Skinfold reference curves and their use in predicting metabolic syndrome risk in children<sup>,</sup>

Andaki, Alynne C.R.; Quadros, Teresa M.B. de; Gordia, Alex P.; Mota, Jorge; Tinôco, Adelson L.A.; Mendes, Edmar L.

doi:10.1016/j.jped.2016.11.013

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Original articles • J. Pediatr. (Rio J.) 93 (5) • Sep-Oct 2017 • https://doi.org/10.1016/j.jped.2016.11.013 copy

Skinfold reference curves and their use in predicting metabolic syndrome risk in children^☆ ☆ Please cite this article as: Andaki AC, Quadros TM, Gordia AP, Mota J, Tinôco AL, Mendes EL. Skinfold reference curves and their use in predicting metabolic syndrome risk in children. J Pediatr (Rio J). 2017;93:490–6. ^,^☆☆ ☆☆ Study carried out at Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

To draw skinfold (SF) reference curves (subscapular, suprailiac, biceps, triceps) and to determine SF cutoff points for predicting the risk of metabolic syndrome (MetS) in children aged 6–10 years old.

Methods:

This was a cross-sectional study with a random sample of 1480 children aged 6–10 years old, 52.2% females, from public and private schools located in the urban and rural areas of the municipality of Uberaba (MG). Anthropometry, blood pressure, and fasting blood samples were taken at school, following specific protocols. The LMS method was used to draw the reference curves and ROC curve analysis to determine the accuracy and cutoff points for the evaluated skinfolds.

Results:

The four SF evaluated (subscapular, suprailiac, biceps, and triceps) and their sum (∑4SF) were accurate in predicting MetS for both girls and boys. Additionally, cutoffs have been proposed and percentile curves (p5, p10, p25, p50, p75, p90, and p95) were outlined for the four SF and ∑4SF, for both genders.

Conclusion:

SF measurements were accurate in predicting metabolic syndrome in children aged 6–10 years old. Age- and gender-specific smoothed percentiles curves of SF provide a reference for the detection of risk for MetS in children.

KEYWORDS
Anthropometry; Metabolic syndrome X; Cross-sectional studies; Child

Variables	Girls (n = 773)		Boys (n = 707)		p-Value
	Mean (SD)	Median (min-max)	Mean (SD)	Median (min-max)
BSF (mm)	10.14 (5.15)	9.00 (3.00-29.00)	8.57 (5.29)	6.67 (3.00-28.00)	0.001
TSF (mm)	14.45 (5.66)	13.33 (5.00-35.00)	12.71 (6.67)	10.67 (5.00-35.00)	0.001
SSSF (mm)	11.77 (7.63)	9.00 (4.00-44.00)	9.85 (7.50)	7.00 (4.00-44.00)	0.001
SISF (mm)	14.40 (10.56)	9.67 (3.00-51.00)	11.12 (10.23)	6.67 (3.00-50.00)	0.001
∑4SFs (mm)	50.93 (28.31)	42.0 (10.00-163.00)	42.37 (29.79)	31.00 (11.00-202.67)	0.001

Age (years)	Predictors	AUC	p-Value	95% CI		Cutoff (mm)	S (%)	Sp (%)
6	BSF	0.832	0.014	0.709	0.955	11.6	80	79
	TSF	0.771	0.044	0.566	0.977	15.3	80	82
	SSSF	0.864	0.007	0.760	0.967	9	100	74
	SISF	0.805	0.024	0.666	0.943	12.3	80	75
	∑4SFs	0.833	0.013	0.708	0.959	40.3	100	68

7	BSF	0.894	<0.001	0.81	0.977	13.0	88	85
	TSF	0.927	<0.001	0.874	0.98	17	100	83
	SSSF	0.924	<0.001	0.871	0.978	13.6	100	86
	SISF	0.909	<0.001	0.841	0.977	13.6	100	76
	∑4SFs	0.927	<0.001	0.872	0.982	57.3	100	83

8	BSF	0.803	<0.001	0.705	0.902	10	87	65
	TSF	0.838	<0.001	0.751	0.924	17.6	73	84
	SSSF	0.874	<0.001	0.775	0.974	14.3	80	84
	SISF	0.828	<0.001	0.727	0.929	12.3	87	65
	∑4SFs	0.858	<0.001	0.770	0.945	57.6	80	78

9	BSF	0.862	<0.001	0.773	0.951	14.0	86	79
	TSF	0.844	<0.001	0.731	0.956	17.6	85	71
	SSSF	0.88	<0.001	0.802	0.959	14	86	80
	SISF	0.84	<0.001	0.752	0.927	14.3	100	60
	∑4SFs	0.871	<0.001	0.788	0.954	66	86	78

10	BSF	0.764	<0.001	0.627	0.902	14.3	68	80
	TSF	0.756	<0.001	0.629	0.884	19	75	81
	SSSF	0.823	<0.001	0.701	0.945	15.6	79	78
	SISF	0.78	<0.001	0.648	0.911	18.6	80	71
	∑4SFs	0.791	<0.001	0.659	0.923	71.6	80	80

Age (years)	Predictors	AUC	p-Value	95% CI		Cutoff (mm)	S (%)	Sp (%)
6	BSF	0.95	0.002	0.902	1.00	13.3	100	91.5
	TSF	0.95	0.002	0.893	1.00	16.0	100	88.7
	SSSF	0.93	0.004	0.854	1.00	8.6	100	82.6
	SISF	0.90	0.007	0.807	0.997	11.3	100	81.6
	∑4SFs	0.94	0.003	0.87	1.00	51.3	100	86.1

7	BSF	0.86	0.007	0.726	0.994	8.3	80	72.2
	TSF	0.83	0.015	0.681	0.969	11.6	80	72.6
	SSSF	0.90	0.003	0.789	1.00	7.6	100	71.6
	SISF	0.82	0.016	0.635	1.00	7.0	60	60.7
	∑4SFs	0.86	0.007	0.71	1.00	32.3	100	66.2

8	BSF	0.84	0.044	0.641	1.00	8.3	66.6	63.1
	TSF	0.84	0.048	0.626	1.00	11.6	66.6	61.1
	SSSF	0.88	0.025	0.756	1.00	9.3	100	73.9
	SISF	0.91	0.016	0.821	1.00	13.3	100	82.5
	∑4SFs	0.89	0.024	0.761	1.00	42.6	100	75.5

9	BSF	0.86	0.001	0.767	0.955	10	87.5	68.2
	TSF	0.86	0.001	0.769	0.954	14.6	88.8	72.0
	SSSF	0.92	0.001	0.868	0.980	12.3	100	83.7
	SISF	0.92	0.001	0.852	0.982	14.6	88.8	81.4
	∑4SFs	0.90	0.001	0.832	0.974	55.3	88.8	81.4

10	BSF	0.80	0.001	0.678	0.930	11.3	86.6	70.9
	TSF	0.78	0.001	0.645	0.917	17.3	80	79.6
	SSSF	0.77	0.002	0.638	0.905	13.3	80	72.3
	SISF	0.79	0.001	0.653	0.920	22.0	73.3	86.3
	∑4SFs	0.79	0.001	0.661	0.920	61.6	80.0	80.3

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[1] * Corresponding author. E-mail:alynneandaki@yahoo.com.br (A.C. Andaki).