Metabolically Healthy Obesity: Presence of Arterial Stiffness in the Prepubescent Population

Aim: Arteriosclerotic cardiovascular disease, one of the world’s leading causes of death, first manifests itself at an early age. The identification of children who may have increased cardiovascular risk in the future could be an important prevention strategy. Our aim was to assess the clinical, analytical, and dietary variables associated with arterial stiffness (AS), measured by carotid-femoral pulse wave velocity (cfPWV) in a prepubescent population with metabolically healthy obesity (MHO). Subjects and Methods: A cross-sectional study in prepubescent subjects with obesity who had ≤1 metabolic syndrome criteria (abdominal perimeter and blood pressure ≥90th percentile, triglycerides >150 mg/dL, HDL-cholesterol <40 mg/dL, fasting plasma glucose ≥100 mg/dL) was conducted. Adherence to Mediterranean Diet, blood pressure, BMI, waist/height ratio (WHtR), glycemic status, lipid profile, and cfPWV were analyzed. 75 MHO children (boys: 43; girls: 32; p = 0.20) (age = 10.05 ± 1.29 years; BMI = 25.29 ± 3.5 kg/m2) were included. Results: We found a positive correlation between cfPWV and weight (r = 0.51; p < 0.0001), BMI (r = 0.44; p < 0.0001), WHtR (r = 0.26; p = 0.02), fasting insulin levels (r = 0.28; p = 0.02), and insulin resistance (Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index) (r = 0.25; p = 0.04). Multiple linear regression analysis identified BMI and HOMA-IR as independent parameters associated with cfPWV. Conclusions: Prepubescent children with obesity who were shown to be metabolically healthy presented with arterial stiffness, which is closely related to BMI and the state of insulin resistance.

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Comparison between metabolically healthy obesity and metabolically unhealthy obesity by different definitions among Mexican children

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0077 ◽

2020 ◽

Vol 33 (2) ◽

pp. 215-222 ◽

Cited By ~ 2

Author(s):

María Lola Evia-Viscarra ◽

Rodolfo Guardado-Mendoza

Keyword(s):

Blood Pressure ◽

Family Background ◽

Density Lipoprotein ◽

Model Assessment ◽

Metabolically Healthy Obesity ◽

Cvd Risk ◽

Cross Sectional ◽

Mexican Children ◽

Metabolically Healthy ◽

Metabolically Unhealthy Obesity

AbstractBackgroundThere is no consensus on the definition of metabolically healthy obesity (MHO) and the diagnostic criteria in children.ObjectivesTo estimate the prevalence of MHO and compare clinical and biochemical characteristics between MHO and metabolically unhealthy obesity (MUO), and to evaluate the association between MUO and cardiovascular disease (CVD) risk, anthropometrics and family background using different definitions in children.MethodsThis was a cross-sectional study. Participants included 224 obese children between the years 2007 and 2017. MHO was defined by three different criteria: (i) absence of metabolic syndrome (MHO-MS), (ii) no insulin resistance (IR) by homeostatic model assessment (HOMA) <3.16 cut-off (MHO-IR3.16) and (iii) absence of IR at <95th percentile for Mexican children (MHO-95th).ResultsThe prevalence of MHO-MS, MHO-IR3.16 and MHO-IR95th was 12.9%, 56.3% and 41.5%, respectively. The prevalence of simultaneous MHO-MS plus MHO-IR95th was 5.36%. Children with MHO-MS vs. MUO-MS showed lower height, weight and body mass index (BMI) percentiles; MHO-IR3.16 vs. MUO-IR3.16 showed lower age, acanthosis, Tanner, waist circumference (WC), waist-to-height ratio (WHtR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and glucose; and MHO-IR95th vs. MUO-IR95th showed lower acanthosis, WC, DBP, glucose and high high-density lipoprotein cholesterol (HDL-C). MUO-MS was associated with WC > 90th, type 2 diabetes mellitus (T2DM) in first-degree relatives and obesity in siblings. MUO-IR3.16 was associated with pubertal stages, WC > 90th, WHtR > 0.55 and fasting hyperglycemia. MUO-IR95th was associated with WHtR > 0.55 and HDL < 10th. MHO-MS and MHO-IR3.16 or MHO-IR95th did not have agreement.ConclusionsThe prevalence of MHO varied depending on the definition, although the real MHO with no MS or IR is very low. Low DBP and high HDL-C in MHO were present in any definition. Association of MUO with anthropometric, biochemical and family background differs across definitions.

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THE CHARACTERISTICS OF SECRETION OF ADIPONECTIN AND ITS RELATIONSHIP WITH PARTICULAR INDICESOF METABOLISM IN MALES OF ABLE-BODIED AGE IN CASE OF OBESITY

Medical Journal of the Russian Federation ◽

10.18821/0869-2106-2017-23-6-312-315 ◽

2017 ◽

Vol 23 (6) ◽

pp. 312-315

Author(s):

Olga V. Karataeva

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Low Density Lipoproteins ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Metabolically Healthy Obesity ◽

Significant Difference ◽

Fasting Glycaemia ◽

Metabolically Healthy ◽

Degree Of Severity

The sampling consisted of 79 examined males of able-bodied age. The arterial hypertension stage I and II was established in 58% of them; obesity of various degree of severity was diagnosed in 63% of them; metabolic syndrome according criteria ATP-III was noted in 46.8% of examined patients. The general clinical and anthropometric examination was carried out. The laboratory analyses included estimation of lipidogram, fasting glycaemia and also hormones adiponectin and insulin with following calculation of index of insulin resistance HOMA-IR (Homeostasis Model Assessment of Insulin Resistance). The study was organized to investigate effecting of obesity on secretion of adiponectin and its relationship with indices of lipidogram and level of insulin resistance. The comparative analysis of groups with and absence of obesity established no significant difference in level of adiponectin and indices of lipidogram. the significant differences were established in the levels of basal insulin hence in value of index NOMA-IR that points to hyperinsulinemia and expressed insulin resistance in patients with obesity. The patients were separated in two groups depending on presence of manifestations of metabolic syndrome: with metabolically healthy obesity and metabolically complicated obesity. The analysis established a significant decreasing of level of adiponectin in the group of metabolically complicated obesity accompanied by insulin resistance, dyslipidemia and increased level of glycaemia. The study established no effect of degree of obesity on decreasing of level of adiponectin. The significant differences between levels of adiponectin in comparison between group without obesity and group of metabolically healthy obesity. The correlation analysis in group with obesity demonstrated back-coupling between level of adiponectin and content of total cholesterol, low density lipoproteins and coefficient of atherogenicity. The comparison of groups according median of adiponectin established significant differences in rate of development of metabolic syndrome and value of coefficient of atherogenicity.

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Family history of cardiovascular disease and non-HDL cholesterol in prepubescent non-obese children

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.04.347 ◽

2016 ◽

Vol 62 (4) ◽

pp. 347-352 ◽

Cited By ~ 3

Author(s):

Maria Wany Louzada Strufaldi ◽

Fabíola Isabel Suano de Souza ◽

Rosana Fiorini Puccini ◽

Maria do Carmo Pinho Franco

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Family History ◽

Hdl Cholesterol ◽

Systemic Blood Pressure ◽

Normal Body Mass Index ◽

Cross Sectional ◽

History Of

Summary Objective: To describe the values of non-HDL cholesterol (NHDL-c) and the frequency of a family history of early cardiovascular disease (family HCVD) in healthy prepubescent children. Analyze the association between NHDL-c and family HCVD, and possible associations with other risk factors for cardiovascular disease (CVD). Method: Cross-sectional study including 269 prepubescent (aged 6-10 years) schoolchildren with a normal body mass index (+1SD<BMI>-2SD). Data collected: Family HCVD; weight and height, waist circumference and systemic blood pressure; lipid profile (total cholesterol TC, HDL-c, triglycerides and LDL-c), NHDL-c calculation (CT-HDL-c, cut-off = 145 mg/dL) and insulin resistance (HOMA-IR). Results: High levels were found for NHDL-c in 10 (3.7%) of these schoolchildren, and family early HCVD was found in 46 (17.1%) of them. There was a weak association between family HCVD and NHDL-c (Cramer’s-V-test = 0.120; p=0.050). Among the children with NHDL-c≥145 mg/dL, 4 (40%) have family HCVD. The presence of family HCVD was not associated with the variables being studied. The variables independently associated with NHDL-c ≥ 145 mg/dL were: HOMA-IR (OR=1.7; 95CI 1.1-2.6) and diastolic blood pressure (OR=1.1; 95CI 1.02-1.2). Conclusion: NHDL-c values were associated with blood pressure and insulin resistance. Family HCVD was not associated with other classic risk factors for CVD, even though the frequency found was five times higher than that of high NHDL-c.

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Associations of resistin with inflammatory and fibrinolytic markers, insulin resistance, and metabolic syndrome in middle-aged and older Chinese

Acta Endocrinologica ◽

10.1530/eje-08-0427 ◽

2008 ◽

Vol 159 (5) ◽

pp. 585-593 ◽

Cited By ~ 37

Author(s):

Qibin Qi ◽

Jing Wang ◽

Huaixing Li ◽

Zhijie Yu ◽

Xingwang Ye ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Plasminogen Activator Inhibitor ◽

Population Based ◽

Model Assessment ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factor Α

ObjectiveResistin increases insulin resistance (IR) in mice. However, the role of resistin in human disease remains controversial. We aimed to assess plasma resistin levels and their associations with inflammatory and fibrinolytic markers, IR and metabolic syndrome (MetS) among Chinese.Design and methodsPlasma resistin was measured in a population-based cross-sectional survey of 3193 Chinese aged from 50 to 70 years in Beijing and Shanghai.ResultsThe median resistin concentration was 8.60 ng/ml (interquartile range, 5.78–14.00) among all participants, and it was higher in women than in men (P=0.008). Resistin was correlated weakly with body mass index, waist circumference, high-density lipoprotein (HDL) cholesterol (negatively), homeostatic model assessment of IR and tumor necrosis factor-α receptor 2 (TNFR2; r=0.04, 0.07, –0.09 and 0.06 respectively, all P<0.05), and more highly with C-reactive protein (CRP), interleukin (IL)6 and plasminogen activator inhibitor (PAI)1 (r=0.12, 0.12 and 0.21 respectively, all P<0.001), but only HDL cholesterol, CRP, IL6, TNFR2, and PAI1 remained significantly associated with resistin in multiple regression analysis (all P<0.05). Furthermore, elevated resistin levels were associated with the higher prevalence of IR and MetS. However, the significant relationships disappeared after adjustment for inflammatory and fibrinolytic markers especially PAI1.ConclusionsThis study suggests that resistin is more strongly associated with inflammatory and fibrinolytic markers than with obesity or IR status. The associations of resistin with IR and MetS could largely be explained by inflammatory and fibrinolytic markers especially PAI1 levels.

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High BMI with Adequate Lean Mass Is Not Associated with Cardiometabolic Risk Factors in Children and Adolescents

Journal of Nutrition ◽

10.1093/jn/nxaa328 ◽

2020 ◽

Author(s):

Pei Xiao ◽

Hong Cheng ◽

Yinkun Yan ◽

Junting Liu ◽

Xiaoyuan Zhao ◽

...

Keyword(s):

Insulin Resistance ◽

Body Composition ◽

Children And Adolescents ◽

Lean Mass ◽

Ldl Cholesterol ◽

Hdl Cholesterol ◽

Obesity Paradox ◽

Model Assessment ◽

Cross Sectional ◽

High Tc

ABSTRACT Background Despite an increasing number of studies investigating the links between increased BMI and a better prognosis of cardiovascular disease, which has been termed the “obesity paradox,” few of them take the lean mass into consideration. Objectives This study aimed to explore the associations of body composition compartments, especially the lean mass, with cardiometabolic abnormalities in children and adolescents. Methods In a nationwide cross-sectional study of 6- to 18-y-old children (n = 8967, 50.1% boys), we measured body composition using DXA scan, and calculated BMI, fat mass index (FMI), and lean mass index (LMI). The exploratory outcomes were cardiometabolic abnormalities, including hypertension, dyslipidemia, hyperglycemia, and insulin resistance. Adjusted linear regression coefficients and ORs were calculated to assess the associations between body composition indicators and cardiometabolic abnormalities. Results Unlike BMI and FMI, LMI was inversely associated with homeostasis model assessment of insulin resistance (β: −0.06; 95% CI: −0.09, −0.03; P < 0.001), fasting plasma glucose (β: −0.08; 95% CI: −0.11, −0.05; P < 0.001), non-HDL cholesterol (β: −0.10; 95% CI: −0.13, −0.08; P < 0.001), LDL cholesterol (β: −0.12; 95% CI: −0.14, −0.09; P < 0.001), and total cholesterol (TC) (β: −0.16; 95% CI: −0.19, −0.14; P < 0.001). After multivariable adjustment, all the odds of cardiometabolic abnormalities were increased from the lowest quartile to the highest quartile of BMI and FMI (P-trend < 0.05); however, the odds of high TC, high LDL cholesterol, hyperglycemia, and insulin resistance were decreased with LMI (P-trend < 0.05). Obese children with high LMI did not have significantly increased odds of high TC, high LDL cholesterol, and high non-HDL cholesterol compared with normal-weight children without high LMI. Conclusions Greater lean mass may have a protective impact on high TC, high LDL cholesterol, hyperglycemia, and insulin resistance in children and adolescents. This finding suggests that the “obesity paradox” may be partly explained by high lean mass.

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Insulin resistance and adipokine levels correlate with early atherosclerosis – a study in prediabetic patients

Open Medicine ◽

10.1515/med-2015-0003 ◽

2014 ◽

Vol 10 (1) ◽

Cited By ~ 2

Author(s):

Bogdan Mircea Mihai ◽

Antoniu Octavian Petriș ◽

Didona Anca Ungureanu ◽

Cristina Mihaela Lăcătușu

Keyword(s):

Insulin Resistance ◽

Clinical Signs ◽

Hdl Cholesterol ◽

Intima Media Thickness ◽

Cross Sectional Study ◽

Model Assessment ◽

Cross Sectional ◽

Carotid Imt ◽

Lipid Parameters ◽

Early Atherosclerosis

AbstractCardiovascular risk of prediabetes is still subject to controversies. We analyzed the associations between insulin resistance, adipokines and incipient atherosclerosis estimated by intima-media thickness (IMT) in a cross-sectional study on 122 prediabetic subjects without clinical signs of atherosclerotic disease. Homeostasis model assessment of insulin resistance (HOMA-IR, calculated as fasting insulin × fasting plasma glucose / 22.5), adiponectin, leptin, leptin-to-adiponectin ratio, carotid and femoral IMT were evaluated. We also assessed other parameters related to insulin resistance and adipokines (HbA1c, anthropometric and lipid parameters), as they may also influence atherosclerosis. Carotid IMT was correlated to adiponectin and leptin-to-adiponectin ratio (all p < 0.05), but not with HOMA-IR or leptin, while femoral IMT showed no relationship with these factors. After adjusting for leptin, leptin-to-adiponectin ratio, triglycerides, HDL-cholesterol, cholesterol-to-HDL ratio, triglycerides-to-HDL ratio and HbA1c, IMT values became correlated with HOMA-IR. Adjustment for HOMA-IR induced the appearance of new correlations between adipokines and both IMT values. In conclusion, insulin resistance and adipokines seem related to IMT in prediabetic subjects without clinical signs of arterial obstruction.

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Evaluation of endothelial function and arterial stiffness in obese individuals with insulin resistance

Nutrition and Health ◽

10.1177/0260106018819374 ◽

2019 ◽

Vol 25 (2) ◽

pp. 85-92 ◽

Cited By ~ 2

Author(s):

VP Menezes ◽

C Cohen ◽

J Del-Rei ◽

W Oigman ◽

MF Neves ◽

...

Keyword(s):

Insulin Resistance ◽

Arterial Stiffness ◽

Endothelial Function ◽

Statistical Significance ◽

Hdl Cholesterol ◽

Intima Media Thickness ◽

Abdominal Circumference ◽

Model Assessment ◽

Group 2 ◽

Group 1

Background: Obesity is associated with metabolic imbalance, including insulin resistance and endothelial dysfunction. Aim: We aimed to evaluate clinical and vascular parameters in obese with or without insulin resistance. Methods: Participants ( n=39) were divided into two groups according to Homeostasis Model Assessment – Insulin Resistance lower (group 1) or higher (group 2) than 2.7. All patients were submitted to clinical, anthropometric, biochemical, vascular structure and endothelial function assessment. Results: The mean age (53±9 vs. 52±7 years, p=0.784) and body mass index (34.3±4.1 vs. 35.2±3.9 kg/m2, p=0.464) were similar in both groups, and 74.4% were treated hypertensive subjects. Fasting glucose (84±7 vs. 97±18 mg/dl, p=0.004) and insulin (9.32±2.48 vs. 22.74±7.49 μU/ml, p<0.001) were higher in group 2. Group 2 presented lower HDL-cholesterol (59±14 vs. 42±12 mg/dl, p<0.001) and higher triglycerides (122±87 vs. 191±112 mg/dl, p=0.042) levels compared with group 1. HOMA-IR was correlated with abdominal circumference ( r=0.51, p=0.001), abdominal/hip ratio ( r=0.57, p<0.001) and triglycerides/HDL ratio ( r=0.53, p=0.001). Differences in brachial flow-mediated dilation did not reach statistical significance (10.2±6.2 vs. 7.9±4.7%, p=0.245). Carotid intima–media thickness, carotid-femoral pulse wave velocity (8.5±1.9 vs. 9.1±1.5 m/s, p=0.334) and central hemodynamic parameters were also similar between groups. Conclusion: Obese individuals with insulin resistance have higher visceral adiposity associated with impaired glucose and lipid metabolism. Endothelial function and arterial stiffness were similar between the groups, perhaps because of antihypertensive treatment in most of these subjects.

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Rice and noodle consumption is associated with insulin resistance and hyperglycaemia in an Asian population

British Journal Of Nutrition ◽

10.1017/s0007114513003486 ◽

2013 ◽

Vol 111 (6) ◽

pp. 1118-1128 ◽

Cited By ~ 25

Author(s):

Yasmin L. M. Zuñiga ◽

Salome A. Rebello ◽

Puay Leng Oi ◽

Huili Zheng ◽

Jeannette Lee ◽

...

Keyword(s):

Insulin Resistance ◽

Cell Function ◽

Fasting Glucose ◽

Asian Population ◽

Hdl Cholesterol ◽

Population Based ◽

Model Assessment ◽

Homa Index ◽

Cross Sectional ◽

High Consumption

High consumption of refined grains, particularly white rice, has been reported to be associated with a higher risk of type 2 diabetes. Therefore, in the present study, we evaluated the association between rice and noodle consumption and markers of glucose homeostasis, inflammation and dyslipidaemia in an Asian population. We carried out a population-based cross-sectional study in 2728 Singaporean Chinese men and women aged between 24 and 92 years. Rice and noodle intake was assessed using a validated FFQ and studied in relation to glycaemic (fasting glucose, glycated Hb, homeostasis model assessment (HOMA) index for insulin resistance (HOMA-IR) and HOMA index for β-cell function (HOMA-β)), inflammatory (plasma adiponectin and C-reactive protein (CRP)) and lipid (fasting TAG and HDL-cholesterol (HDL-C)) markers. We used multiple linear regression analyses with adjustment for total energy intake and sociodemographic, anthropometric (BMI and waist:hip ratio) and lifestyle factors. Higher rice consumption was found to be associated with higher fasting glucose concentrations (0·81 % higher values per portion increment; 95 % CI 0·09, 1·54) and HOMA-IR (4·62 %; 95 % CI 1·29, 8·07). Higher noodle consumption was also found to be significantly associated with higher fasting glucose concentrations (1·67 %; 95 % CI 0·44, 2·92), HOMA-IR (6·17 %; 95 % CI 0·49, 12·16) and fasting TAG concentrations (9·17 %; 95 % CI 3·44, 15·22). No significant association was observed between rice and noodle consumption and adiponectin, CRP and HDL-C concentrations or HOMA-β in the fully adjusted model. These results suggest that high consumption of rice and noodles may contribute to hyperglycaemia through greater insulin resistance and that this relationship is independent of adiposity and systemic inflammation.

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Association of Anti-TPO Antibodies with Insulin Resistance in Patients of Hypothyroidism with Metabolic Syndrome: A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45695.14123 ◽

2020 ◽

Author(s):

Amit Jain ◽

Sagar Dholariya ◽

Mirza Masroor ◽

P Lali ◽

L Chandra ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Subclinical Hypothyroidism ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Thyroid Peroxidase ◽

Multivariate Linear Regression Analysis ◽

Model Assessment ◽

Sectional Study ◽

Cross Sectional

Introduction: Hypothyroidism and Metabolic Syndrome (MetS) are associated with insulin resistance. Exact reason for development of insulin resistance in hypothyroidism is still unclear. Aim: To determine the association between Anti-Thyroid Peroxidase Antibodies (Anti-TPO Abs) and Thyroid Stimulating Hormone (TSH) with components of MetS, Fasting Insulin (FSI) and Homeostatic Model Assessment Index for Insulin Resistance (HOMA-IR). Materials and Methods: Total 118 subjects of hypothyroidism were included in this cross-sectional study. The diagnosis of MetS was made based on National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Independent association of components of MetS, FSI and HOMA-IR with TSH and anti-TPO Abs was analysed by multivariate linear regression analysis. Results: MetS was more prevalent in subclinical hyperthyroidism (53.0%) compared to overt hypothyroidism (49.3%). Serum anti-TPO Abs level was significantly high in MetS group compared to non-MetS group in both overt (200.0±170.2 and 122.8±98.9, p=0.02*) and subclinical (184.9±142.9 and 114.5±90.9, p=0.04*) hyperthyroidism. Waist Circumference (WC), Fasting Plasma Glucose (FPG), FSI and HOMA-IR were independently associated with anti-TPO Abs in both overt and subclinical hypothyroidism. Anti-TPO was also increased significantly in linear trend along with increased in the number of MetS components in both overt and subclinical hypothyroidism. Conclusion: MetS is highly prevalent in hypothyroidism and anti-TPO Abs rather than TSH and is more associated with insulin resistance in patients of hypothyroidism with MetS.

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Identification of neck circumference cut-off points for insulin resistance as a marker in adolescents

Revista de Nutrição ◽

10.1590/1678-9865202134e200190 ◽

2021 ◽

Vol 34 ◽

Author(s):

Ingrid Ribeiro da Cruz MELO ◽

Márcia Ferreira Cândido de SOUZA ◽

Íkaro Daniel de Carvalho BARRETO ◽

Danielle Góes da SILVA ◽

Ricardo Queiroz GURGEL

Keyword(s):

Insulin Resistance ◽

Linear Regression ◽

Multiple Linear Regression ◽

Characteristic Curve ◽

Linear Regression Analysis ◽

Neck Circumference ◽

Model Assessment ◽

Cardiovascular Risks ◽

Homeostasis Model Assessment ◽

Cross Sectional

ABSTRACT Objective To identify cut-off points of neck circumference measurement to predict insulin resistance in adolescents. Methods Cross-sectional analysis with data derived from the Study of Cardiovascular Risks in Adolescents, nationwide, multicenter, school-based survey. We evaluated 901 adolescents, aged 12 to 17, from public and private schools in two cities of Sergipe state in Brazil. We measured demographic, anthropometric, and biochemical data, and insulin resistance using Homeostasis Model Assessment-Insulin Resistance. We used multiple linear regression and logistic analysis to evaluate the association between dependent variables (biochemical) and independent variables (anthropometric) controlled by body mass index, age, gender, and Tanner’s stage. We used the Receiver operating characteristic curve to determine cut-off points of neck circumference that can identify insulin resistance. Results The multiple linear regression analysis showed a positive association between neck circumference measurement with fasting glycemia and glycated hemoglobin (p<0.001) and a negative association with insulin (p<0.024). Furthermore, in logistic regression, the measurement of neck circumference was the only anthropometric indicator positively correlated with homeostasis model assessment-insulin resistance. The cut-off points of neck circumference for predicting insulin resistance were: 30.55cm for female pubertal and 32.10cm for post-pubertal adolescents; 35.90cm for male pubertal adolescents and 36.65cm for post-pubertal adolescents. Conclusions The measurement of neck circumference is a simple, practical anthropometric indicator and can be used as a screening tool to identify insulin resistance in adolescents.

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