eficaz na detecção de fibrose hepática significativa e de cirrose na HCC. Neste estudo o ELF teve o seu desempenho avaliado em relação a biópsia hepática e demonstrou apresentar boa acurácia na detecção tanto de fibrose significativa quanto de cirrose. Na comparação com a EHT apresentou acurácia semelhante para estes mesmos desfechos, com significância estatística. No entanto, foi observada uma superestimação da fibrose com a utilização dos pontos de corte propostos pelo fabricante. Este achado está em acordo com a literatura, onde não há consenso sobre o melhor ponto de corte a ser empregado na prática clínica. Com a ampliação da casuística foi possível propor novos pontos de corte, através da análise clássica, com a biópsia hepática como padrão ouro...

Liver fibrosis is the most relevant issue concerning chronic hepatitis C (CHC) and determines its prognosis. Historically, liver biopsy has been the reference method for evaluating fibrosis related to CHC, though it presents many drawbacks. There is a continuing interest in the development of non invasive markers capable of replacing liver biopsy. The ideal surrogate for fibrosis evaluation should be accurate, simple, low cost and yield prognostic information. So far, the most well known non invasive methods are transient hepatic elastography (TE) and laboratory panels. TE has already been extensively validated and is integrated in patients routine. There is plenty of laboratory panels in continuing evaluation and some are already integrated in daily practice abroad. In Brasil, until the present moment, it is not a reality. Enhanced Liver Fibrosis (ELF) panel comprises the serum concentration of hyaluronic acid, tissue inhibitor of matrix metalloproteinases-1, and aminoterminal propeptide of type III procollagen and has demonstrated good performance in detecting significant fibrosis and cirrhosis in CHC patients. In the present study ELF had it’s performance evaluated against liver biopsy and obtained satisfactory accuracy in detecting significant fibrosis and cirrhosis. In comparison to TE no statistically significant diference was observed, for the same endpoints mentioned before. However, the application of manufacturer’s cutoff points produced overestimation of fibrosis stages. These findings are in accordance with other author’s results, in that there is no consensus so far on the most adequate cutoff points for main clinical end points. Enlarging the data permited calculating new cutoff points, through the classical statistical approach, using liver biopsy as the gold standard...

Use of Serum Homocysteine to Predict Cardiovascular Disease in Korean Men with or without Metabolic Syndrome

The aim of this study was to examine whether serum homocysteine (Hcy) levels correlated with cardiovascular disease (CVD) depending on the presence or absence of metabolic syndrome (MetS) in Korean men. We conducted a case-control study, including 138 CVD and 290 non-CVD age-matched control subjects. The subjects were divided into four subgroups: 34 CVD/MetS, 104 CVD, 77 MetS, and 213 normal subgroups. The mean Hcy was significantly higher, whereas HDL and intake of vitamin B1 and B2 were lower in the CVD group (P < 0.05) than non-CVD group. When compared to the control group, subjects with CVD/MetS, CVD and MetS exhibited high Hcy levels, with the highest observed in the CVD/MetS subgroup (P < 0.001). Multivariate stepwise linear regression between CVD and markers of CVD showed Hcy significantly correlated with CVD (P < 0.05). To predict CVD based on Hcy, Hcy threshold of 11.72 microM in non-MetS subjects had an area under the curve (AUC) of 0.664 (95% CI 0.598-0.731). In MetS subjects, the AUC was 0.618 and Hcy threshold was 13.32 microM (95% CI 0.509-0.726). The results of our study show that the presence of MetS needs to be considered when using Hcy levels for predicting CVD.

Study on the optimal waist circumference cut-off points of metabolic syndrome in Kazakh / 中华内分泌代谢杂志

Questionnaire-based survey, physical examination, and blood testing were conducted according to cluster random samplings in Kazakh residents in Xinjiang.2 760 samples were collected to analyze the association of different strata of waist circumference and clustering of metabolic syndrome (MS) components.Accoding to International Diabetes Federation standard, the prevalence of ≥1and ≥2 components of MS showed increasing trend with the increase of waist circunference, and odds ratio of clustering of MS components also increased significantly.The distance of receiver operating characteristic curve was the shortest and the prevalence of MS was 22.1% ;22.4% in men, and 21.9% in women;when the waist circumference was ≥91 cm for men, and ≥88 cm for women.

Body mass index cut-offs for overweight and obesity in Chinese children and adolescents aged 2-18 years / 中华流行病学杂志

Objective To study the body cut-offs of mass index (BMI) for the purpose of screening overweight and obesity for Chinese children and adolescents aged 2-18 years. Methods Based on the BMI growth reference values for Chinese children aged 0-18, using the common methods to establish the BMI cut-offs for screening overweight and obesity. These methods were having the same empirical percentile or Z scores and the BMI value at 18 years consistent with adults.Three sets of BMI cut-offs, including (BMI24, BMI28) , (P85, P95) and (Z1, Z2) , were initially identified. Differences were compared on different cut-off points and prevalence rates of overweight and obesity with different BMI reference, different values and "prevalence" of overweight and obesity based on "2004 Beijing Child and Adolescent Metabolic Syndrome Study ". Cut-offs standards which recommended by the Chinese Working Group on Obesity for Children (WGOC) and by the International Obesity Task Force (IOTF) were also used. Finally the appropriate cut-offs were defined. Results Three sets of BMI cut-offs for screening overweight and obesity for Chinese children and adolescents aged 2-18 years were obtained according to the above mentioned methods for selection. The prevalence rates of overweight and obesity defined by those cut-offs appeared not to be significantly different. Compared with the WGOC, the BMI cut-off points for screening overweight and obesity for both boys and girls from our study were very close to the WGOC', but cut-off points for screening overweight for girls aged 8.5-15.5 y was 0.3-1.0 kg/m2 lower than the WGOC'. Going through the database on screening of "2004 Beijing Children's Metabolic Syndrome Survey ", the prevalence of overweight for girls was about 3.4% higher than using the cut-offs of WGOC. Conclusion Results from this study suggested that the BMI cut-offs passed through the cut-off point of BMI24 and BMI28 at 18 years was appropriate for screening overweight and obesity in Chinese children from 2 to 18 years, and achieved the continuity in age and consistency in screening standard when using the BMI indicator in children and adolescents.

Comparison of Doppler Waveform Index in Benign and Malignant Ovarian Tumor / 대한부인종양콜포스코피학회잡지

Doppler sonography has been introduced to evaluate uterine and ovarian diseases. It has been reported to be used to distinguish benign from malignant adnexal masses. The purpose of this study was to assess the blood flow characteristics of adnexal masses and to determine the optimal cut-off points for the Doppler indices obtained, resistance index and pulsatility index, to best differentiate benign from malignant lesions. We performed pulsed Doppler ultrasound in seventy-eight adnexal masses between February 1989 and June 1994. The pulsatility and resistance index were calculated from the waveforms generated from blood flow within the ovary. There were 51 benign and 27 malignant histologically proved ovarian lesions. All women have been operated on. The results were as follows ; Benign tumors and cysts had a significantly higher pulsatility index(mean, 1.23+/-0.74; range, 4.46-3.36) and resistance index(mean, 0.64+/-0.19; range 0.34-1.43) than did malignant tumors(pulsatility index : mean, 0.87+/-0.49; range, 0.31-2.27; resistance index : mean, 0.50+/-17; range, 0.23-0.8). However, some overlap in individual values for benign and malignant lesions was found. In conclusion, our data suggest that high pulsatility and resistance indices may indicate benign adnexal masses ; however, considerable overlap in pulsatility and resistance indices between benign and malignant lesions were noted, and further work will be needed before the validity of these factors is proved.