2011, Number 3
Waist-hip index versus waist circumference for diagnosis of metabolic syndrome in first degree-children and adolescents relatives of persons with type 1 diabetes
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ABSTRACTObjective: to compare the measurements of waist circumference and waist-hip circumference to determine the frequency of metabolic syndrome in first degree relatives of persons with type 1diabetes, using different pediatric definitions.
Methods: two hundred twenty four first degree relatives of persons with type 1 diabetes were studied in ages from 4 to 10 years. Weight, height, waist-hip circumference, blood pressure, glycemia, triglycerides and HDL-cholesterol were determined. The definitions of metabolic syndrome according to Cook, Ford, International Federation of Diabetes and the Cuban consensus were applied. A variant of Cuban consensus was performed using: body mass index and waist-hip index according the Cuban tables, values of glucose ≥ 5,6 mmol/L and blood pressure ≥ 90 percentile (Cuban tables). In an independent way, criteria of HDL-cholesterol and triglycerides were taken into account. The waist-hip index of Cuban tables, the waist circumference suggested by the Latin-American and European Association of Diabetes for study definitions were applied. For comparison of frequencies of metabolic syndrome the Fisher exact test was used.
Results: the frequency of metabolic syndrome with application of Cuban consensus variant was of 9,37 % (21/224). Comparing the above variant with the definitions of Cook, Ford and of the International Federation of Diabetes (using the waist circumference of the Latin-American Association of Diabetes, there was a significant difference between Cook and the International Federation of Diabetes (4,01 %, p= 0,0360; 1,33 %, p= 0,0002, respectively). Comparing the presence of metabolic syndrome of the Cuban consensus variant with Cook (8,48 %; 19/224) and Ford (8,93 %; 20/224) taking into account the waist-hip index of the Cuban tables, it is possible to detect similar frequencies of first degree relatives of persons with type 1 diabetes with metabolic syndrome. On the other hand, we found significant differences comparing the frequencies of metabolic syndrome of the Cuban consensus variant (p= 0,0019), of Cook (p= 0,0053) and of Ford (p= 0,0032) with the definition suggested by the International Federation of Diabetes (2,23 %; 5/224) using the waist-hip index.
Conclusions: our data demonstrate that for the diagnosis of metabolic syndrome we must to use the waist-hip index and not the circumference suggested by the Latin- American Association of Diabetes, still without to present own data of waist-hip circumference of the Cuban population.
Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1 640-5.