CAPACITY OF ANTHROPOMETRIC INDICES TO DISCRIMINATE METABOLIC SYNDROME IN THE CLIMACTERIC
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Abstract
During the climacteric period, endocrine and metabolic changes occur which have important repercussions on women's health, including an increase in the prevalence of metabolic syndrome. The identification of climacteric women who are predisposed to developing metabolic syndrome, using simple and inexpensive tools, is fundamental for improving care for women assisted by the public health system. The aim of the study was to assess the ability of anthropometric indices to discriminate metabolic syndrome in women at different stages of the climacteric. This is a cross-sectional, quantitative and analytical study with women aged between 40 and 65, selected by probabilistic sampling, who are assisted by the Family Health Strategy in the municipality of Montes Claros, Minas Gerais, Brazil. Data collection included sociodemographic characteristics and lifestyle habits. Metabolic syndrome was assessed according to the criteria of the International Diabetes Federation, 2006. The Body Mass Index, Abdominal Circumference, Body Roundness Index, Body Shape Index and Visceral Adiposity Index were calculated. Descriptive statistics, the chi-square test, binary logistic regression, the ROC curve and the Youden index were used to analyze the data. The sample consisted of 874 women. Metabolic syndrome was more prevalent in postmenopausal women and the indices were associated with metabolic syndrome in both climacteric phases. The VAI obtained the highest area under the curve (AUC) ROC value in the pre- (AUC: 0.821) and post-menopause (AUC: 0.812). WC (AUC pre: 0.79 and post: 0.728) and BRI (AUC pre: 0.792 and AUC post: 0.727) had good discriminative capacity in both in the two climacteric phases. Waist circumference, Body Body Roundness Index and Visceral Adiposity Index can be used to identify climacteric women predisposed to developing metabolic syndrome. metabolic syndrome, setting up screening tools for this comorbidity in primary care.
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This work is licensed under a Creative Commons Attribution 4.0 International License.
References
ADEJUMO, E. M. et al. “Anthropometric parameter that best predict metabolic syndrome in South west Nigeria”. Diabetes and Metabolic Syndrome: Clinical Research & Reviews, vol. 13, n. 1, 2019.
AMATO, M. C.; GIORDANO, C. “Visceral adiposity index: an indicator of adipose tissue dysfunction”. International Journal of Endocrinology, vol. 2014, 2014.
AMATO, M.C. et al. “Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk”. Diabetes Care, vol. 33, n. 4, 2010.
ANDRADE, M. V. et al. “Transition to universal primary health care coverage in Brazil: Analysis of uptake and expansion patterns of Brazil's Family Health Strategy (1998-2012)”. PloS One, vol. 13, n. 8, 2018.
ASSUNÇÃO, D. F. S. et al. “Qualidade de vida de mulheres climatéricas”. Revista da Sociedade Brasileira de Clínica Médica, vol. 15, n. 2, 2017.
BABER, R.J. et al. “2016 IMS Recommendations on women's midlife health and menopause hormone therapy”. Climacteric, vol. 19, n. 2, 2016.
BAVEICY, K. et al. “Predicting Metabolic Syndrome by Visceral Adiposity Index, Body Roundness Index and a Body Shape Index in Adults: A Cross-Sectional Study from the Iranian RaNCD Cohort Data”. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, vol. 13, 2020.
BERTOLI, S. et al. “Association of Body Shape Index (ABSI) with cardio-metabolic risk factors: A crosssectional study of 6081 Caucasian adults”. Plos One, vol. 12, n. 9, 2017.
BIJARI, M. et al. “The Accuracy of Visceral Adiposity Index for the Screening of Metabolic Syndrome: A Systematic Review and Meta-Analysis”. International Journal of Endocrinology, vol. 2021, 2021.
BORGES, L. S. R. “Medidas de Acurácia Diagnóstica na Pesquisa Cardiovascular”. International Journal of Cardiovascular Sciences, vol. 29, n. 3, 2016.
BRACHT, J. R. et al. “The role of estrogens in the adipose tissue milieu”. Annals of the New York Academy of Sciences, vol. 1461, n. 1, 2020.
BRASIL. Política Nacional de Atenção Primária. Brasília: Ministério da Saúde, 2020. Disponível em:< . Acesso em: 23/01/2024.
BRASIL. Protocolos da Atenção Básica: Saúde das Mulheres. Brasília: Ministério da Saúde, 2016. Disponível em:< . Acesso em: 23/01/2024.
CASTRO, L. M. X. et al. Monitoramento e acompanhamento da Política Nacional de Atenção Integral à Saúde da Mulher PNAISM e do Plano Nacional de Políticas para as Mulheres PNPM. Brasília: Ministério da Saúde, 2015.
CHRISTAKIS, M. K. et al. “The effect of menopause on metabolic syndrome: cross-sectional results from the Canadian Longitudinal Study on Aging”. Menopause, vol. 27, n. 9, 2020.
CRAIG, C. L. et al. “International physical activity questionnaire: 12-country reliability and validity”. Medicine and Science in Sports and Exercise, vol. 35, n. 8, 2003.
CZECZELEWSKI, M. et al. “Association of body composition indexes with cardio-metabolic risk factors”. Obesity Medicine, vol. 17, 2020.
FEBRASCO - Federação Brasileira das Associações de Ginecologia e Obstetrícia. Manual de Orientação do Climatério. São Paulo: USP, 2010.
FOGAÇA E SILVA, E. M. et al. “Prevalência de obesidade em mulheres na pós-menopausa atendidas em um ambulatório no sul do Brasil”. Revista da Associação Brasileira de Nutrição, vol. 10, 2019.
GARROW, J. Treat Obesity Seriously: A Clinical Manual. Edinburgh: Churchill Livingstone, 1981.
GUERRA, K. D. O. S. et al. “Avaliação do risco cardiovascular em mulheres climatéricas atendidas na atenção primária a saúde”. Boletim de Conjuntura (BOCA), vol. 16, n. 47, 2023.
HAO, S. et al. “Dietary and exercise interventions for metabolic health in perimenopausal women in Beijing”. Asia Pacific Journal of Clinical Nutrition, vol. 30, n. 4, 2021.
IDF - International Diabetes Federation. “The IDF Consensus Worldwide Definition of the Metabolic Syndrome”. IDF [2006]. Disponível em: . Acesso em: 23/01/2024.
KRAKAUER, N. Y.; KRAKAUER; J. C. “A new body shape index predicts mortality hazard independently of body mass index”. PloS One, vol. 7, n. 7, 2012.
LEAN, M. E. J.; HAM, T. S.; MORRISON, C. E. “Waist circumference as a measure for indicating need for weight management”. BMJ, vol. 311, n. 6998, 1995.
LI, H. et al. “Relationship between obesity indicators and hypertension-diabetes comorbidity in an elderly population: a retrospective cohort study.” BMC Geriatrics, vol. 23, 2023.
LIU, P. J. et al. “Body roundness index and body adiposity index: two new anthropometric indices to identify metabolic syndrome among Chinese postmenopausal women.” Climacteric, v.19, n.5, 2016.
MA, H. et al. “On use of partial area under the ROC curve for evaluation of diagnostic performance.” Statistics in Medicine, vol. 32, n. 20, 2013.
MEHNDIRATTA, N. et al. “A Prospective study on the incidence of metabolic syndrome in premenopausal end postmenopausal women”. Journal Mid-life Health, vol. 11, 2020.
MENDES, K. G. et al. “Menopausal Status and Metabolic Syndrome in Women in Climacteric Period Treated at a Clinic in Southern Brazil”. Open Journal of Endocrine and Metabolic Diseases, vol. 3, 2013.
NAIR, A. R.; PILLAI, A.J.; NAIR, N. “Cardiovascular Changes in Menopause.” Current cardiology Reviews, vol. 17, n. 4, 2021.
NAMS - North American Menopause Society. Menopause Guide. Washington: NAMS, 2020.
OLIVEIRA, R. P. et al. “Índice de adiposidade visceral como preditor de risco cardiometabólico em crianças e adolescentes”. Revista Brasileira de Medicina do Esporte, vol. 23, n. 3, 2017.
PARK, H. S. et al. “The metabolic syndrome and associated lifestyle factors among South Korean adults”. International Journal of Epidemiology, vol. 33, 2004.
PRASUN, P. “Mitochondrial dysfunction in metabolic syndrome”. Biochimica et Biophysica Acta - Molecular Basis of Disease, vol. 1866, n. 10, 2020.
RA, J. S.; KIM, H. “Combined Effects of Unhealthy Lifestyle Behaviors on Metabolic Syndrome among Postmenopausal Women.” Healthcare, vol. 9, n.7, 2021.
RAMIREZ-VÉLEZ, R. et al. “Validation of Surrogate Anthropometric Indices in Older Adults: What Is the Best Indicator of High Cardiometabolic Risk Factor Clustering?”. Nutrients, vol. 11, n. 8, 2019.
REIS, V. M. C. O. et al. “Prevalence and factors associated with metabolic syndrome in climacteric women”. International Journal of Development Research, vol. 10, n. 6, 2020.
RICO-MARTÍN, S. et al. “Effectiveness of body roundness index in predicting metabolic syndrome: A systematic review and meta-analysis.” Obesity Reviews, vol. 21, n. 7, 2020.
SAKLAYEN, M. G. “The Global Epidemic of the Metabolic Syndrome”. Current Hypertension Reports, vol. 20, n. 2, 2018
SON, W. M.; PARK, J. J. “Resistance Band Exercise Training Prevents the Progression of Metabolic Syndrome in Obese Postmenopausal Women”. Journal of Sports Science and Medicine, vol. 20, 2021.
SPG - Sociedade Portuguesa De Ginecologia. Consenso Nacional sobre Menopausa. Coimbra: SPG, 2021.
STEFANESCU, A. et al. “Using a Body Shape Index (ABSI) e Body Roundness Index (BRI) to predist risk of metabolic Syndrome in Peruvian adults”. Journal of International Medical Reseacrh, vol. 48, 2019.
SULIGA, E. et al. “The Usefulness of Anthropometric Indices to Identify the Risk of Metabolic Syndrome”. Nutrients, vol. 11, n.11, 2019.
TAN, A. et al. “Effects of exercise training on metabolic syndrome risk factors in post-menopausal women - A systematic review and meta-analysis of randomised controlled trials”. Clinical Nutrition, vol. 42, n. 3, 2023.
TAPE, T. G. Interpreting diagnostic tests. Omaha: University of Nebraska Medical Center, 2001
THOMAS, D. M. et al. “Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model”. Obesity, vol. 21, n. 11, 2013.
THOMSON, C. A. et al. “Body shape, adiposity index, and mortality in postmenopausal women: Findings from the Women's Health Initiative.” Obesity, vol. 24, n. 5, 2016.
TIAN, T. et al. “Predicting value of five anthropometric measures in metabolic syndrome among Jiangsu Province, China”. BMC Public Health, vol. 20, 2020.
WANG, H. et al. “Comparison of anthropometric indices for predicting the risk of metabolic syndrome and its components in Chinese adults: a prospective, longitudinal study”. BMJ Open, vol. 7, n. 9, 2017.
WHO - World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: WHO, 2000.
WU, L. et al. “Novel and traditional anthropometric indices for identifying metabolic syndrome in non-overweight/obese adults”. Nutrition and Metabolism, vol. 18, n. 1, 2021.