Adolescents with Mild Stunting Show Alterations in Glucose and Insulin Metabolism

Purpose. To evaluate glucose and insulin profiles in adolescents with mild stunting and overweight in order to assess the possibility of increased predisposition to diabetes. Subjects and Methods. The study population consisted of 66 pubertal adolescents classified as mildly stunted (height-for-age z scores ≥−2 and <−1) or of normal stature, as well as overweight (body mass index ≥85th percentile) or normal weight. Beta-cell function and insulin resistance were evaluated according to the homeostasis model assessment (HOMA). Results. In the group with mild stunting, glucose, insulin, and HOMA-IR levels were significantly higher in overweight adolescents compared with those of normal weight, whereas HOMA-B levels were significantly lower. Adolescents with mild stunting showed significantly higher accumulations of body and abdominal fat than their normal stature counterparts. Conclusions. The presence of mild stunting was associated with higher levels of glucose and insulin, diminished function of beta cells, and increased insulin resistance. These results reinforce the need for intervention in adolescents with mild stunting

A menor circunferência da cintura em adolescentes de baixa estatura leve está relacionada à concentração elevada de insulina

Objective: Augmented waist circumference (WC) is associated with non-communicable diseases and could represent a valuable marker in screening for metabolic dysfunctions in subjects with insufficient linear growth. The objective of the present study was to determine whether bio-chemical and hemodynamic parameters and waist circumference vary between mildly-stunted and non-stunted adolescents from impoverished communities of São Paulo, Brazil. Methods: The cross-sectional study involved 206 subjects, aged between 9 and 19 years and living in impoverished areas of São Paulo, Brazil. The sample population was divided according to height-for-age Z-score (HAZ) into stunted (−1 > HAZ ≥ −2) and non-stunted (HAZ ≥ −1) groups, and was sub-divided according to gender. Logistic regression analysis was employed to compare individuals with elevated (> 75th percentile) insulin concentrations. The receiver operating characteristic curves were constructed to determine WC cut-off points that could be used to identify stunted and non-stunted individuals with elevated insulin concentrations. Results: WC cut-off points of 58.25 cm and 67.2 cm allowed for correct classification of 90.7% of stunted and 88.7% of non-stunted individuals in the studied population. While the sensitivity of the model was high for stunted and non-stunted subjects (98.8% and 97.2%, respectively), the specificity was modest (57.1% and 41.2%, respectively). Conclusion: The results presented herein suggest that an increase in plasma insulin is one of the primary metabolic modifications in stunted individuals, and that this alteration could be identified at a lower WC cut-off point than in non-stunted counterparts.Universidade Federal de Alagoas (UFAL)Universidade Federal de São Paulo (UNIFESP) Ciências Aplicadas à PediatriaUniversidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Departamento de FisiologiaUNIFESP, Ciências Aplicadas à PediatriaUNIFESP, Depto. de FisiologiaSciEL

The influence of stunting within the nutricional deviation in adolescents and pre-adolescents

Objetivos: Avaliar a influência do déficit estatural nos desvios nutricionais em pré-adolescentes e adolescentes de baixa renda. Metodologia: Calculou-se o índice de Massa Corpórea (IMC) a partir do peso e estatura de alunos da rede pública entre 4 e 8ª séries. Foram utilizadas as tabelas do NCHS (2000) para crianças e adolescentes e foi considerado excesso de peso IMC/I ≥ P 85 e déficit de peso IMC/I ≥ P5. Déficit estatural foi classificado quando EII foi menor que -1 DP. Foram compradas as prevalências de baixo peso e excesso de peso nos grupos com e sem déficit estatural, de acordo com sexo e faixa etária.Resultados: Foram avaliados 3766 jovens sendo 50,4 % do sexo feminino. A média de idade foi de 12,8± 2,0 anos, sem diferença significativa entre os grupos. No grupo com déficit de estatura, observou-se que o excesso de peso é mais prevalente entre os mais velhos. Naqueles sem déficit de estatura a distribuição por idades foi semelhante para as três classificações de IMC/I. A distribuição por sexo mostra que o excesso de peso no grupo com déficit de estatura teve prevalência maior entre as meninas (76,1%) enquanto que no grupo com estatura normal a diferença foi mínima entre os sexos (4,4%).Conclusão: Na presença do déficit de estatura, o excesso de peso foi mais prevalente nos maiores de 12 anos e entre o sexo feminino. Os meninos sem déficit de estatura mostraram uma prevalência maior de excesso de peso em relação aos com déficit de estatura..BV UNIFESP: Teses e dissertaçõe

Influence of stunting on nutrition disorders in adolescents and pre-adolescents

OBJECTIVE: The objective of this study was to evaluate the influence of stunting on nutrition disorders in low-income preadolescents and adolescents. METHODS: Body mass index was calculated from the weight and height of 4 to 8th grade students from public schools. The tables from the National Center for Health Statistics of 2000 for children and adolescents were used as reference guides. Individuals were considered overweight when Body Mass Index-for-age >P85 and underweight when Body Mass Index-for-age <P5. Individuals were considered stunted when height-for-age was below one standard deviation. Overweight and underweight rates were compared between the non-stunted and stunted groups according to gender and age. RESULTS: A total of 3766 individuals were studied, 50.4% being females. Mean age was 12.8 years, with a standard deviation of 2.0 years and no significant difference between the groups. In the stunted group, overweight was more common among the older children. In the non-stunted group, the distribution by age was similar for all three Body Mass Index-for-age classifications. Distribution by gender shows that overweight in the stunted group prevailed among females (76.1%) while in the non-stunted group the difference was minimal between the genders (4.4%). CONCLUSION: In the stunted group, overweight was more common among those older than 12 years and among females. Non-stunted boys were overweight more often than stunted boys.OBJETIVO: Avaliar a influência do déficit estatural nos desvios nutricionais em pré-adolescentes e adolescentes de baixa renda. MÉTODOS: Calculou-se o Índice de Massa Corporal a partir do peso e da estatura de alunos da rede pública entre 4 e 8ª séries. Foram utilizadas as tabelas do National Center for Health Statistics de 2000 para crianças e adolescentes e foi considerado excesso de peso Índice de Massa Corporal/Idade>P85 e déficit de peso Índice de Massa Corporal/Idade <P5. Déficit estatural foi classificado quando estatura/idade foi menor que -1 desvio-padrão. Foram comparadas as proporções de baixo peso e excesso de peso nos grupos com e sem déficit estatural, de acordo com sexo e faixa etária. RESULTADOS: Foram avaliados 3 766 jovens sendo 50,4% do sexo feminino. A média de idade foi de 12,8, desvio-padrão de 2,0 anos, sem diferença significante entre os grupos. No grupo com déficit de estatura, observou-se que o excesso de peso é mais prevalente entre os mais velhos. Naqueles sem déficit de estatura a distribuição por idades foi semelhante para as três classificações de Índice de Massa Corporal/Idade. A distribuição por sexo mostra que o excesso de peso no grupo com déficit de estatura foi mais acentuada entre as meninas (76,1%) enquanto que no grupo com estatura normal a diferença foi mínima entre os sexos (4,4%). CONCLUSÃO: Na presença do déficit de estatura, o excesso de peso foi mais prevalente nos maiores de 12 anos e entre o sexo feminino. Os meninos sem déficit de estatura mostraram uma proporção maior de excesso de peso em relação aos com déficit de estatura

Lower waist circumference in mildly‐stunted adolescents is associated with elevated insulin concentration

Objective: Augmented waist circumference (WC) is associated with non‐communicable diseases and could represent a valuable marker in screening for metabolic dysfunctions in subjects with insufficient linear growth. The objective of the present study was to determine whether biochemical and hemodynamic parameters and waist circumference vary between mildly‐stunted and non‐stunted adolescents from impoverished communities of São Paulo, Brazil. Methods: The cross‐sectional study involved 206 subjects, aged between 9 and 19 years and living in impoverished areas of São Paulo, Brazil. The sample population was divided according to height‐for‐age Z‐score (HAZ) into stunted (–1 > HAZ ≥ –2) and non‐stunted (HAZ ≥ –1) groups, and was sub‐divided according to gender. Logistic regression analysis was employed to compare individuals with elevated (> 75th percentile) insulin concentrations. The receiver operating characteristic curves were constructed to determine WC cut‐off points that could be used to identify stunted and non‐stunted individuals with elevated insulin concentrations. Results: WC cut‐off points of 58.25 cm and 67.2 cm allowed for correct classification of 90.7% of stunted and 88.7% of non‐stunted individuals in the studied population. While the sensitivity of the model was high for stunted and non‐stunted subjects (98.8% and 97.2%, respectively), the specificity was modest (57.1% and 41.2%, respectively). Conclusion: The results presented herein suggest that an increase in plasma insulin is one of the primary metabolic modifications in stunted individuals, and that this alteration could be identified at a lower WC cut‐off point than in non‐stunted counterparts

A baixa estatura leve está associada a índices mais elevados de gordura corporal: estudo de uma população de baixa renda

OBJETIVO: Testar se os indivíduos com escores z de estatura para idade entre -2 e -1 apresentam maior porcentagem de gordura corporal e, portanto, não devem ser classificados como tendo estado nutricional normal. MÉTODOS: Foram estudados 96 indivíduos (52 meninos e 44 meninas, 57% púberes). A composição corporal foi analisada por absortometria radiológica de dupla energia. RESULTADOS: O percentual de gordura abdominal em meninas pré-púberes com baixa estatura foi maior (27,4%; p = 0,01) quando comparado ao grupo com estatura normal (20,6%). Diferenças semelhantes na gordura abdominal (%) foram observadas para as meninas e meninos púberes com baixa estatura e estatura normal (37,6 e 29,8%, p = 0,01; 24,6 e 15,7%, p = 0,01, respectivamente). Os percentuais de gordura corporal total das meninas pré-púberes e dos meninos púberes com baixa estatura foram superiores (29,9 e 24,5%, p = 0,03; 26,3 e 18,1%, p = 0,01, respectivamente) aos dos grupo com estatura normal. Os grupos com estatura normal apresentaram menor circunferência da cintura. CONCLUSÃO: Adolescentes com baixa estatura leve apresentam alterações na composição corporal, indicando aumento do risco para doenças metabólicas