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Waist-to-height ratio: an accurate anthropometric index of abdominal adiposity and a predictor of high HOMA-IR values in nondialyzed chronic kidney disease patients.
Nutrition. 2014 Mar; 30(3):279-85.N

Abstract

OBJECTIVE

Chronic kidney disease (CKD) is associated with metabolic disorders, including insulin resistance (IR), mainly when associated with obesity and characterized by high abdominal adiposity (AbAd). Anthropometric measures are recommended for assessing AbAd in clinical settings, but their accuracies need to be evaluated. The aim of this study was to evaluate the precision of different anthropometric measures of AbAd in patients with CKD. We also sought to determine the AbAd association with high homeostasis model assessment index of insulin resistance (HOMA-IR) values and the cutoff point for AbAd index to predict high HOMA-IR values.

METHODS

A subset of clinically stable nondialyzed patients with CKD followed at a multidisciplinary outpatient clinic was enrolled in this cross-sectional study. The accuracy of the following anthropometric indices: waist circumference, waist-to-hip ratio, conicity index and waist-to-height ratio (WheiR) to assess AbAd, was evaluated using trunk fat, by dual x-ray absorptiometry (DXA), as a reference method. HOMA-IR was estimated to stratify patients in high and low HOMA-IR groups. The total area under the receiver-operating characteristic curves (AUC-ROC; sensitivity/specificity) was calculated: AbAd with high HOMA-IR values (95% confidence interval [CI]).

RESULTS

We studied 134 patients (55% males; 54% overweight/obese, body mass index ≥ 25 kg/m(2), age 64.9 ± 12.5 y, estimated glomerular filtration rate 29.0 ± 12.7 mL/min). Among studied AbAd indices, WheiR was the only one to show correlation with DXA trunk fat after adjusting for confounders (P < 0.0001). Thus, WheiR was used to evaluate the association between AbAd with HOMA-IR values (r = 0.47; P < 0.0001). The cutoff point for WheiR as a predictor for high HOMA-IR values was 0.55 (AUC-ROC = 0.69 ± 0.05; 95% CI, 0.60-0.77; sensitivity/specificity, 68.9/61.9).

CONCLUSIONS

WheiR is recommended as an effective and precise anthropometric index to assess AbAd and to predict high HOMA-IR values in nondialyzed patients with CKD.

Authors+Show Affiliations

Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil. Electronic address: mibsab@terra.com.br.Nephrology Division, Rio de Janeiro State University, Rio de Janeiro, Brazil.Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.Nephrology Division, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24332526

Citation

Silva, Maria Inês Barreto, et al. "Waist-to-height Ratio: an Accurate Anthropometric Index of Abdominal Adiposity and a Predictor of High HOMA-IR Values in Nondialyzed Chronic Kidney Disease Patients." Nutrition (Burbank, Los Angeles County, Calif.), vol. 30, no. 3, 2014, pp. 279-85.
Silva MI, Lemos CC, Torres MR, et al. Waist-to-height ratio: an accurate anthropometric index of abdominal adiposity and a predictor of high HOMA-IR values in nondialyzed chronic kidney disease patients. Nutrition. 2014;30(3):279-85.
Silva, M. I., Lemos, C. C., Torres, M. R., & Bregman, R. (2014). Waist-to-height ratio: an accurate anthropometric index of abdominal adiposity and a predictor of high HOMA-IR values in nondialyzed chronic kidney disease patients. Nutrition (Burbank, Los Angeles County, Calif.), 30(3), 279-85. https://doi.org/10.1016/j.nut.2013.08.004
Silva MI, et al. Waist-to-height Ratio: an Accurate Anthropometric Index of Abdominal Adiposity and a Predictor of High HOMA-IR Values in Nondialyzed Chronic Kidney Disease Patients. Nutrition. 2014;30(3):279-85. PubMed PMID: 24332526.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Waist-to-height ratio: an accurate anthropometric index of abdominal adiposity and a predictor of high HOMA-IR values in nondialyzed chronic kidney disease patients. AU - Silva,Maria Inês Barreto, AU - Lemos,Carla Cavalheiro da Silva, AU - Torres,Márcia Regina Simas Gonçalves, AU - Bregman,Rachel, Y1 - 2013/12/12/ PY - 2013/05/12/received PY - 2013/08/07/revised PY - 2013/08/08/accepted PY - 2013/12/17/entrez PY - 2013/12/18/pubmed PY - 2014/10/1/medline KW - Abdominal adiposity KW - Anthropometric indices KW - Chronic kidney disease KW - Insulin resistance KW - Receiver-operating characteristics KW - Waist-to-height ratio SP - 279 EP - 85 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 30 IS - 3 N2 - OBJECTIVE: Chronic kidney disease (CKD) is associated with metabolic disorders, including insulin resistance (IR), mainly when associated with obesity and characterized by high abdominal adiposity (AbAd). Anthropometric measures are recommended for assessing AbAd in clinical settings, but their accuracies need to be evaluated. The aim of this study was to evaluate the precision of different anthropometric measures of AbAd in patients with CKD. We also sought to determine the AbAd association with high homeostasis model assessment index of insulin resistance (HOMA-IR) values and the cutoff point for AbAd index to predict high HOMA-IR values. METHODS: A subset of clinically stable nondialyzed patients with CKD followed at a multidisciplinary outpatient clinic was enrolled in this cross-sectional study. The accuracy of the following anthropometric indices: waist circumference, waist-to-hip ratio, conicity index and waist-to-height ratio (WheiR) to assess AbAd, was evaluated using trunk fat, by dual x-ray absorptiometry (DXA), as a reference method. HOMA-IR was estimated to stratify patients in high and low HOMA-IR groups. The total area under the receiver-operating characteristic curves (AUC-ROC; sensitivity/specificity) was calculated: AbAd with high HOMA-IR values (95% confidence interval [CI]). RESULTS: We studied 134 patients (55% males; 54% overweight/obese, body mass index ≥ 25 kg/m(2), age 64.9 ± 12.5 y, estimated glomerular filtration rate 29.0 ± 12.7 mL/min). Among studied AbAd indices, WheiR was the only one to show correlation with DXA trunk fat after adjusting for confounders (P < 0.0001). Thus, WheiR was used to evaluate the association between AbAd with HOMA-IR values (r = 0.47; P < 0.0001). The cutoff point for WheiR as a predictor for high HOMA-IR values was 0.55 (AUC-ROC = 0.69 ± 0.05; 95% CI, 0.60-0.77; sensitivity/specificity, 68.9/61.9). CONCLUSIONS: WheiR is recommended as an effective and precise anthropometric index to assess AbAd and to predict high HOMA-IR values in nondialyzed patients with CKD. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/24332526/Waist_to_height_ratio:_an_accurate_anthropometric_index_of_abdominal_adiposity_and_a_predictor_of_high_HOMA_IR_values_in_nondialyzed_chronic_kidney_disease_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(13)00382-1 DB - PRIME DP - Unbound Medicine ER -