Hypertriglyceridemic Waist Phenotype Indicates Insulin Resistance In Adolescents According To The Clamp Technique In The Brams Study

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)This study aimed to identify cutoff points for detecting hypertriglyceridemic waist phenotype (HTWP) in adolescents and to investigate the association of the HTWP with insulin resistance (IR) and metabolic syndrome components. Methods: A multicentric cross-sectional study of 861 adolescents (10-19 years of age, 504 girls) was conducted. Pubertal stage, anthropometric, and laboratory parameters were assessed. IR was assessed by Homeostasis Model Assessment for Insulin Resistance (HOMA1-IR) index and hyperglycemic clamp (n = 80). HTWP was defined by the presence of increased plasma triglycerides (TGs) and increased waist circumference (WC) according to cutoff points obtained in ROC curve analysis given the HOMA1-IR index as a reference method. Results: Cutoffs for WC and TGs, with a higher sum of sensitivity (S) and specificity (E), were, respectively: >84cm (S:65.1%, E:71.9%) and >87mg/dL (S:65.1%, E:73.4%) in pubertal girls; >88.5cm (S:80.2%, E:60.2%) and >78mg/dL (S:60.5%, E:53.2%) in postpubertal girls; >94cm (S:73.1%, E:83.1%) and >79mg/dL (S:61.5%, E:60.2%) in pubertal boys; and >99cm (S:81.3%, E:78.7%) and >86mg/dL in postpubertal boys (S:68.1%, E:60.7%). HTWP frequency was 27.5%. In the phenotype presence, after adjustment for age and pubertal stage, blood pressure and fasting glucose levels were elevated and high-density lipoprotein cholesterol was lower (p<0.001). Adolescents with the HTWP showed more IR, evaluated both by the HOMA1-IR and by the clamp test (p