Body composition indicators in the metabolic syndrome risk prediction in 6-10-year-old children

Quadros, Teresa Maria Bianchini de; Gordia, Alex Pinheiro; Mendes, Edmar Lacerda; Andaki, Alynne Christian Ribeiro

doi:10.1590/1980-0037.2023v25e85289

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Original article • Rev. bras. cineantropom. desempenho hum. 25 • 2023 • https://doi.org/10.1590/1980-0037.2023v25e85289 linkcopy

Body composition indicators in the metabolic syndrome risk prediction in 6-10-year-old children

Indicadores de composição corporal na predição de risco de síndrome metabólica em crianças de 6 a 10 anos de idade

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The aim of this study was to develop percentiles of body composition indicators and determine cutoff points to predict metabolic syndrome (MS) risk in 6-10-year-old children. This is a cross-sectional, population-based epidemiological study with the participation of 1480 schoolchildren aged 6-10-year. Anthropometric assessment (body mass, height, and skinfolds) and blood pressure measurement were performed in schools. The body mass index (BMI), as well as the body fat percentage (%BF), lean body mass (LBM), fat body mass (FBM), were calculated according to standardized formulas for children. Blood collection to assess the lipid and glycemic profile was also performed at school, on pre-established days and times. The MS diagnosis was determined based on changes in triglycerides, HDL-c, blood glucose, waist circumference, and blood pressure. The LMS method was used to develop the percentiles, the area under the ROC curve (AUC) to identify the accuracy of the indicators, and the sensitivity and specificity to determine the cutoff points. FBM and %BF had significantly higher values in girls, who also had lower values for %LM compared to boys (p<0.05). The indicators of body composition, BMI, FBM, and %BF were accurate in predicting the MS risk for both sex at all ages. The main indicators of body composition to predict the MS risk, in both sex, were BMI, FBM, and %BF. These findings suggest that simple anthropometric measurements, which can be performed in clinical practice, have the potential to direct non-pharmacological actions.

Key words: Body composition; Metabolic syndrome; Child

Variables	Girls (n=773)		Boys (n=707)		p-value
Variables	Mean (SD)	Median (min-max)	Mean (SD)	Median (min-max)	p-value
Body mass (kg)	30.05 (8.88)	28.70 (15.70 - 64.70)	30.58 (9.54)	28.25 (16.50 - 69.90)	0.500
Height (m)	1.31 (0.10)	1.31 (1.03 -1.70)	1.31 (0.10)	1.31 (1.07 - 1.66)	0.900
BMI (kg/m2)	17.49 (3.31)	16.52 (10.24 - 30.53)	17.49 (3.51)	16.40 (10.75 - 31.43)	0.600
LBM (kg)	23.09 (4.60)	22.63 (12.63 - 40.17)	23.72 (4.44)	23.22 (13.15 - 41.64)	0.010
FBM (kg)	7.49 (5.19)	5.84 (1.43 - 33.93)	6.80 (6.18)	4.60 (1.05 - 39.34)	0.001
%BF	22.42 (8.47)	20.96 (5.01 - 55.56)	19.66 (10.18)	16.55 (5.31 - 57.98)	0.001

Variable	Age (years)	L	M	S	5th	10th	25th	50th	75th	90th	95th
BMI	6	-1.16	15.69	0.15	12.60	13.16	14.24	15.69	17.50	19.56	21.07
	7	-1.23	15.91	0.16	12.65	13.24	14.37	15.91	17.88	20.19	21.93
	8	-1.29	16.23	0.17	12.80	13.41	14.59	16.23	18.36	20.92	22.90
	9	-1.36	16.87	0.18	13.20	13.85	15.10	16.87	19.21	22.12	24.43
	10	-1.43	17.03	0.18	13.25	13.90	15.19	17.03	19.51	22.66	25.25
LBM	6	-0.16	17.97	0.15	14.07	14.84	16.24	17.97	19.92	21.89	23.17
	7	-0.11	19.88	0.15	15.65	16.49	18.01	19.88	21.96	24.05	25.40
	8	-0.06	22.15	0.14	17.52	18.44	20.11	22.15	24.41	26.65	28.10
	9	-0.01	24.66	0.15	19.36	20.42	22.33	24.66	27.24	29.79	31.43
	10	0.03	26.13	0.15	20.33	21.49	23.58	26.13	28.95	31.74	33.53
FBM	6	-0.11	3.77	0.57	1.54	1.86	2.59	3.77	5.59	8.08	10.15
	7	-0.08	4.46	0.60	1.73	2.12	3.00	4.46	6.70	9.79	12.35
	8	-0.04	5.56	0.62	2.06	2.56	3.68	5.56	8.46	12.43	15.70
	9	-0.01	6.84	0.64	2.42	3.04	4.46	6.84	10.53	15.55	19.66
	10	0.02	7.83	0.66	2.61	3.34	5.01	7.83	12.19	18.12	22.93
%BF	6	-0.03	18.20	0.34	10.51	11.86	14.52	18.20	22.85	28.08	31.78
	7	0.02	19.08	0.36	10.44	11.94	14.91	19.08	24.38	30.38	34.63
	8	0.06	20.44	0.38	10.88	12.53	15.83	20.44	26.29	32.86	37.50
	9	0.11	22.16	0.39	11.50	13.34	17.02	22.16	28.64	35.86	40.92
	10	0.15	22.87	0.39	11.55	13.51	17.43	22.87	29.69	37.23	42.48

Variable	Age (years)	L	M	S	5th	10th	25th	50th	75th	90th	95th
BMI	6	-2.68	15.54	0.12	13.29	13.68	14.45	15.54	17.00	18.87	20.45
	7	-2.30	15.68	0.14	13.11	13.56	14.44	15.68	17.37	19.56	21.42
	8	-1.93	16.06	0.16	13.03	13.55	14.59	16.06	18.07	20.69	22.91
	9	-1.55	16.84	0.18	13.24	13.86	15.09	16.84	19.21	22.27	24.80
	10	-1.17	17.50	0.20	13.27	14.00	15.45	17.50	20.25	23.69	26.44
LBM	6	0.44	19.06	0.13	15.33	16.11	17.47	19.06	20.72	22.28	23.24
	7	0.31	20.72	0.13	16.53	17.40	18.92	20.72	22.63	24.44	25.58
	8	0.18	22.89	0.13	18.30	19.24	20.91	22.89	25.02	27.07	28.37
	9	0.06	25.04	0.13	20.15	21.14	22.91	25.04	27.36	29.61	31.04
	10	-0.05	27.16	0.13	21.97	23.02	24.89	27.16	29.65	32.10	33.66
FBM	6	-0.20	3.03	0.59	1.24	1.49	2.06	3.03	4.61	6.94	9.01
	7	-0.20	3.35	0.68	1.22	1.50	2.16	3.35	5.40	8.68	11.80
	8	-0.17	4.34	0.72	1.47	1.84	2.72	4.34	7.20	11.84	16.28
	9	-0.23	5.27	0.76	1.77	2.20	3.26	5.27	9.07	15.77	22.78
	10	-0.03	6.76	0.80	1.86	2.46	3.96	6.76	11.62	19.06	25.70
%BF	6	-0.20	14.85	0.40	8.02	9.13	11.43	14.85	19.57	25.43	29.95
	7	-0.17	14.81	0.44	7.54	8.69	11.12	14.81	20.02	26.64	31.83
	8	-0.15	16.88	0.47	8.16	9.52	12.41	16.88	23.32	31.64	38.25
	9	-0.13	17.84	0.50	8.17	9.65	12.83	17.84	25.17	34.80	42.52
	10	-0.11	19.82	0.53	8.59	10.27	13.94	19.82	28.58	40.23	49.67

Girls									Boys
Age (year)	Variable Predictive	AUC	p- value	Confidence Interval (95%)		Cut-off point	SE (%)	SP (%)	Variable Predictive	AUC	p- value	Confidence Interval (95%)		Cut-off point	SE (%)	SP (%)
Age (year)	Variable Predictive	AUC	p- value	Lower limit	Upper limit	Cut-off point	SE (%)	SP (%)	Variable Predictive	AUC	p- value	Lower limit	Upper limit	Cut-off point	SE (%)	SP (%)
6	BMI	0.900	0.003	0.820	0.980	17.9	100	84.06	BMI	0.908	0.006	0.803	1	18.2	100	83.1
	LBM	-	-	-	-	5	100	73.5	LBM	0.788	0.054	0.648	0.929	21	75	77.4
	FBM	0.842	0.011	0.727	0.957	20.4	100	72	FBM	0.927	0.004	0.846	1	6.6	100	87.3
	% BF	0.842	0.011	0.727	0.957	20.4	100	72	% BF	0.944	0.003	0.879	1	24.6	100	87.5
7	BMI	0.922	< 0.001	0.866	0.977	18.4	100	83.51	BMI	0.892	0.003	0.778	1	17.6	80	86.3
	LBM	0.923	< 0.001	0.869	0.978	8.3	100	87.5	LBM	-	-	-	-	-	-	-
	FBM	0.737	0.026	0.592	0.882	22.4	75	74.2	FBM	0.865	0.006	0.72	1	6	80	81.4
	% BF	0.933	< 0.001	0.883	0.983	27.3	100	87.6	% BF	0.861	0.007	0.72	1	18	80	71.2
8	BMI	0.838	< 0.001	0.711	0.965	19	80	84	BMI	0.919	0.014	0.848	0.989	20.4	100	88.3
	LBM	0.728	< 0.001	0.59	0.866	23	80	62	LBM	-	-	-	-	-	-	-
	FBM	0.876	< 0.001	0.794	0.958	8.6	80	83	FBM	0.874	0.028	0.756	0.992	6.9	100	75.5
	% BF	0.878	< 0.001	0.795	0.96	23.2	93.3	72	% BF	0.846	0.043	0.646	1	18.6	66.6	61.6
9	BMI	0.881	< 0.001	0.789	0.973	18.6	85.7	77.7	BMI	0.843	0.001	0.692	0.995	17.9	88.8	71.4
	LBM	0.82	< 0.001	0.696	0.944	27.7	71.4	83.3	LBM	0.759	0.016	0.531	0.987	26.9	66.6	74.4
	FBM	0.887	< 0.001	0.801	0.972	8.7	92.8	72.5	FBM	0.920	0	0.861	0.979	8.6	100	81.4
	% BF	0.877	< 0.001	0.792	0.962	27.5	85.7	82.4	% BF	0.904	0	0.839	0.969	24	100	78.8
10	BMI	0.806	< 0.001	0.688	0.924	18.1	78.9	62.6	BMI	0.800	<0.001	0.672	0.927	18.6	78.5	71.2
	LBM	0.681	0.021	0.538	0.824	27.5	63.1	61.3	LBM	0.801	<0.001	0.684	0.917	27.9	86.6	65.1
	FBM	0.809	< 0.001	0.685	0.933	12.4	75	84	FBM	0.797	0.001	0.68	0.915	9.4	85.7	72.7
	% BF	0.802	< 0.001	0.675	0.929	29.9	80	81.3	% BF	0.77	0.002	0.637	0.903	27.6	80	74.2

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[1] Legend: n = sample; SD = standard deviation; min = minimum value; max = maximum value; BMI = body mass index; LBM = lean body mass; FBM = fat body mass; % BF = body fat percentage. Note: Significant difference between sex p ≤ 0.05 from Mann Whitney test.