Anthropometric Indicators Of Insulin Resistance [indicadores Antropométricos De Resistência à Insulina]

Some studies have analyzed the efficacy of anthropometric indicators in predicting insulin resistance (IR), for they are more economic and accessible. In this study, the objective was to discuss the measures and anthropometric indices that have been associated with IR. A bibliographic review was done, based on Scielo, Science Direct and Pubmed. Among these studies, waist and sagittal abdominal diameter presented better predictive capacity for IR, with more consistent results. The waist-to-thigh, waist-to-size, neck-to-thigh ratios, the conicity and the sagittal index have showed positive results; nevertheless, more studies are necessary to consolidate them as predictors to IR. The obtained results, with the use of body mass index and of the waist-to-hip ratio, were inconsistent. In the Brazilian population, the realization of studies evaluating the performance of these indicators in predicting IR is suggested, since the results of the studies conducted in other populations are not always applicable to ours, due to ethnical differences resulting from the great miscegenation in the country.951e14e23Silva, E.A., Flexa, F., Zanella, M.T., Obesidade abdominal, resistência à insulina e hipertensão: Impacto sobre a massa e a função do ventrículo esquerdo em mulheres (2007) Arq Bras Cardiol, 89 (2), pp. 86-92Boden-Albala, B., Sacco, R.L., Lee, H.S., Grahame-Clarke, C., Rundek, T., Elkind, M.V., Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study (2008) Stroke, 39 (1), pp. 30-35Ribeiro Filho, F.F., Mariosa, L.S., Ferreira, S.R., Zanella, M.T., Gordura visceral e síndrome metabólica: Mais que uma simples associação (2006) Arq Bras Endocrinol Metab, 50 (2), pp. 230-238Vasques, A.C.J., Rosado, L.E.F.P.L., Alfenas, R.C.G., Geloneze, B., Análise crítica do uso dos índices do Homeostasis Model Assessment (HOMA) na avaliação da resistência à insulina e capacidade funcional das células-b pancreáticas (2008) Arq Bras Endocrinol Metab, 52 (1), pp. 32-39Taniguchi, A., Fukushima, M., Sakai, M., Kataoka, K., Nagata, I., Doi, K., Arakawa, H., Nakai, Y., The role of the body mass index and triglyceride levels in identifying insulin-sensitive and insulin-resistant variants in Japanese non-insulin-dependent diabetic patients (2000) Metabolism: Clinical and Experimental, 49 (8), pp. 1001-1005. , DOI 10.1053/meta.2000.7735Pitanga, F.J.G., Lessa, I., Sensibilidade e especificidade do índice de conicidade como discriminador do risco coronariano de adultos em Salvador, Brasil (2004) Rev Bras Epidemiol, 7 (3), pp. 259-269Riserus, U., Arnlov, J., Brismar, K., Zethelius, B., Berglund, L., Vessby, B., Sagittal abdominal diameter is a strong anthropometric marker of insulin resistance and hyperproinsulinemia in obese men (2004) Diabetes Care, 27 (8), pp. 2041-2046. , DOI 10.2337/diacare.27.8.2041Chuang, Y.C., Hsu, K.H., Hwang, C.J., Hu, P.M., Lin, T.M., Chiou, W.K., Waist-to-thigh ratio can also be a better indicator associated with type 2 diabetes than traditional anthropometrical measurements in Taiwan population (2006) Ann Epidemiol, 16 (5), pp. 321-331Meshkani, R., Taghikhani, M., Larijani, B., Khatami, S., Khoshbin, E., Adeli, K., The relationship between homeostasis model assessment and cardiovascular risk factors in Iranian subjects with normal fasting glucose and normal glucose tolerance (2006) Clinica Chimica Acta, 371 (1-2), pp. 169-175. , DOI 10.1016/j.cca.2006.03.018, PII S0009898106001689Geloneze, B., Tambascia, M.A., Laboratorial evaluation and diagnosis of insulin resistance (2006) Arquivos Brasileiros de Endocrinologia e Metabologia, 50 (2), pp. 208-215. , http://www.scielo.br/pdf/abem/v50n2/29304.pdf, DOI 10.1590/S0004-27302006000200007DeFronzo, R.A., Tobin, J.D., Andres, R., Glucose clamp technique: A method for quantifying insulin secretion and resistance (1979) American Journal of Physiology Endocrinology Metabolism and Gastrointestinal Physiology, 6 (3), pp. E214-E223Matthews, D.R., Hosker, J.P., Rudenski, A.S., Naylor, B.A., Treacher, D.F., Turner, R.C., Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man (1985) Diabetologia, 28 (7), pp. 412-419Hermans, M.P., Pepersack, T.M., Godeaux, L.H., Beyer, I., Turc, A.P., Prevalence and determinants of impaired glucose metabolism in frail elderly patients: The Belgian elderly diabetes survey (BEDS) (2005) Journals of Gerontology - Series a Biological Sciences and Medical Sciences, 60 (2), pp. 241-247Bonora, E., Targher, G., Alberiche, M., Bonadonna, R.C., Saggiani, F., Zenere, M.B., Monauni, T., Muggeo, M., Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: Studies in subjects with various degrees of glucose tolerance and insulin sensitivity (2000) Diabetes Care, 23 (1), pp. 57-63Ross, R., Advances in the application of imaging methods in applied and clinical physiology (2003) Acta Diabetologica, 40 (SUPPL. 1), pp. S45-S50. , DOI 10.1007/s00592-003-0025-yLeite, C.C., Matsuda, D., Wajchenberg, B.L., Cerri, G.G., Halpern, A., Correlação da medida de espessura intra-abdominal medida pela ultra-sonografia com os fatores de risco cardiovascular (2000) Arq Bras Endocrinol Metab, 44 (1), pp. 49-56Ho, S.Y., Lam, T.H., Janus, E.D., Waist to stature ratio is more strongly associated with cardiovascular risk factors than other simple anthropometric indices (2003) Ann Epidemiol, 13 (10), pp. 683-691Conus, F., Allison, D.B., Rabasa-Lhoret, R., St-Onge, M., St-Pierre, D.H., Tremblay-Lebeau, A., Poehlman, E.T., Metabolic and behavioral characteristics of metabolically obese but normal-weight women (2004) Journal of Clinical Endocrinology and Metabolism, 89 (10), pp. 5013-5020. , DOI 10.1210/jc.2004-0265Pouliot, M.-C., Despres, J.-P., Lemieux, S., Moorjani, S., Bouchard, C., Tremblay, A., Nadeau, A., Lupien, P.J., Waist circumference and abdominal sagittal diameter: Best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women (1994) American Journal of Cardiology, 73 (7), pp. 460-468. , DOI 10.1016/0002-9149(94)90676-9Sampaio, L.R., Simoes, E.J., Assis, A.M., Ramos, L.R., Validade e confiabilidade do diâmetro abdominal sagital enquanto preditor de gordura abdominal visceral (2007) Arq Bras Endocrinol Metab, 51 (6), pp. 980-986Balkau, B., Charles, M.A., Comment on the provisional report from the WHO consultation (1999) Diabet Med, 16 (5), pp. 442-443. , European Group for the Study of Insulin Resistance (EGIR)Alberti, K.G., Zimmet, P., Shaw, J., Metabolic syndrome - A new world-wide definition. A Consensus Statement from the International Diabetes Federation (2006) Diabet Med, 23 (5), pp. 469-480Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2001) JAMA, 285 (19), pp. 2486-2497Han, T.S., Van Leer, E.M., Seidell, J.C., Lean, M.E., Waist circumference action levels in the identification of cardiovascular risk factors: Prevalence study in a random sample (1995) BMJ, 311, pp. 1401-1405(2000) Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation, , World Health Organization. Geneva: WHO Technical Report Series 894. World Health OrganizationLohman, T.G., Roche, A.F., Martorell, R., (1988) Anthropometric Standardization Reference Manual, , Champaign: Human Kinetics Pub(2000) The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, , National Institute of Health (NIH). Bethesda: NIHRoss, R., Berentzen, T., Bradshaw, A.J., Jansson, I., Kahn, H.S., Katzmarzyk, P.T., Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference? (2007) Obes Rev, 9 (4), pp. 312-325Wang, J., Thornton, J.C., Bari, S., Williamson, B., Gallagher, D., Heymsfield, S.B., Horlick, M., Pierson Jr., R.N., Comparisons of waist circumferences measured at 4 sites (2003) American Journal of Clinical Nutrition, 77 (2), pp. 379-384Snijder, M.B., Zimmet, P.Z., Visser, M., Dekker, J.M., Seidell, J.C., Shaw, J.E., Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: The AusDiab Study (2004) International Journal of Obesity, 28 (3), pp. 402-409. , DOI 10.1038/sj.ijo.0802567Weidner, M.D., Gavigan, K.E., Tyndall, G.L., Hickey, M.S., McCammon, M.R., Houmard, J.A., Which anthropometric indices of regional adiposity are related to the insulin resistance of aging? (1995) Int J Obes Relat Metab Disord, 19 (5), pp. 325-330Mamtani, M.R., Kulkarni, H.R., Predictive performance of anthropometric indexes of central obesity for the risk of type 2 diabetes (2005) Arch Med Res, 36 (5), pp. 581-589Ybarra, J., Sanchez-Hernandez, J., Pou, J.M., Fernandez, S., Gich, I., Ordonez-Llanos, J., Jurado, J., Perez, A., Anthropometrical measures are easily obtainable sensitive and specific predictors of insulin resistance in healthy individuals (2005) Prevention and Control, 1 (2), pp. 175-181. , DOI 10.1016/j.precon.2005.05.001, PII S1573208805000346Williamson, D.F., Kahn, H.S., Worthman, C.M., Burnette, J.C., Russell, C.M., Precision of recumbent anthropometry (1993) Am J Hum Biol, 5 (2), pp. 159-167Iribarren, C., Darbinian, J.A., Lo, J.C., Fireman, B.H., Go, A.S., Value of the sagittal abdominal diameter in coronary heart disease risk assessment: Cohort study in a large, multiethnic population (2006) American Journal of Epidemiology, 164 (12), pp. 1150-1159. , DOI 10.1093/aje/kwj341Van Der Kooy, K., Leenen, R., Seidell, J.C., Deurenberg, P., Visser, M., Abdominal diameters as indicators of visceral fat: Comparison between magnetic resonance imaging and anthropometry (1993) British Journal of Nutrition, 70 (1), pp. 47-58Sjöstrom, L., A computer-tomography based multicompartment body composition technique and anthropometric predictions of lean body mass, total and subcutaneous adipose tissue (1991) Int J Obes, 15 (SUPPL. 2), pp. 19-30McClain, M.R., Srinivasan, S.R., Chen, W., Steinmann, W.C., Berenson, G.S., Risk of type 2 diabetes mellitus in young adults from a biracial community: The bogalusa heart study (2000) Preventive Medicine, 31 (1), pp. 1-7. , DOI 10.1006/pmed.2000.0682Kullberg, J., Von Below, C., Lonn, L., Lind, L., Ahlstrom, H., Johansson, L., Practical approach for estimation of subcutaneous and visceral adipose tissue (2007) Clinical Physiology and Functional Imaging, 27 (3), pp. 148-153. , DOI 10.1111/j.1475-097X.2007.00728.xOhrvall, M., Berglund, L., Vessby, B., Sagittal abdominal diameter compared with other anthropometric measurements in relation to cardiovascular risk (2000) International Journal of Obesity, 24 (4), pp. 497-501Kahn, H.S., Simoes, E.J., Koponen, M., Hanzlick, R., The abdominal diameter index and sudden coronary death in men (1996) American Journal of Cardiology, 78 (8), pp. 961-964. , PII S0002914996004791Kahn, H.S., Alternative anthropometric measures of risk: Possible improvements on the waist-hip ratio (2003) Progress in Obesity Research, pp. 639-643. , Medeiros-Neto G, Halpern A, Bouchard C. (eds.). 9th ed. London: John Libbey Eurotext LtdDespres, J.P., Prud'Homme, D., Pouliot, M.C., Tremblay, A., Bouchard, C., Estimation of deep abdominal adipose-tissue accumulation from simple anthropometric measurements in men (1991) Am J Clin Nutr, 54 (3), pp. 471-477Petersson, H., Daryani, A., Riserus, U., Sagittal abdominal diameter as a marker of inflammation and insulin resistance among immigrant women from the Middle East and native Swedish women: A cross-sectional study (2007) Cardiovascular Diabetology, 6, p. 10. , DOI 10.1186/1475-2840-6-10Seidell, J.C., Perusse, L., Despres, J.-P., Bouchard, C., Waist and hip circumferences have independent and opposite effects on cardiovascular disease risk factors: The Quebec Family Study (2001) American Journal of Clinical Nutrition, 74 (3), pp. 315-321Van Der Kooy, K., Leenen, R., Seidell, J.C., Deurenberg, P., Droop, A., Bakker, C.J.G., Waist-hip ratio is a poor predictor of changes in visceral fat (1993) American Journal of Clinical Nutrition, 57 (3), pp. 327-333Kahn, H.S., Choosing an index for abdominal obesity: An opportunity for epidemiologic clarification (1993) J Clin Epidemiol, 46, pp. 491-494Kahn, H.S., Austin, H., Williamson, D.F., Arensberg, D., Simple anthropometric indices associated with ischemic heart disease (1996) Journal of Clinical Epidemiology, 49 (9), pp. 1017-1024. , DOI 10.1016/0895-4356(96)00113-8Smith, D.A., Ness, E.M., Herbert, R., Schechter, C.B., Phillips, R.A., Diamond, J.A., Landrigan, P.J., Abdominal diameter index: A more powerful anthropometric measure for prevalent coronary heart disease risk in adult males (2005) Diabetes, Obesity and Metabolism, 7 (4), pp. 370-380. , DOI 10.1111/j.1463-1326.2004.00406.xSjöström, C.D., Håkangård, A.C., Lissner, L., Sjöström, L., Body compartment and subcutaneous adipose tissue distribution- risk factor patterns in obese subjects (1995) Obes Res, 3, pp. 9-22Laakso, M., Matilainen, V., Keinanen-Kiukaanniemi, S., Association of neck circumference with insulin resistance-related factors (2002) International Journal of Obesity, 26 (6), pp. 873-875. , DOI 10.1038/sj.ijo.0802002Ben-Noun, L., Laor, A., Relationship of neck circumference to cardiovascular risk factors (2003) Obesity Research, 11 (2), pp. 226-231McCarthy, H.D., Ashwell, M., A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message - 'keep your waist circumference to less than half your height' (2006) Int J Obes, 30 (6), pp. 988-992Parikh, R.M., Joshi, S.R., Menon, P.S., Shah, N.S., Index of central obesity: A novel parameter (2007) Med Hypotheses, 68 (6), pp. 1272-1275Ashwell, M., Hsieh, S.D., Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity (2005) International Journal of Food Sciences and Nutrition, 56 (5), pp. 303-307. , DOI 10.1080/09637480500195066Hsieh, S.D., Muto, T., The superiority of waist-to-height ratio as an anthropometric index to evaluate clustering of coronary risk factors among non-obese men and women (2005) Preventive Medicine, 40 (2), pp. 216-220. , DOI 10.1016/j.ypmed.2004.05.025, PII S0091743504002968Valdez, R., A simple model-based index of abdominal adiposity (1991) J Clin Epidemiol, 44 (9), pp. 955-956Valdez, R., Seidell, J.C., Ahn, Y.I., Weiss, K.M., A new index of abdominal adiposity as an indicator of risk for cardiovascular disease. A cross-population study (1993) International Journal of Obesity, 17 (2), pp. 77-82Mantzoros, C.S., Evagelopoulou, K., Georgiadis, E.I., Katsilambros, N., Conicity index as a predictor of blood pressure levels, insulin and triglyceride concentrations of healthy premenopausal women (1996) Hormone and Metabolic Research, 28 (1), pp. 32-34Monteiro, J.C., Obesidade: Diagnóstico, métodos e fundamentos (1998) Obesidade, p. 31. , Halpern A, Matos AFG, Suplicy HL, Mancini MC, Zanella MT. São Paulo: LemosSnijder, M.B., Van Dam, R.M., Visser, M., Seidell, J.C., What aspects of body fat are particularly hazardous and how do we measure them? (2006) Int J Epidemiol, 35 (1), pp. 83-92Farin, H.M.F., Abbasi, F., Reaven, G.M., Body mass index and waist circumference both contribute to differences in insulin-mediated glucose disposal in nondiabetic adults (2006) American Journal of Clinical Nutrition, 83 (1), pp. 47-51. , http://www.ajcn.org/cgi/reprint/83/1/47Ascaso, J.F., Romero, P., Real, J.T., Priego, A., Valdecabres, C., Carmena, R., Insulin resistance quantification by fasting insulin plasma values and HOMA index in a non-diabetic population (2001) Medicina Clinica, 117 (14), pp. 530-533Chang, S.A., Kim, H.S., Yoon, K.H., Ko, S.H., Kwon, H.S., Kim, S.R., Body mass index is the most important determining factor for the degree of insulin resistance in non-obese type 2 diabetic patients in Korea (2004) Metabolism, 53 (2), pp. 142-146Stern, S.E., Williams, K., Ferrannini, E., DeFronzo, R.A., Bogardus, C., Stern, M.P., Identification of individuals with insulin resistance using routine clinical measurements (2005) Diabetes, 54 (2), pp. 333-339Tarastchuk, J.C.E., Guerios, E.E., Bueno, R.R.L., Andrade, Pm., Nercolini, P.C., Ferraz, J.G., Obesidade e intervenção coronariana: Devemos continuar valorizando o Índice de Massa Corpórea? (2008) Arq Bras Cardiol, 90 (5), pp. 311-31