Índice cintura/estatura como predictor de riesgo cardiovascular en niños con sobrepeso y obesidad. Hospital Belén de Trujillo

Abstract

Determinar si el Ìndice cintura/estatura (ICE) tiene valor como predictor de riesgo cardiovascular en niÒos con sobrepeso y obesidad en el Hospital BelÈn de Trujillo durante el periodo 2018-2024. Material y métodos: Se llevÛ a cabo un estudio analÌtico observacional retrospectivo de pruebas diagnÛsticas con 83 niÒos entre 6 y 14 aÒos, con diagnÛstico de sobrepeso y obesidad atendidos en consultorio externo. Se calculó el ICE, considerándose elevado si el valor de este era ≥ 0.5. Para evaluar el riesgo cardiovascular se tuvo en cuenta el perfil lipÌdico alterado. Para establecer si el ICE tiene valor como predictor de riesgo cardiovascular se calculÛ los Ìndices clÌnicos de: Sensibilidad, Especificidad, Valor predictivo positivo y negativo, RazÛn de verosimilitud positiva y negativa. Para determinar un nuevo punto de corte, para el ICE, se utilizÛ la curva ROC (curva de eficacia diagnÛstica). Resultados: al evaluar las caracterÌsticas de la poblaciÛn, se encontrÛ diferencias significativas (p <0.05), en lo referente a la edad, el IMC, y las alteraciones del perfil lipídico en los niños con ICE ≥0.5 Al tomar como punto de corte el valor de ICE ≥0.5 se encontró que la sensibilidad, especificidad, valor predictivo positivo y negativo fueron: 94.55%, 21.43%, 70.27% y 66.67% respectivamente; al evaluar el área bajo la curva ROC, se obtuvo que el ICE ≥0.5 tiene una capacidad discriminativa moderada para detectar el riesgo cardiovascular (p <0.05). Se encontrÛ que el nuevo punto de corte para el ICE que maximiza la suma de sensibilidad (69.09%) + especificidad (67.86%) es un ICE ≥0.58. Conclusión: El Ìndice cintura/estatura (ICE) tiene valor como predictor de riesgo cardiovascular en niÒos con sobrepeso y obesidad atendidos en el Hospital Belen de Trujillo

To determine whether the waist-to-height ratio (WHR) has value as a predictor of cardiovascular risk in overweight and obese children at the BelÈn Hospital in Trujillo during the period 2018-2024. Material and methods: A retrospective observational analytical study of diagnostic tests was carried out with 83 children between 6 and 14 years of age, diagnosed with overweight and obesity treated in an outpatient clinic. The WHR was calculated, and was considered high if its value was ≥0.5. To assess cardiovascular risk, the altered lipid profile was taken into account. To establish whether the WHR has value as a predictor of cardiovascular risk, the following clinical indices were calculated: Sensitivity, Specificity, Positive and Negative Predictive Value, Positive and Negative Likelihood Ratio. To determine a new cut-off point for the WHR, the ROC curve (diagnostic efficacy curve) was used. Results: When evaluating the characteristics of the population, significant differences (p <0.05) were found in relation to age, BMI, and lipid profile alterations in children with ICE ≥0.5. When taking the ICE value ≥0.5 as a cut-off point, it was found that the sensitivity, specificity, positive and negative predictive value were: 94.55%, 21.43%, 70.27% and 66.67% respectively; when evaluating the area under the ROC curve, it was found that the ICE ≥0.5 has a moderate discriminatory capacity to detect cardiovascular risk (p <0.05). It was found that the new cut-off point for the ICE that maximizes the sum of sensitivity (69.09%) + specificity (67.86%) is an ICE ≥0.58. Conclusion: The waist-to-height ratio (WHR) has value as a predictor of cardiovascular risk in overweight and obese children treated at the Belen Hospital in Trujillo.