Obesidade e maturação biológica em crianças e adolescentes

Abstract

Childhood obesity is associated with several comorbidities and may influence the growth process, resulting in accelerated sexual maturation and linear growth, often accompanied by advanced bone age. The aim herein was to verify the agreement, sensitivity, and specificity of proposed BMI classification parameters for children aged 6 to 10 years old in the city of Montes Claros, MG, as well as relationships between obesity, maturational status, physical performance and BMI in children and adolescents. Thus, three cross-sectional studies were carried out. In the first, a sample of 4,151 children aged 6 to 10 years old was used, and the BMI was classified according to criteria established by the World Health Organization (WHO), International Obesity Task Force (IOTF), Center for Disease Control and Prevention (CDC), Conde & Monteiro and a recent local proposal. The agreement index between the mentioned criteria was calculated, in addition to sensitivity and specificity. The local proposal proved to be highly concordant with WHO criteria (k=0.895), mainly for the overweight class, with sensitivity and specificity values of 0.8680 and 0.9956, respectively for the overweight class, indicating the high discrimination power of the BMI. Local BMI parameters for children aged 6 to 10 years represent a viable and usable proposal for overweightness screening in this population group, aiding professionals in monitoring these individuals. The second study was carried out with 2,049 adolescents aged 11 to 14 years, measuring body mass, height, sitting height and horizontal and abdominal impulsion tests in 1 minute. The Maturity offset protocol was used to determine maturational status. A total of 79.7% of normomature, 9.9% advanced and 10.4% delayed adolescents were assessed. A gender effect was significant in all BMI comparisons (p˂0.01). Concerning physical performance, advanced adolescents were superior, although only the results of the 1-minute sit-up (13- and 14-year-old age groups [p=0.016]) and horizontal jump (11- and 12-year-old age group [p=0.006]) tests were significant. Physical performance varies with BMI, so adolescents with advanced biological maturation presented better results than their normomature or delayed peers. In the last study, a sample comprising 70 obese and 70 non-obese girls aged 8 to 15 years old was employed. Hip and waist circumferences, body mass, height and BMI were measured. Maturational status was determined by bone age applying the Fels Method. The results indicated a correlation between nutritional and maturational status, with r=0.80 and p˂0.01, and that obese girls present higher BMI, body mass and circumference values than non-obese girls, as well as advanced bone age, all presenting significant differences at p˂0.01. When analyzing the contrasting maturational groups, maturationally advanced individuals always presented higher values, at p˂0.01. Nutritional status is related to maturational status and obese girls exhibit a more advanced bone age than non-obese girls.