Frecuencia del fenotipo de cintura hipertrigliceridémica y su asociación con anormalidades metabólicas en adolescentes de una región andina del Perú / Frequency of hypertriglyceridemic waist phenotype and its association with metabolic abnormalities in adolescents from a Andean region of Peru

RESUMEN Introducción. La cintura hipertrigliceridémica ha sido propuesta como un fenotipo con una fuerte asociación al síndrome metabólico, no se conoce la frecuencia de este fenotipo en adolescentes del Perú, incluyendo sus zonas andinas. Objetivo. Estimar la frecuencia de la cintura hipertrigliceridémica y su asociación con anormalidades metabólicas y otros factores en adolescentes peruanos de una región andina. Métodos. Estudio de fuente secundaria de diseño transversal analítico. Analizamos los datos de 397 adolescentes seleccionados aleatoriamente en dos escuelas públicas de la ciudad de Cajamarca. Se definió cintura hipertrigliceridémica como la presencia simultánea de una circunferencia de cintura incrementada (≥percentil 90 para edad y sexo) e hipertrigliceridemia sérica (≥110 mg/dL). Se realizó la estimación de la prevalencia de manera puntual y con su intervalo de confianza al 95%, también realizamos un análisis de regresión logística binaria para identificar factores asociados. Resultados. El fenotipo de cintura hipertrigliceridémica fue 2,01% (IC95%: 0,51 a 3,52). El componente más frecuente fue hipertrigliceridemia con 39,55% (IC95%: 34,61 a 44,48), mientras que la circunferencia de cintura incrementada afectó al 3,02% (IC95%: 1,21 a 4,83). El exceso de peso fue la única variable asociada con el fenotipo de cintura hipertrigliceridémica (OR ajustado: 62,7; IC95%: 6,7 a 587,9; p<0,001). Conclusiones. Dos de cien adolescentes de 11 a 17 años residentes de una región altoandina del Perú tuvieron el fenotipo de cintura hipertrigliceridémica. Dicho fenotipo estuvo asociado con el exceso de peso.

ABSTRACT Introduction. The hypertriglyceridemic waist has been proposed as a phenotype with a strong association with the metabolic syndrome. The frequency of this phenotype in adolescents from Peru, including Andes population is unknown. Objective. To estimate the frequency of the hypertriglyceridemic waist and its association with metabolic abnormalities and other factors in Peruvian adolescents from an Andean region. Methods. We performed a data secondary analysis through cross-sectional design. We analyzed 397 randomly selected adolescents from two public schools in the Cajamarca city. We defined hypertriglyceridemic waist as the simultaneous presence of increased waist circumference (≥ 90th percentile for age and sex) and serum hypertriglyceridemia (≥110 mg/dL). We estimated the point prevalence of hypertriglyceridemic waist and their 95% confidence interval, we also performed a binary logistic regression analysis to identify associated risks. Results. The phenotype of hypertriglyceridemic waist was 2.01% (95%CI: 0.51 to 3.52). The most frequent component was hypertriglyceridemia with 39.55% (95%CI: 34.61 to 44.48), while increased waist circumference affected 3.02% (95%CI: 1.21 to 4.83). Excess weight was the only variable association with hypertriglyceridemic waist phenotype (adjusted OR: 62.7; 95%CI: 6.7 - 587.9; p<0.001). Conclusions. Two of one hundred adolescents aged 11 to 17 years living in a high Andean region of Peru had the hypertriglyceridemic waist phenotype. This phenotype was associated with excess weight.

Asociación entre el fenotipo hipertrigliceridemia-obesidad abdominal, la resistencia a la insulina y las variables cardiometabólicas en el síndrome de ovario poliquístico / Association among the hypertriglyceridemic waist phenotype, insulin resistance and the cardiometabolic variables in the polycystic ovary syndrome

Introducción: El síndrome de ovario poliquístico se asocia con frecuencia a alteraciones cardiometabólicas; y su asociación con el fenotipo hipertrigliceridemia-obesidad abdominal ha sido poco estudiada en Cuba. Objetivo: Identificar la frecuencia del fenotipo hipertrigliceridemia-obesidad abdominal en mujeres de edad mediana con síndrome de ovario poliquístico y su asociación con la resistencia a la insulina, trastornos del metabolismo de la glucosa y ateroesclerosis subclínica. Método: Estudio descriptivo, transversal, en 30 mujeres. Se tomaron variables clínicas: edad, peso, talla, índice de masa corporal, circunferencia de cintura y cadera, índice cintura/cadera, tensión arterial, además de concentraciones de glucosa, insulina, colesterol total, triglicéridos, HDL-c y LDL-c, e índice HOMA-IR. La aterosclerosis subclínica se evaluó por doppler carotideo y ecocardiograma (hipertrofia ventricular izquierda y grasa epicárdica). El fenotipo hipertrigliceridemia-obesidad abdominal se definió como triglicéridos elevados (≥ 1,7 mmol/L) y circunferencia de la cintura ≥ 80 cm. Resultados: La frecuencia del fenotipo hipertrigliceridemia-obesidad abdominal fue 43,3 por ciento (13/30). Los valores medios de circunferencia abdominal, tensión arterial, así como de glucemia (p < 0,003), insulinemia (p = 0,028), triglicéridos (p < 0,0001), e índice HOMA-IR (p = 0,012) fueron más elevados en el grupo de mujeres con esa condición. A pesar de no haber diferencias significativas la frecuencia de mujeres con incremento del grosor íntima-media carotídeo y de grasa epicárdica fue superior en aquellas con el fenotipo. Conclusiones: La presencia del fenotipo hipertrigliceridemia-obesidad abdominal es frecuente en mujeres con síndrome de ovario poliquístico, y se asocia con alteraciones del metabolismo de la glucosa y la resistencia a la insulina. Este pudiera ser utilizado en la práctica clínica como un marcador de riesgo para alteraciones cardiometabólicas(AU)

Introduction: The polycystic ovary syndrome is frequently associated to cardiometabolic alterations; and its relation with the hypertriglyceridemic waist phenotype has been poorly studied in Cuba. Objective: Identify the frequency of the hypertriglyceridemic waist phenotype in middle age women with polycystic ovary syndrome and its association with insulin resistance, disorders in the glucose metabolism and subclinical atherosclerosis. Methods: Descriptive, cross-sectional study in 30 women. As clinical variables there were used: age, weight, size, body mass index, waist-hip circumference, waist/hip index, blood pressure; glucose, insulin, total cholesterol, triglycerides, HDL-c and LDL-c concentrations, and HOMA-IR index. Subclinical atherosclerosis was assessed by a carotid doppler and an echocardiogram (left ventricular hypertrophy and epicardial fat). The hypertriglyceridemic waist phenotype was defined as high triglycerides levels (≥ 1.7 mmol/L) and CC ≥ 80 cm. Results: The frequency of the hypertriglyceridemic waist phenotype was 43.3 percent (13/30). The mean values of abdominal circumference, blood pressure, as well as glycemia (p < 0.003), insulinaemia (p = 0.028), triglycerides (p < 0.0001), and HOMA-IR index (p = 0.012) were higher in the group of women with that condition. Although there were not significant differences, the frequency of women with increase of the carotid intima-media thickness and epicardical fat was higher in those with the phenotype. Conclusions: The presence of the hypertriglyceridemic waist phenotype is frequent in women with the polycystic ovary syndrome, and it is associated with alterations of the glucose metabolism and insulin resistance. This can be used in the clinical practice as a marker of risk for cardiometabolic alterations(AU)

Association of hypertriglyceridemic waist phenotype with impaired fasting glucose and diabetes in middle-aged and elderly population / 预防医学

Objective@#To explore the association of hypertriglyceridemic waist phenotype ( HTGW ) with impaired fasting glucose ( IFG ) and diabetes, so as to provide reference for the early prevention and control of diabetes.@*Methods@# The survey was conducted among 35 to 75-year-old residents in 8 project sites in Jiangsu Province from 2015 to 2019. The information about demography and lifestyle was collected by the general information questionnaire and the primary screening questionnaire from the National Center for Cardiovascular Diseases; waist circumference, height, weight, triglyceride, high-density lipoprotein cholesterol, total cholesterol and fasting plasma glucose were measured. The multinomial logistic regression model was employed to analyze the association of HTGW with IFG and diabetes.@*Results@#A total of 118 383 subjects were included, among whom 21 851 cases of HTGW, 27 245 cases of IFG and 22 899 cases of diabetes were identified, with the prevalence of 18.46%, 23.01% and 19.34%. The multinomial logistic regression analysis showed HTGW was statistically associated with IFG ( OR=1.414, 95%CI: 1.343-1.489 ) and diabetes ( OR=2.216, 95%CI: 2.098-2.341 ).@*Conclusion@# HTGW is associated with IFG and diabetes, which make it possible to be an indicator for screening and assessment of glucose abnormality in middle-aged and elderly population.

Hypertriglyceridemic waist and associated factors in children and adolescents with type 1 diabetes mellitus / Cintura hipertrigliceridêmica e fatores associados em crianças e adolescentes portadores de diabetes melito tipo 1

ABSTRACT Objective: To assess the frequency of the hypertriglyceridemic waist phenotype and its associated factors in children and adolescents with type 1 diabetes mellitus. Methods: This is an observational analytical study with individuals with type 1 diabetes mellitus, aged 5 to 18 years, of both genders, followed in a university hospital in the Brazilian Northeast. Weight, height, and waist circumference were measured, and the lipid profile and glycated hemoglobin were analyzed. The hypertriglyceridemic waist phenotype was defined by the simultaneous presence of increased waist circumference (≥90th percentile for age and gender) and elevated serum triglyceride levels (≥75 mg/dL for children and ≥90 mg/dL for adolescents). We also investigated the family history of cardiovascular diseases and diabetes, as well as sociodemographic and behavioral variables. In the statistical inference tests, the proportions were compared by Pearson's chi-square test ­and/­or Fisher's exact test, being significant p<0.05. Results: A total of 102 patients were evaluated, most of them females (54.9%) and adolescents (66.7%). The frequency of hypertriglyceridemic waist was 23.5%, which was associated with females (p=0.043), overweight (p=0.023), hypercholesterolemia (p=0.002), high LDL (p=0.001), and borderline VLDL (<0.001). Conclusions: The frequency of the hypertriglyceridemic waist phenotype was associated with females, atherogenic lipid profile, and overweight, indicating the importance of the nutritional monitoring of this population, aiming at reducing future cardiovascular diseases.

RESUMO Objetivo: Avaliar a frequência do fenótipo cintura hipertrigliceridêmica e analisar seus fatores associados em crianças e adolescentes portadores de diabetes melito tipo 1. Métodos: Trata-se de um estudo observacional analítico com indivíduos com diabetes melito tipo 1, de cinco a 18 anos de idade, de ambos os sexos, acompanhados em um hospital universitário do Nordeste brasileiro. Foram realizadas medidas de peso, altura e circunferência da cintura, além da análise do perfil lipídico e da hemoglobina glicada. O fenótipo cintura hipertrigliceridêmica foi definido pela presença simultânea da circunferência da cintura aumentada (≥percentil 90 por idade e sexo) e dos níveis séricos de triglicerídeos elevados (≥75 mg/dL para crianças e ≥90 mg/dL para adolescentes). Investigaram-se, ainda, os antecedentes familiares para doenças cardiovasculares e diabetes, e também variáveis sociodemográficas e comportamentais. Nos testes de inferência estatística, as proporções foram comparadas pelo teste do qui-quadrado de Pearson e/ou exato de Fisher, sendo significante p<0,05. Resultados: Foram avaliados 102 pacientes, com predomínio do sexo feminino (54,9%) e de adolescentes (66,7%). A frequência de cintura hipertrigliceridêmica foi de 23,5%; a qual apresentou associação com o sexo feminino (p=0,043), excesso de peso (p=0,023), hipercolesterolemia (p=0,002), LDL elevado (p=0,001) e VLDL em valores limítrofes (<0,001). Conclusões: A frequência do fenótipo cintura hipertrigliceridêmica foi associada ao sexo feminino, ao perfil lipídico aterogênico e ao excesso ponderal, evidenciando a importância do acompanhamento nutricional dessa população, visando à redução de agravos cardiovasculares futuros.

Fenotipo hipertrigliceridemia cintura abdominal alterada y su asociación con los factores de riesgo cardiovasculares / Hypertriglyceridemic waist phenotype and its association with cardiovascular risk factors

Introducción: el fenotipo clínico hipertrigliceridemia cintura abdominal alterada guarda relación con la presencia de hiperinsulinemia, hipertrigliceridemia e hipercolesterolemia, y en consecuencia, es un riesgo de enfermedades cardiovasculares y diabetes mellitus tipo 2. Objetivo: determinar la asociación del fenotipo hipertrigliceridemia cintura abdominal alterada con los principales factores de riesgo cardiovasculares. Material y Métodos: se realizó un estudio descriptivo correlacional, con una muestra probabilística obtenido por un método polietápico. La muestra quedó conformada por 1108 sujetos entre 15 y 74 años, incluidos dentro del componente de vigilancia de enfermedades no transmisibles de la iniciativa CARMEN, pertenecientes al municipio de Cienfuegos. Las variables evaluadas fueron las siguientes: sexo, color de la piel, tabaquismo, hipertensión arterial, obesidad, actividad física, diabetes mellitus, índice de masa corporal, circunferencia abdominal, colesterol total y triglicéridos. Se determinó la razón de prevalencia para las diferentes variables. El nivel de significación exigido fue del 95 por ciento. Resultados: La razón de probabilidad demostró mayor riesgo de presentar el fenotipo en el sexo femenino (2,31), así como en los sujetos mayores de 45 años (2,92), obesos (19,24), hipertensos (2,96) y diabéticos (2,30). Conclusiones: existe una relación significativa entre el fenotipo hipertrigliceridemia cintura abdominal alterada y los principales factores de riesgo cardiovasculares, tales como el incremento de la edad, el índice aterogénico, los niveles de colesterol, la diabetes mellitus y la hipertensión arterial(AU)

Introduction: The hypertriglyceridemic waist phenotype is related to the presence of hyperinsulinemia, hypertriglyceridemia, and hypercholesterolemia and consequently, it is a risk of cardiovascular diseases and type 2 diabetes mellitus. Objective: To determine the association of hypertriglyceridemic waist phenotype with the main cardiovascular risk factors. Material and Methods: A descriptive study was carried out with a probabilistic sample obtained from a multi-stage method. The sample consisted of 1108 subjects between 15 and 74 years old, included in the surveillance component for noncommunicable diseases (NCDs) from the CARMEN initiative in Cienfuegos. The variables evaluated were: sex, skin color, smoking, hypertension, obesity, physical activity, diabetes mellitus, body mass index, abdominal circumference, total cholesterol, and triglycerides. The Prevalence Ratio (PR) was determined for the different variables. The level of significance required was 95 percent. The research was approved by the Scientific Council of the University of Medical Sciences of Cienfuegos and the Research Ethics Committee. The results are presented in tables and figures. Results: PR showed a greater risk of presenting the phenotype in females (2,31), as well as in subjects over 45 years (2,92), obese (19,24), and hypertensive and diabetics for a PR of (2.96 and 2.30), respectively. Conclusions: There is a significant relationship between hypertriglyceridemic waist phenotype and the main cardiovascular risk factors such as increasing age, atherogenic index, cholesterol levels, diabetes mellitus, and hypertension(AU)

Prevalence and factors associated with hypertriglyceridemic waist in the elderly: a population-based study / Prevalência e fatores associados à cintura hipertrigliceridêmica em idosos: um estudo de base populacional

Abstract To identify the prevalence and factors associated with hypertriglyceridemic waist (HW) in community-dwelling elderly people in northeast Brazil. Population-based cross-sectional study. Some 316 elderly (≥ 60 years) people of both sexes participated in this study. Data were collected using a questionnaire, based on that used in the Health, Welfare and Aging Study (SABE), in addition to blood tests, blood pressure measurements and anthropometric measurements. The hypertriglyceridemic waist condition was diagnosed using high values of triglycerides (≥ 150 mg/dl) and waist circumference increased ≥ 88 and ≥ 102 cm for women and men, respectively. Logistic regression analysis was used to compare the hypertriglyceridemic waist and associated factors, significance level of 5%. The prevalence of hypertriglyceridemic waist (HW) was 27.1%. The logistic regression model (OR) adjusted showed the condition of HW associated to the feminine sex (OR 4.19), to the insufficiently active elderly (OR 2.41) and with overweight (OR 4.06). A high prevalence (27.1%) of hypertriglyceridemic waist was observed, indicating the female sex, physical inactivity and overweight as key factors associated with hypertriglyceridemic waist in community-dwelling elderly people.

Resumo Identificar a prevalência e os fatores associados à cintura hipertrigliceridêmica em idosos residentes em uma comunidade no nordeste do Brasil. Estudo populacional com delineamento transversal. Participaram do estudo 316 idosos com idade ≥ 60 anos, de ambos os sexos. Os dados foram coletados por meio de um formulário próprio, baseado no questionário usado na Pesquisa Saúde, Bem-Estar e Envelhecimento, além dos exames sanguíneos, aferição da pressão arterial e medidas antropométricas. A cintura hipertrigliceridêmica (CH) foi diagnosticada quando os níveis de triglicerídeos apresentaram valores (≥ 150 mg/dl) e a circunferência da cintura ≥ 88cm para as mulheres e 102 para os homens. Para identificar os fatores associados a CH foi utilizado a análise de regressão logística, com nível de significância 5%. A prevalência de cintura hipertrigliceridêmica foi 27,1%. O modelo de regressão logística (OR) ajustado mostrou a condição de CH associada ao sexo feminino (OR 4.19), aos idosos insuficientemente ativos (OR 2.41) e com sobrepeso (OR 4.06). Foi observada uma alta prevalência de cintura hipertrigliceridêmica em idosos residentes em comunidade, apontando o sexo feminino, a inatividade física e o sobrepeso/obesidade como fatores associados.

Fenótipo cintura hipertrigliceridêmica: fatores associados e comparação com outros indicadores de risco cardiovascular e metabólico no ELSA-Brasil / Hypertriglyceridemic waist phenotype: associated factors and comparison with other cardiovascular and metabolic risk indicators in the ELSA-Brasil study / Fenotipo de cintura hipertrigliceridémica: factores asociados y comparación con otros indicadores de riesgo cardiovascular y metabólico en el ELSA-Brasil

O objetivo deste estudo foi estimar a prevalência do fenótipo cintura hipertrigliceridêmica (FCH) em participantes do Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil), identificar fatores de risco associados e comparar com outros indicadores de risco cardiovascular e metabólico. Trata-se de um estudo transversal com dados da linha de base de uma coorte de servidores públicos. O FCH é definido pela presença simultânea de circunferência da cintura (CC) aumentada (≥ 80cm para mulheres, ≥ 90cm para homens de acordo com a Federação Internacional de Diabetes - IDF; e ≥ 88cm para mulheres, ≥ 102cm para homens de acordo com o Programa Nacional de Educação sobre o Colesterol dos Estados Unidos - NCEP) e hipertrigliceridemia. A associação entre as variáveis independentes e FCH foi testada por meio de modelos de regressão logística multivariada. O FCH foi comparado também com outros indicadores de risco cardiovascular e metabólico por meio de testes de correlação, índice kappa, sensibilidade e especificidade. Após exclusões, foram analisados 12.811 participantes. A prevalência do FCH variou de 24,7% (IDF) a 13,3% (NCEP). FCH foi associado a ter idade mais avançada, ao consumo excessivo de álcool, ser ex-fumante, apresentar HDL baixo, não-HDL alto e PCR aumentado, independente do sexo ou critério de definição. FCH associou-se a indicadores de risco cardiovascular, especialmente à síndrome metabólica. A elevada prevalência de FCH e sua associação com indicadores de risco cardiovascular, especialmente com a síndrome metabólica, apoia sua utilização como ferramenta de triagem de risco cardiometabólico na prática clínica.

This study's objectives were to estimate the prevalence of hypertriglyceridemic waist (HTW) phenotype in participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), identify associated risk factors, and compare with other cardiovascular and metabolic risk indicators. This was a cross-sectional study with baseline data from a cohort of public employees. HTW is defined as the simultaneous presence of increased waist circumference (WC) (≥ 80cm for women, ≥ 90cm for men according to the International Diabetes Federation - IDF; and ≥ 88cm for women, ≥ 102cm for men according to the U.S. National Cholesterol Education Program - NCEP) and hypertriglyceridemia. Associations between independent variables and HTW were tested with multivariate logistic regression models. HTW was also compared to other cardiovascular and metabolic risk indicators by means of correlation tests, kappa index, sensitivity, and specificity. After exclusions, 12,811 participants were analyzed. Prevalence of HTW ranged from 24.7% (IDF) to 13.3% (NCEP). HTW was associated with age, excessive alcohol consumption, former smoking, low HDL, non-high HDL, and increased C-reactive protein, independently of gender or the criterion used to define HTW. HTW was associated with cardiovascular risk indicators, especially metabolic syndrome. The high prevalence of HTW and its association with cardiovascular risk indicators, especially metabolic syndrome, supports its use as a cardiometabolic risk screening tool in clinical practice.

El objetivo de este estudio fue estimar la prevalencia del fenotipo cintura hipertrigliceridémica (FCH), en participantes del Estudio Longitudinal de la Salud del Adulto (ELSA-Brasil), identificar factores de riesgo asociados, y compararlo con otros indicadores de riesgo cardiovascular y metabólico. Se trata de un estudio transversal con datos de la línea de referencia de una cohorte de empleados públicos. El FCH se define por la presencia simultánea de circunferencia de la cintura (CC) aumentada (≥ 80cm para mujeres, ≥ 90cm para hombres de acuerdo con la Federación Internacional de Diabetes - IDF; y ≥ 88cm para mujeres, ≥ 102cm para hombres de acuerdo con el Programa National de Educación sobre el colesterol de los EE.UU. - NCEP) e hipertrigliceridemia. La asociación entre las variables independientes y FCH fue probada mediante modelos de regresión logística multivariada. El FCH se comparó también con otros indicadores de riesgo cardiovascular y metabólico, mediante pruebas de correlación, índice kappa, sensibilidad y especificidad. Tras las exclusiones, se analizaron a 12.811 participantes. La prevalencia del FCH varió de un 24,7% (IDF) a un 13,3% (NCEP). El FCH se asoció a tener una edad más avanzada, al consumo excesivo de alcohol, ser ex-fumador, presentar HDL bajo, no-HDL alto y PCR aumentado, independiente del sexo o criterio de definición. FCH se asoció a indicadores de riesgo cardiovascular, especialmente al síndrome metabólico. La elevada prevalencia de FHC y su asociación con indicadores de riesgo cardiovascular, especialmente con el síndrome metabólico, apoya su utilización como herramienta de clasificación de riesgo cardiometabólico en la práctica clínica.

Hypertriglyceridemic Waist Phenotype and Changes in the Fasting Glycemia and Blood Pressure in Children and Adolescents Over One-Year Follow-Up Period / Fenótipo Cintura Hipertrigliceridêmica e mudanças na glicemia de jejum e pressão arterial de crianças e adolescentes após um ano de seguimento

Abstract Background: The hypertriglyceridemic waist (HTW) phenotype is defined as the simultaneous presence of increased waist circumference (WC) and serum triglycerides (TG) levels and it has been associated with cardiometabolic risk in children and adolescents. Objective: The objective was to evaluate the influence of HTW phenotype in the fasting glycemia and blood pressure in children and adolescents over one-year follow-up period. Methods: It is a cohort study involving 492 children and adolescents from 7 to 15 years old, both genders, who were submitted to anthropometric, biochemical and clinical evaluation at the baseline, and also after 6 and 12 months of follow-up. Generalized Estimating Equation (GEE) models were calculated to evaluate the longitudinal influence of the HTW phenotype in the glycemia and blood pressure over one-year. Results: It was observed a prevalence of 10.6% (n = 52) of HTW phenotype in the students. The GEE models identified that students with HTW phenotype had an increase of 3.87 mg/dl in the fasting glycemia mean (CI: 1.68-6.05) and of 3.67mmHg in the systolic blood pressure (SBP) mean (CI: 1.55-6.08) over one-year follow-up, after adjusting for confounding variables. Conclusions: The results of this study suggest that HTW phenotype is a risk factor for longitudinal changes in glycemia and SBP in children and adolescents over one-year follow-up period.

Resumo Fundamento: O fenótipo de cintura hipertrigliceridêmica (CHT) é definido como a presença simultânea de circunferência de cintura (CC) e níveis séricos de triglicérides (TG) aumentados e tem sido associado com risco cardiometabólico em crianças e adolescentes. Objetivo: Avaliar a influência do fenótipo CHT na glicemia de jejum e na pressão arterial em crianças e adolescentes em um período de acompanhamento de um ano. Métodos: Trata-se de um estudo de coorte envolvendo 492 crianças e adolescentes de 7 a 15 anos de ambos os sexos, que foram submetidos à avaliação antropométrica, bioquímica e clínica no início e também após 6 e 12 meses de seguimento. Os modelos de Equação de Estimulação Generalizada (GEE) foram calculados para avaliar a influência longitudinal do fenótipo CHT na glicemia e na pressão arterial ao longo de um ano. Resultados: Foi observada uma prevalência de 10,6% (n = 52) do fenótipo CHT nos estudantes. Os modelos GEE identificaram que os estudantes com fenótipo CHT apresentaram aumento de 3,87 mg/dl na média de glicemia em jejum (IC: 1,68-6,05) e de 3,67 mmHg na pressão arterial sistólica media (PAS) (IC: 1,55-6,08) depois de um ano de acompanhamento, após ajuste para variáveis de confusão. Conclusões: Os resultados deste estudo sugerem que o fenótipo CHT é um fator de risco para alterações longitudinais da glicemia e da PAS em crianças e adolescentes em um período de um ano de seguimento.

Cintura hipertrigliceridémica y enfermedad por hígado graso no alcohólico en pacientes hipertensos / Hypertriglyceridemic waist and nonalcoholic fatty liver disease in hypertensive patients

Introducción: la enfermedad por hígado graso no alcohólico y la cintura hipertrigliceridémica constituyen nuevos marcadores de enfermedad cardiovascular aterosclerótica. Objetivos: caracterizar la cintura hipertrigliceridémica y la enfermedad por hígado graso no alcohólico como factores de riesgo cardiometabólico en pacientes hipertensos. Métodos: se realizó un estudio longitudinal prospectivo en 131 pacientes ingresados en el Hospital Docente Clínico Quirúrgico Miguel Enríquez con diagnóstico de hipertensión arterial, desde julio-2015 hasta julio-2016. Se incluyeron las variables edad, sexo, tabaquismo, diabetes, índice de masa corporal, cintura hipertrigliceridémica, glucemia, colesterol total, años de evolución de la hipertensión, hipertensión mal controlada y enfermedad por hígado graso no alcohólico. Resultados: la tercera parte de los pacientes mostraron cintura hipertrigliceridémica e hígado graso no alcohólico. Los adultos hipertensos con cintura hipertrigliceridémica tienen una mayor probabilidad de obesidad, glucemia en ayunas elevada, así como mayor descontrol y tiempo de evolución de la hipertensión arterial. La cintura hipertrigliceridémica muestra una estrecha relación y un buen valor predictivo (sensibilidad del 86,1 por ciento y especificidad del 84,1 por ciento) para la identificación de hígado graso no alcohólico en adultos hipertensos. Conclusiones: la cintura hipertrigliceridémica posee un buen valor predictivo para la identificación de hígado graso no alcohólico en pacientes hipertensos y se relaciona con una mayor probabilidad de obesidad y disglucemias(AU)

Introduction: Nonalcoholic fatty liver disease and hypertriglyceridemic waist are new markers of atherosclerotic cardiovascular disease. Objectives: To characterize the hypertriglyceridemic waist and nonalcoholic fatty liver disease as cardiometabolic risk factors in hypertensive patients. Methods: A prospective longitudinal study was conducted in 131 patients admitted to Miguel Enríquez Clinical-Surgical Teaching Hospital with a diagnosis of arterial hypertension, from July 2015 to July 2016. The variables included were age, sex, smoking, diabetes, body mass index, hypertriglyceridemic waist, blood glucose, total cholesterol, years of hypertension evolution, poorly-controlled hypertension, and nonalcoholic fatty liver disease. Results: One third of the patients showed hypertriglyceridemic waist and nonalcoholic fatty liver. Hypertensive adults with hypertriglyceridemic waist have a higher probability of obesity, elevated fasting glycaemia, as well as greater lack of control and natural history of hypertension. The hypertriglyceridemic waist shows a close relationship and a good predictive value (sensitivity of 86.1percent and specificity of 84.1percent for the identification of nonalcoholic fatty liver in hypertensive adults. Conclusions: The hypertriglyceridemic waist has a good predictive value for the identification of nonalcoholic fatty liver in hypertensive patients and is related to a greater probability of obesity and dysglycemia(AU)

Utility of the Visceral Adiposity Index and Hypertriglyceridemic Waist Phenotype for Predicting Incident Hypertension

BACKGROUND: The aim of this study was to assess the utility of the visceral adiposity index (VAI) and the hypertriglyceridemic waist (HTGW) phenotype as possible hypertension (HTN) predictors in a high-risk population without diabetes and HTN. METHODS: Incident HTN over a 7-year follow-up was assessed among 1,375 first-degree non-diabetic and non-hypertensive relatives of consecutive patients with type 2 diabetes who were 30 to 70 years of age. HTN was defined as a blood pressure reading ≥140/90 mm Hg or the use of antihypertensive medications. We examined the incidence of HTN across VAI quintiles and four groups defined according to baseline fasting serum triglyceride (TG) levels and waist circumference (WC). RESULTS: The VAI and the HTGW phenotype at baseline were related to an increased risk for HTN. In comparison with the lowest VAI quintile, the highest VAI quintile showed a significant associated with HTN in an age- and gender-adjusted model (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.07 to 2.55). Those with HTGW were 2.3 times (OR, 2.27; 95% CI, 1.54 to 3.35) more likely to develop HTN than those with a normal WC and normal TG levels. CONCLUSION: Greater VAI values weakly predicted HTN, whereas the HTGW phenotype was a stronger predictor of incident HTN in an Iranian high-risk population.

Association of hypertriglyceridemic-waist phenotype with liver enzymes and cardiometabolic risk factors in adolescents: the CASPIAN-III study / Associação do fenótipo de cintura hipertrigliceridêmica com enzimas hepáticas e fatores de risco cardiometabólico em adolescentes: o estudo CASPIAN-III

Abstract Objective This study aims to investigate the role of metabolic syndrome (MetS) and the hypertriglyceridemic-waist (HW) phenotype in determining cardiometabolic risk factors and elevated liver enzymes in a national sample of Iranian pediatric population. Method This nationwide study was conducted in the framework of the third survey of a surveillance program. Students, aged 10-18 years, were recruited from 27 provinces in Iran. The prevalence of cardiometabolic risk factors was compared in students with and without HW and MetS. The association of HW with different cardiometabolic risk factors was determined. Results The mean age of studied population was 14.73 ± 2.41 years. Prevalence of HW and MetS was 3.3% and 4%, respectively. Sixty-nine (71.1%) participants with HW had MetS. The prevalence of obesity, elevated systolic blood pressure, hypercholesterolemia, and elevated alanine aminotransaminase (ALT) was significantly higher in subjects with HW phenotype and MetS than in their peers (p < 0.05). A significant association was observed between HW and elevated levels of cholesterol and ALT, as well as between obesity and low HDL-C (p < 0.05). Conclusions The current findings serve as complementary evidence to previous studies, which have been mainly conducted among adults, suggesting that the HW phenotype is associated with cardiometabolic risk factors, especially with elevated cholesterol and ALT. The authors propose that, in primary care settings and in large epidemiological studies, the measurement of all MetS components can be replaced by studying HW as a screening tool for identifying children at high risk for cardiometabolic disorders.

Resumo Objetivo Investigar o desempenho da síndrome metabólica (SM) e do fenótipo de cintura hipertrigliceridêmica (CH) na determinação de fatores de risco cardiometabólico e enzimas hepáticas elevadas em uma amostra nacional da população pediátrica iraniana. Método Estudo nacional feito na estrutura da terceira pesquisa de um programa de vigilância. Foram recrutados alunos de 10-18 anos de 27 províncias do Irã. A prevalência de fatores de risco cardiometabólico foi comparada em alunos com e sem CH e SM. Foi determinada a associação da CH com diferentes fatores de risco cardiometabólico. Resultados A média de idade da população estudada foi de 14,73 ± 2,41 anos. A prevalência de CH e SM foi de 3,3% e 4%, respectivamente; 69 (71,1%) dos participantes com CH apresentaram SM. A prevalência de obesidade, pressão arterial sistólica elevada, hipercolesterolemia e alanina aminotransferase (ALT) elevada foi significativamente maior em meninos e meninas com fenótipo CH e SM do que em seus outros pares (p < 0,05). A associação de CH foi significativa com elevados níveis de colesterol e ALT, bem como obesidade e HDL-C baixo (p < 0,05). Conclusões Os achados atuais servem de evidência complementar de estudos anteriores, conduzidos principalmente com adultos, e sugerem que o fenótipo CH está associado a fatores de risco cardiometabólico, principalmente com colesterol e ALT altos. Propomos que, em ambientes de cuidados básicos e em grandes estudos epidemiológicas, a medição de todos os componentes de SM possa ser substituída pelo estudo da CH como ferramenta de triagem para identificar crianças com alto risco de apresentarem distúrbios cardiometabólicos.

Anthropometric indices to identify metabolic syndrome and hypertriglyceridemic waist phenotype: a comparison between the three stages of adolescence / Indicadores antropométricos para identificar síndrome metabólica e fenótipo cintura hipertrigliceridêmica: uma comparação entre as três fases da adolescência

OBJECTIVE: To determine the prevalence of metabolic syndrome (MS) and the hypertriglyceridemic waist phenotype (HW) in a representative adolescent sample; as well as to establish which anthropometric indicator better identifies MS and HW, according to gender and adolescent age. METHODS: This cross sectional study had the participation of 800 adolescents (414 girls) from 10-19 years old. Anthropometric indicators (body mass index, waist perimeter, waist/stature ratio, waist/hip ratio, and central/peripheral skinfolds) were determined by standard protocols. For diagnosis of MS, the criteria proposed by de Ferranti et al. (2004) were used. HW was defined by the simultaneous presence of increased waist perimeter (>75th percentile for age and sex) and high triglycerides (>100 mg/dL). The ability of anthropometric indicators was evaluated by Receiver Operating Characteristic curve. RESULTS: The prevalence of MS was identical to HW (6.4%), without differences between genders and the adolescence phases. The waist perimeter showed higher area under the curve for the diagnosis of MS, except for boys with 17-19 years old, for whom the waist/stature ratio exhibited better performance. For diagnosing HW, waist perimeter also showed higher area under the curve, except for boys in initial and final phases, in which the waist/stature ratio obtained larger area under the curve. The central/peripheral skinfolds had the lowest area under the curve for the presence of both MS and HW phenotype. CONCLUSIONS: The waist perimeter and the waist/stature showed a better performance to identify MS and HW in both genders and in all three phases of adolescence.

OBJETIVO: Determinar a ocorrência de síndrome metabólica (SM) e do fenótipo cintura hipertrigliceridêmica (CH) em amostra de adolescentes e estabelecer qual indicador antropométrico melhor identifica SM e CH, de acordo com gênero e fase da adolescência. MÉTODOS: Estudo transversal com 800 adolescentes (414 meninas) de 10-19 anos. Indicadores antropométricos (índice de massa corporal, perímetro da cintura, relação cintura/estatura, relação cintura/quadril e relação pregas cutâneas centrais/periféricas) foram determinados por protocolos padronizados. Para diagnóstico da SM, foi usada a proposta de Ferranti et al. (2004). A CH foi definida pela presença simultânea de perímetro da cintura aumentado (>75 percentil por idade e sexo) e triglicerídeos elevados (>100 mg/dL). O desempenho dos indicadores antropométricos foi avaliado por meio da curva Receiver Operating Characteristic. RESULTADOS: A prevalência de SM foi idêntica à de CH (6,4%), sem diferenças entre os gêneros e entre as fases da adolescência. O perímetro da cintura apresentou maior área abaixo da curva no diagnóstico da SM, exceto para meninos entre 17-19 anos, para os quais a relação cintura/estatura exibiu melhor desempenho. No diagnóstico da CH, a cintura isolada apresentou maior área abaixo da curva, exceto para os meninos nas fases inicial e final da adolescência, nos quais a relação cintura/estatura obteve maior área. A relação entre as pregas cutâneas apresentou pior desempenho para identificar SM e CH. CONCLUSÕES: O perímetro da cintura e a relação cintura/estatura mostraram o melhor desempenho para identificar SM e CH em ambos os sexos e nas três fases da adolescência.

Circunferencia hipertrigliceridémica y perfil de riesgo cardiometabólico en adolescentes normopeso y con exceso de peso / Hypertriglyceridemic waist and cardiometabolic risk profile among normal weight and overweight adolescents

Antecedentes. La cintura hipertrigliceridémica (CHTG) se asocia con elevado riesgo cardiometabólico en adultos; sin embargo, se dispone de poca información sobre si la misma genera cambios metabólicos adversos en adolescentes con y sin exceso de peso. Objetivo. Evaluar el perfil del riesgo cardiometabólico asociado con la CHTG y su capacidad para predecir factores de este perfil en adolescentes, categorizados según el puntaje Z del índice de masa corporal. Materiales y métodos. Se evaluaron 96 adolescentes (12-17 años) divididos en dos grupos: normopeso y sobrepeso/obesidad. Se determinaron peso, talla, circunferencia de cintura, presión arterial, estadio de maduración sexual y marcadores bioquímicos del riesgo cardiometabólico. Se calculó un índice de riesgo cardiometabólico agrupado. Resultados. La frecuencia de la CHTG fue de 9.8%. El número de casos de esta fue mayor al avanzar la maduración sexual (p<0.001) y en el grupo con exceso de peso (p=0.043). En el grupo total, la CHTG fue capaz de predecir presión arterial elevada (p<0.002), colesterol no-HDL elevado (p<0.012) y riesgo cardiometabólico agrupado elevado (p<0.001). En tanto que en el grupo normopeso, elevó la relación TGL/HDLc (p=0.003) y el índice de riesgo cardiometabólico agrupado (p=0.001). Por último, en el grupo con sobrepeso/obesidad, esta elevó: presión sistólica (p=0.005) y diastólica (p=0.006), colesterol total (p=0.037) y no-HDL (p=0.029), relación colesterol total/HDLc (p=0.032), relación triglicéridos/HDLc (p<0.001) e índice de riesgo cardiometabólico agrupado (p<0.001), independientemente del sexo, edad y estadio de maduración sexual. Conclusiones. La CHTG fue prevalente y se asoció a un perfil metabólico adverso y riesgo cardiometabólico agrupado elevado en adolescentes con y sin exceso de peso, recomendándose su detección en atención primaria.

Background. Hypertriglyceridemic waist phenotype (HW) is associated with high cardiometabolic risk (CMR) in adults; however, there is little information on whether it causes adverse metabolic changes in adolescents with and without excess body weight or not. Objective. To evaluate the profile of CMR associated with HW and its ability to predict CMR factors in adolescents, categorized by body mass index Z-score. Materials and methods. 96 adolescents (aged 12-17) divided into two groups (normal weight and overweight/obesity) were evaluated. Weight, height, waist circumference, blood pressure and biochemical markers of CMR were measured; the stage of sexual maturation was established. Clustered CMR index was calculated. Results. The frequency of HW was 9.8%. The number of cases of HW was higher in the later stages of sexual maturation (p<0.001) and in the overweight/obesity group (p=0.043). In the total group, the HW was able to predict the presence of high blood pressure (p<0.002), high cholesterol non-HDL (p<0.012) and elevated clustered CMR (p<0.001). In the normal weight group, the presence of HW significantly raised the triglycerides/ HDL-cholesterol ratio (p=0.003) and clustered CMR index (p=0.001); in the overweight/obesity group, HW increased systolic (p=0.005) and diastolic (p=0.006) blood pressure, total (p=0.037) and non-HDL (p=0.029) cholesterol, total cholesterol/ HDL-cholesterol ratio (p=0.032), triglycerides/HDL-cholesterol ratio (p<0.001) and the clustered CMR index (p<0.001), regardless of gender, age and stage of sexual maturation. Conclusions. HW was prevalent and associated with an adverse metabolic profile and high clustered CMR in adolescents with and without excess body weight, so its detection is recommended in primary care.

Estudio de correlación entre los diagnósticos de cintura hipertrigliceridémica y síndrome metabólico en adultos de Trujillo, Perú / Study of correlation between diagnostic hypertriglyceridemic waist and metabolic syndrome in adults in Trujillo, Peru

Objetivos. Determinar la concordancia entre la cintura hipertrigliceridémica (CHTG) y el síndrome metabólico (SM) en adultos de Trujillo según criterios diagnósticos. Materiales y métodos. Estudio observacional, prospectivo y de corte transversal en un muestra de 500 personas adultas de Trujillo, seleccionadas mediante muestreo probabilístico y estratificado (por sexo y edad). Se recopiló información consistente en medidas antropométricas, presión arterial y pruebas bioquímicas; luego se aplicó los criterios propuestos por el ATP III y Joint Interin Statement (JIS) para SM, así como los de Gómez y JIS para CHTG. Se usó el programa EPIDAT, donde se calculó la frecuencia, test Z, prueba de T Student y el test de Kappa (k) con un intervalo de confianza (IC) del 95 %. Resultados. Se recogió información concerniente a 239 varones y 261 mujeres. La frecuencia de CHTG según criterios de Gómez fue 30% en el total de la muestra, 29,7% en varones y 30,3% en mujeres. Según criterios JIS la frecuencia fue 34% en el total de población, 38,1% en varones y 30,3% en mujeres. El SM según criterios JIS tuvo una buena concordancia con CHTG según criterios de Gómez con k=0,63 y según criterios JIS con k=0,66, en el total de población. Conclusiones. Se evidenció buena concordancia entre la CHTG según ambos criterios y SM según JIS.

Objectives. To determine the correlation between hypertriglyceridemic waist (HTGW) and metabolic syndrome (MS) in adults of Trujillo according to diagnostic criteria. Materials and methods. Observational, prospective and cross-sectional study with a sample of 500 adults in Trujillo, selected by probability sampling and stratified by sex and age. Information on anthropometric measurements, blood pressure and biochemical tests was collected; Criteria proposed by the ATP III and Joint Interim Statement (JIS) for MS, as well as Gomez and JIS for HTGW were applied. EPIDAT software was used to calculate Z test, Student t test and the Kappa (k) with a confidence interval (CI) of 95%. Results. Information regarding 239 men and 261 women were collected. The frequency of HTGW according to Gomez criteria was 30% in the total sample, 29.7% in men and 30.3% women. According to JIS criteria the frequency was 34% in the total sample, 38.1% in men and 30.3% women. Metabolic Syndrome with JIS criteria had good agreement with HTGW according to Gomez criteria with k = 0.63 and according to JIS criteria with k = 0.66. Conclusions. Good agreement was evidenced between the HTGW according to Gomez and JIS criteria and MS according to JIS.

Cintura hipertrigliceridémica y resistencia a la insulina en una comunidad rural y una urbana de Tinaquillo, Venezuela

Objetivo: Evaluar la frecuencia de circunferencia hipertrigliceridémica (CHT) y resistencia a la insulina (RI), y su asociación con otros factores de riesgo cardiovascular, en una comunidad rural y una urbana de Tinaquillo, Estado Cojedes, Venezuela. Métodos: Se evaluaron 89 individuos mayores de 18 años (45 pertenecientes a la comunidad rural y 44 a la comunidad urbana) a los cuales se les determinó peso, talla, circunferencia de cintura, presión arterial así como glucosa, insulina, triglicéridos, colesterol total, LDLc y HDLc en suero. Además, se aplicó una encuesta para medir antecedentes personales de enfermedad cardiovascular (ECV) y estilo de vida. Resultados: Se encontró una baja frecuencia de CHT (9%). Caso contrario, resultó la RI (51%), siendo elevada en ambas comunidades pero significativamente mayor en la comunidad urbana. La CHT en el grupo total se asoció estadísticamente con la presencia de insulinorresistencia y obesidad. Por su parte, la insulinorresistencia tuvo asociación estadística con obesidad y obesidad abdominal, tanto en el grupo total como en las comunidades evaluadas por separado. Conclusiones: Los resultados confirman que las comunidades próximas a la industrialización tienen un riesgo mayor a padecer ECV. No obstante, la comunidad rural mostró un cifra importante de RI, lo que indica que ésta población es igualmente propensa al riesgo cardiovascular, sugiriendo que los programas de promoción en salud emergentes deben tener alcance hasta las comunidades rurales y no limitarse a las comunidades urbanas.

Objective: To evaluate the frequency of hypertriglyceridemic waist (HTW) and insulin resistance (IR) and its association with cardiovascular risk factors in a rural community and an urban community Tinaquillo, Cojedes State, Venezuela. Methods: Eighty-nine individuals older than 18 years (45 belonging to the rural community and 44 from the urban community) were evaluated. Weight, height, waist circumference, blood pressure were measured, and glucose, insulin, triglycerides, total cholesterol, LDLc and HDLc in serum were determined. In addition, a questionnaire was applied to know personal history of cardiovascular disease (CVD) and lifestyle. Results: A low frequency of HTW (9%) was found. By contrast, the frequency of IR was high (51%), which was high in both communities but significantly higher in urban community. HTW was statistically associated with the presence of IR and obesity in the total group. The IR was statistically significant with obesity and abdominal obesity in both the total group and in the communities evaluated separately. Conclusions: The results confirm that the upcoming industrialization communities are at increased risk for cardiovascular disease. However, the rural community showed a significant frequency of IR, indicating that this population is also prone to cardiovascular risk, suggesting that emerging programs in health promotion should be reach to rural communities and not just urban communities.

Increased Risk of Diabetes Development in Subjects with the Hypertriglyceridemic Waist Phenotype: A 4-Year Longitudinal Study

BACKGROUND: The hypertriglyceridemic waist (HTGW) phenotype is a simple and inexpensive screening parameter to identify people at increased risk of cardiovascular disease. We evaluated whether the HTGW phenotype predicts diabetes in urban Korean adults. METHODS: A total of 2,900 nondiabetic subjects (mean age 44.3 years), comprising 2,078 males (71.7%) and 822 females (28.3%) who underwent annual medical check-ups at our center between January 2005 and December 2009, were recruited. The subjects were divided into four groups according to baseline serum triglyceride (TG) level and waist circumference (WC): normal WC-normal TG (NWNT) level, normal WC-high TG level, enlarged WC-normal TG level, and enlarged WC-high TG (EWHT) level. High serum TG level was defined as > or =150 mg/dL and enlarged WC was defined as > or =90 cm for men and > or =85 cm for women. New cases of diabetes were determined according to questionnaires filled in by participants and the diagnostic criteria of the American Diabetes Association. Cox proportional hazards model analysis was used to assess the association of HTGW phenotype with the incidence of diabetes. RESULTS: A total of 101 (3.5%) new diabetes cases were diagnosed during the study period. The EWHT group had a higher incidence of diabetes (8.3%) compared with the NWNT group (2.2%). The adjusted hazard ratio for diabetes for subjects with the EWHT phenotype at baseline was 4.113 (95% confidence interval [CI], 2.397 to 7.059) after adjustment for age, and 2.429 (95% CI, 1.370 to 4.307) after adjustment for age, sex, total cholesterol, systolic blood pressure, and alcohol drinking history. It was attenuated by inclusion of baseline fasting glucose level in the model. CONCLUSION: Subjects with the HTGW phenotype showed the highest risk of incident diabetes. This tool could be useful for identifying individuals at high risk of diabetes.

Fenótipo cintura hipertrigliceridêmica: associação com alterações metabólicas em adolescentes / Hypertriglyceridemic waist phenotype: association with metabolic abnormalities in adolescents

OBJETIVO: O presente estudo objetivou identificar a prevalência do fenótipo cintura hipertrigliceridêmica (CHT) e avaliar sua associação com alterações metabólicas em adolescentes de baixa condição econômica. MÉTODO: Estudo transversal com amostra probabilística de 1.076 adolescentes entre 11 e 17 anos, de ambos os sexos, estudantes de escolas públicas. Os participantes foram submetidos à avaliação antropométrica (peso, altura e circunferência da cintura) e à dosagem dos níveis de colesterol total, LDL-C, HDL-C, colesterol não HDL, triglicérides (TG) e glicemia de jejum. Foram obtidas informações referentes às condições econômicas das famílias dos participantes.O fenótipo CHT foi definido pela presença simultânea da circunferência da cintura aumentada (> percentil 90 por idade e sexo) e dos níveis séricos de triglicérides elevados (> 100 mg/dL). A análise de regressão logística foi utilizada para avaliação das associações de interesse. RESULTADOS: A prevalência do fenótipo CHT foi de 7,2% entre os adolescentes, sendo mais elevada na presença de obesidade (63,4%), do colesterol não HDL (16,6%) e do LDL-C (13,7%) altos. A análise bivariada indicou que, das variáveis metabólicas, apenas a glicemia não se associou ao fenótipo CHT. A análise multivariada, ajustada por sexo e idade, indicou que o fenótipo CHT se associou positivamente com o colesterol não HDL alto (odds ratio, 7,0; IC 95% 3,9-12,6) e com o HDL-C baixo (odds ratio, 2,7; IC 95%, 1,5-4,8). CONCLUSÕES: Este estudo mostrou que o fenótipo CHT se associou com um perfil lipídico aterogênico e sugere esse fenótipo como uma ferramenta de screening que pode ser utilizada para identificar adolescentes com alterações metabólicas.

OBJECTIVE: This study aimed to identify the prevalence of hypertriglyceridemic waist (HTW) phenotype, and to evaluate its association with metabolic abnormalities in adolescents of low socioeconomic status. METHOD: This was a cross-sectional study with a random sample of 1,076 adolescents between 11 and 17 years, of both genders, from public schools. The participants underwent anthropometric measurements (weight, height, and waist circumference), and levels of total cholesterol, low-density-lipoprotein cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), non-HDL cholesterol triglyceride (TG), and fasting glucose were measured. Information regarding the socioeconomic status of the participants' families was obtained. The HTW phenotype was defined by the simultaneous presence of increased waist circumference (> 90th percentile for age and gender) and serum triglyceride levels (> 100 mg/dL). A logistic regression analysis was used to evaluate the associations of interest. RESULTS: The prevalence of HTW phenotype was 7.2% among the adolescents, being higher in the presence of obesity (63.4%) and high levels of non-HDL cholesterol (16.6%) and LDL-C (13.7%). The bivariate analysis indicated that, of the metabolic variables, only blood glucose was not associated with the HTW phenotype. Multivariate analysis adjusted for age and gender indicated that the HTW phenotype was positively associated with high non-HDL cholesterol (odds ratio: 7.0; 95% CI: 3.9-12.6) and low HDL-C levels (odds ratio: 2.7; 95% CI: 1.5-4.8). CONCLUSIONS: This study demonstrated that the HTW phenotype was associated with an atherogenic lipid profile, and this phenotype is suggested as a screening tool to identify adolescents with metabolic alterations.

Interaction of both hypertriglyceridemic waist and impaired fasting glucose on the incidence of diabetes mellitus / 中华流行病学杂志

Objective To study the use ofhypertriglyceridemic waist (HTGW) to predict the occurrence of diabetes.Also to independently study whether there was an interaction between HTGW and impaired fasting glucose impaired fasting glucose (IFG) on the cause of diabetes.Methods We undertook a cohort study based on data from the “Prevention of Multiple Metabolic Disorders and Metabolic Syndrome (MS) Study in Jiangsu Province,China”.We used the logistic regression model to analyze the relations between both HTGW,IFG and diabetes mellitus and to evaluate the multiplied interaction between HTGW and IFG to include product terms method.Counting additive interaction was carried out under the Excel Calculation Sheet,compiled by Anderson and his colleagues.Results After adjusted for general risk factors and baseline fasting plasma glucose (FPG),results showed that subjects with HTGW had a 2.10 (95％ CI:1.36-3.25) adjusted relative risk (HR) of developing a diabetes when compared with those individuals without HTGW at the baseline study.When IFG was stratified,participants with HTGW were significantly associated with diabetes,regardless of IFG.The multi-adjusted HRs of diabetes were 3.09 (1.70-5.61) and 2.09 (1.08-4.02),respectively.Compared to the participants with non-HTGW and their FPG level below the threshold,those having HTGW and their FPG level was above the threshold,had the highest adjusted HR values [12.05 (95％CI:6.89-21.07)].Data from the additive interaction analysis showed that RERI as 7.00 (95％ CI:0.49-13.51),AP as 0.57 (95％ CI:0.32-0.82) and SI as 2.66 (95％ CI:1.36-5.21).Conclusion HTGW could predict the occurrence of diabetes,independent from IFG while the presence of HTGW with IFG could have an additive interaction on the cause of diabetes.