Sensitivitas dan spesifisitas lingkar pergelangan tangan sebagai prediktor obesitas dan resistensi insulin pada remaja akhir

Addina Rizky Fitriyanti -  Prodi Ilmu Gizi, Fakultas Ilmu Keperawatan dan Kesehatan, Universitas Muhammadiyah Semarang, Indonesia
*Kusmiyati Tjahjono -  Bagian Biokimia, Fakultas Kedokteran, Universitas Diponegoro, Indonesia
Mohammad Sulchan -  Departemen Ilmu Gizi, Fakultas Kedokteran, Universitas Diponegoro, Indonesia
Sunarto Sunarto -  Jurusan Gizi, Politeknik Kesehatan Kemenkes Semarang, Indonesia
Received: 28 Sep 2018; Published: 14 Jun 2019.
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Abstract

Background: Obesity is one of the risk factors for insulin resistance. Insulin resistance plays an important role in the pathogenesis of cardiovascular disease. Wrist circumference has the potential for predicting obesity and insulin resistance.

Objectives:. To evaluate the sensitivity and specificity of wrist circumference against obesity and insulin resistance in late adolescents.

Methods: The design of this study is a crossectional study with a sample of 85 students at Diponegoro University Semarang. Data collected consisted of anthropometric measurements (body weight, height, wrist circumference, neck circumference, waist circumference and pelvic girth) and blood vein sampling (fasting blood glucose and fasting insulin). Statistical analyses used in this study were Pearson or R Spearman correlation test.

Results: Wrist circumference was positively correlated with all biochemical parameters and anthropometric measurements except the waist hip ratio. Wrist circumference correlates positively and significantly with fasting insulin and HOMA-IR in male adolescents. The results of the ROC curve analysis showed that the AUC value of wrist circumference in male adolescents had better performance in predicting obesity (88% (95% CI, 76% - 100%)) than insulin resistance (81% (95% CI, 51% -100%)).

Conclusion: Wrist circumference is one of the anthropometric measurements that can be used for predicting obesity and insulin resistance in late adolescents.

Keywords
sensitivity; specivity; anthropometric measurement; wrist circumference; insulin resistance

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  1. Shafiee G, Qorbani M, Heshmat R, Djalalinia S, Motlagh ME, Arefirad T, et al. Wrist circumference as a novel predictor of obesity in children and adolescents: The CASPIAN-IV study. J Pediatr Endocrinol Metab. 2018;31(7):717-725.
  2. Hajsadeghi S, Firouzi A, Bahadoran P, Hassanzadeh M. The value of wrist circumference for predicting the presence of coronary artery disease and metabolic syndrome. Indian Heart J. 2016;68:S5–9.
  3. Kelishadi R, Heidari-Beni M, Qorbani M, Motamed-Gorji N, Motlagh ME, Ziaodini H, et al. Association between neck and wrist circumferences and cardiometabolic risk in children and adolescents: The CASPIAN-V study. Nutrition. 2017;43–44:32–8.
  4. Lysen LK, Donna A. Israel. Nutrition in Weight Management. In: Mahan LK, Raymond JL, editors. Krause’s Food and The Nutrition Care Process. 14th editi. Canada: Elsevier Inc. 2017. p. 383–402.
  5. Amini A, Soltanian N, Iraj B, Askari G, Ebneyamin S, Ghias M, et al. Original article association of wrist circumference with cardio metabolic risk factors statistical analysis : J Pak Med Assoc. 2012;62(3 suppl 2):34–6.
  6. Capizzi M, Leto G, Petrone A, Zampetti S, Papa RE, Osimani M, et al. Wrist circumference is a clinical marker of insulin resistance in overweight and obese children and adolescents. Circulation. 2011;123:1757–62.
  7. Campagna G, Zampetti S, Gallozzi A, Giansanti S, Chiesa C, Pacifico L, et al. Excellent intra and inter-observer reproducibility of wrist circumference measurements in obese children and adolescents. PLoS One. 2016;11(6):1–10.
  8. Ling JCY, Mohamed MNA, Jalaludin MY, Rampal S, Zaharan NL, Mohamed Z. Determinants of high fasting insulin and insulin resistance among overweight/obese adolescents. Sci Rep. 2016;6(October):1–10.
  9. Mitrea A, Soare A, Popa SG, Tudor MN, Mota M, Pozzilli P. Wrist circumference: An independent predictor of both insulin resistance and chronic kidney disease in an elderly population. Rom J Diabetes, Nutr Metab Dis. 2013;20(3):323–9.
  10. Watkins AN, Kelly AS, Prineas RJ, Marlatt KL, Dengel DR, Sinaiko AR, et al. Childhood wrist circumference is not a predictor of insulin resistance in adulthood. J Pediatr. 2015;166(4):1085–7.
  11. Öztürk A, Çiçek B, Mazıcıoğlu MM, Zararsız G, Kurtoğlu S. Wrist circumference and frame size percentiles in 6-17-year-old Turkish children and adolescents in Kayseri. J Clin Res Pediatr Endocrinol. 2017;9(4):329–36.
  12. Derakhshan A, Eslami A, Bozorgmanesh M, Sheikholeslami F, Azizi F, Hadaegh F. Wrist circumference as a novel negative risk factor for cardiovascular disease among adult men: a median follow-up of 9 years. J Endocrinol Invest. 2016;39(7):763–8.
  13. Noudeh YJ, Hadaegh F, Vatankhah N, Momenan AA, Saadat N, Khalili D, et al. Wrist circumference as a novel predictor of diabetes and prediabetes: Results of cross-sectional and 8.8-year follow-up studies. J Clin Endocrinol Metab. 2013;98(2):777–84.
  14. Obirikorang C, Obirikorang Y, Acheampong E, Anto EO, Toboh E, Asamoah EA, et al. Association of wrist circumference and waist-to-height ratio with cardiometabolic risk factors among type II diabetics in a Ghanaian population. J Diabetes Res. 2018;1–11.
  15. Newbern D, Gumus Balikcioglu P, Balikcioglu M, Bain J, Muehlbauer M, Stevens R, et al. Sex Differences in biomarkers associated with insulin resistance in obese adolescents: metabolomic profiling and principal components analysis. J Clin Endocrinol Metab. 2014;99(12):4730–9.
  16. Kautzky-Willer A, Harreiter J, Pacini G. Sex and gender differences in risk, pathophysiology and complications of type 2 diabetes mellitus. Endocr Rev. 2016;37(3):278–316.
  17. Garza FJG la, Ayala AEG, Nava MG, Monsivais LIM, Martinez AMS, Lopez ER, et al. Body frame size in school children is related to the amount of adipose tissue in different depots but not to adipose distribution. Am J Hum Biol. 2017;1–7.
  18. Shao J, Wang Z, Yang T, Ying H, Zhang Y, Liu S. Bone regulates glucose metabolism as an endocrine organ through osteocalcin. Int J Endocrinol. 2015;1–9.
  19. Namazi N, Djalalinia S, Mahdavi A, Hamid G, Morteza A. Association of wrist circumference with cardio-metabolic risk factors : a systematic review and meta-analysis. Eat Weight Disord - Stud Anorexia, Bulim Obes. 2018;1–11.
  20. Mohebi R, Mohebi A, Sheikholeslami F, Azizi F, Hadaegh F. Wrist circumference as a novel predictor of hypertension and cardiovascular disease : results of a decade follow up in a West Asian cohort. J Am Soc Hypertens. 2014;8(11):800–7.
  21. Dahlan MS. Analisis Penelitian Diagnostik. In: Penelitian Diagnostik. Jakarta: Salemba Medika; 2009. p. 20–30.
  22. Tatar BT, Ersoy C, Kacan T, Kirhan E, Sarandol E. Neck and wrist circumferences propose a reliable approach to qualify obesity and insulin resistance. Med Sci. 2014;3(1):1013–25.
  23. Khadilkar V, Chiplonkar S, Ekbote V, Kajale N, Mandlik R. Reference centile curves for wrist circumference for Indian children aged 3 – 18 years. J Pediatr Metab. 2018;91(20):1–6.