Cutoff points in the Waist-Height Ratio for the Prediction of Insulin Resistance, Second Stage of Sexual Maturation in Brazilian Adolescents.

The objective of this study was verify the best waist-to-height ratio (WHtR) cutoff points for the prediction of insulin resistance (IR) according to stage of sexual maturation in Brazilian adolescents. Data were analyzed from 37,759 adolescents between 12-17 years of age, of both sexes, participating in the ERICA study on cardiovascular risk factors in adolescents ("Estudo de Riscos Cardiovasculares em Adolescentes - ERICA"). The following variables were included: sex, age, sexual maturity according to the Tanner stage, waist circumference, height, waist-to-height ratio, fasting insulin and fasting blood sugar so as to obtain the HOMA-IR. We constructed a ROC curve for each group in order to determine the best WHtR cutoff points for the sample stratified by sex and stratified by sex and sexual maturation stage. The female sex corresponded to 60% of the sample, with a mean age of 14.7 years (SD ±0.08 years) and 13.1 % had IR. The prediction of IR through the WHtR indicator was better for boys, where all the areas under the ROC curve were superior to 0.70. When stratifying by sex alone, the best WHtR cutoff points found were equal to 0.45 for girls and 0.44 for boys. When stratifying by Tanner maturation stages, the cut-off points were reduced with advancing sexual maturation in the male group, while the opposite occurred in the female group. Among Brazilian adolescents, WHtR is a good predictor of IR evaluated by HOMA-IR, but different cut-off points should be adopted according to sex and sexual maturation stage.