Precisión diagnóstica del índice cintura-talla para la identificación del sobrepeso y la obesidad infantil

Medicina Clínica (Impact Factor: 1.25). 01/2012; DOI: 10.1016/j.medcli.2012.01.032

ABSTRACT Objetivo: Explorar la sensibilidad y especificidad del índice cintura talla como identificador del sobrepeso y la obesidad en edad pediátrica.

Material y Métodos: se analizaron 2319 escolares de ambos sexos (1158 varones y 1161 mujeres) en edades comprendidas entre los 6 y 14 años. Se tomaron la talla, el peso, el perímetro de la cintura y los pliegues subcutáneos tricipital, bicipital, subescapular y suprailiaco y se calcularon el índice cintura talla (ICT) el índice de masa corporal (IMC) y el porcentaje de grasa (%G). Se aplicó un ANOVA para evaluar el comportamiento de todas las variables antropométricas a lo largo del período de crecimiento considerado. Se empleó un análisis de curvas ROC (Receiving Operating Characteristics) tomando como variable prueba el ICT y como variable criterio el status de sobrepeso u obesidad evaluados mediante dos métodos: el estándar de Cole et al.. (2000) para IMC y las referencias de Marrodán et al.. (2006) para % G. Se calcularon los valores de sensibilidad y especificidad del ICT y se obtuvieron las áreas bajo la curva, sus intervalos de confianza al 95% y los puntos de corte aplicables en el diagnóstico del sobrepeso y la obesidad respectivamente. El procedimiento estadístico y gráfico se llevó a cabo mediante el programa SPSS 18.0

Resultados: El análisis de ANOVA mostró que el ICT no presenta variaciones con la edad. Esto apoya la propuesta de buscar puntos de corte que, sin necesidad de recurrir a patrones de percentiles, sirvan para identificar los sujetos que presentan sobrepeso u obesidad. Las Áreas bajo la curva (ABC) oscilaron entre el 0,786 (para el sobrepeso en varones) y el 0,953 (para la obesidad en las mujeres) lo que indica que el ICT tiene un alto poder predictivo para identificar los sujetos previamente clasificados con sobrepeso u obesidad por los dos criterios considerados: IMC y %G.

Conclusión: el ICT resultó ser un indicador adecuado y eficaz para medir riesgo de sobrepeso y obesidad en niños entre los 6 y 14 años. Los puntos de corte que identifican la obesidad son: 0,51 en varones y 0,50 en las niñas. Para el sobrepeso, oscilan entre 0,47 y 0,48 dependiendo del sexo y la variable tomada como criterio.

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May 27, 2014