Waist-to-Height Ratio Is a Better Anthropometric Index than Waist Circumference and BMI in Predicting Metabolic Syndrome among Obese Mexican Adolescents

Objective. To identify the degree of association between anthropometric indices and components of metabolic syndrome (MS) and to determine optimal cut-off points of these indices for predicting MS in obese adolescents. Methods. A cross-sectional study with a sample of (n=110) Mexican obese adolescents grouped by sex and the presence/absence of MS. BMI percentile, waist circumference (WC), and waist-to-height ratio (WHtR) were tested. ROC curves of the anthropometric indices were created to identify whether an index was a significant predictor of MS. Results. BMI percentile, WC, and WHtR were significantly correlated with systolic and diastolic blood pressure. As predictors of MS overall patients, the BMI percentile generated an area under curve (AUC) of 0.651 (P=0.008), cut-off point above the 99th percentile. WC generated an AUC of 0.704 (P<0.001), cut-off point of ≥90 cm. WHtR demonstrated an AUC of 0.652 (P=0.008), cut-off point of 0.60. WHtR ≥0.62 and WHtR ≥0.61 generate AUC of 0.737 (P=0.006) and AUC of 0.717 (P=0.014) for predicting hypertension and insulin resistance, respectively, in females. Conclusion. WHtR is a better tool than WC and BMI for identifying cardiometabolic risk. The overall criterion (WHtR ≥ 0.6) could be appropriate for predicting MS in obese Mexican adolescents

Bioética e alimentação no final da vida em pediatria: duas perspectivas complementares sobre o mesmo tema

&nbsp; With advances in curative therapies, children, even if ill, are expected to outlive their parents. However, there are impossible-to-cure conditions that limit life expectancy. Pediatric Palliative Care refers to the active and total care of the body, mind and spirit of children, including support for their families.&nbsp; Con los avances en las terapias curativas se espera que los niños, aun enfermos,&nbsp;sobrevivan a sus padres; sin embargo,&nbsp;existen condiciones imposibles de curar,&nbsp;que limitan la esperanza de vida. Los cuidados paliativos pediátricos se refieren al&nbsp;cuidado activo y total del cuerpo, mente&nbsp;y espíritu de los niños, e incluyen soporte&nbsp;a su familia.&nbsp; Com os avanços nas terapias curativas,&nbsp;espera-se que as crianças, mesmo doentes, sobrevivam aos pais. No entanto,&nbsp;existem condições impossíveis de curar&nbsp;que limitam a expectativa de vida. Os&nbsp;Cuidados Paliativos Pediátricos referem-se&nbsp;ao cuidado ativo e total do corpo, mente e&nbsp;espírito das crianças, incluindo o apoio a&nbsp;sua família