Associação entre maturação sexual com a circunferência do pescoço e o índice de massa corporal em estudantes brasileiros
Palavras-chave:
Índice de massa corporal, Crianças, Puberdade, Precocidade sexualResumo
Objetivo
Avaliar a associação da circunferência do pescoço e do índice de massa corporal com a maturação sexual em crianças de nove anos de idade.
Métodos
Trata-se de um estudo transversal alinhado a um estudo de corte brasileiro denominado Preditores do Excesso de Peso Corporal Materno-infantil. O presente estudo utilizou dados de mulheres adultas e seus filhos obtidos no estudo de base e após 2 e 9 anos de acompanhamento. A maturação sexual da criança foi avaliada segundo o estágio de Tanner. Modelos de regressão logística ajustados para importantes covariáveis foram usados para testar a associação da circunferência do pescoço com estágios de Tanner.
Resultados
A prevalência nos estágios 2-5 para desenvolvimento de mamas em meninas, e para genitália em meninos foi de 69,1% e 51,3%, respectivamente. Houve maior (p<0,05) percentual de meninas (35,3%) nos estágios 2-5 para desenvolvimento de pelos pubianos quando comparadas aos meninos (9,2%). Para cada aumento de uma unidade do índice de massa corporal e da circunferência do pescoço, as chances de as meninas apresentarem estágios 2-5 para desenvolvimento de mamas foram de 1,52 (95% IC 1,17-1,97) e 2,67 (95% IC 1,40-5,09) vezes, respectivamente. Ou seja, as chances de as meninas apresentarem estágios 2-5 para desenvolvimento da mama foram cerca de 1,8 vezes maiores quando a circunferência do pescoço foi considerada como preditor, em relação a medida do índice de massa corporal (OR=2,67 vs. OR=1,52, respectivamente).
Conclusão
Este estudo revelou que a circunferência do pescoço e o índice de massa corporal foram associados à maturação sexual em meninas. Este é um resultado importante do ponto de vista da saúde pública visto que a circunferência do pescoço, adicionalmente ao índice de massa corporal, pode ser uma medida complementar para monitorar a maturação sexual em crianças.
Referências
Aydin BK, Stenlid R, Ciba I, Cerenius SY, Dahlbom M, Bergsten P, et al. High levels of FSH before puberty are associated with increased risk of metabolic syndrome during pubertal transition. Pediatr Obes. 2022;17(8):e12906. https://doi.org/10.1111/ijpo.12906
Macedo DB, Kaiser UB. DLK1, Notch signaling and the timing of puberty. Semin Reprod Med. 2019;37(4):174-81. https://doi.org/10.1055/s-0039-3400963
Howard SR. Interpretation of reproductive hormones before, during and after the pubertal transition— Identifying health and disordered puberty. Clin Endocrinol (Oxf). 2021;95(5):702-15. https://doi.org/10.1111/cen.14578
Umano GR, Maddaluno I, Riccio S, Lanzaro F, Antignani R, Giuliano M, et al. Central precocious puberty during COVID-19 pandemic and sleep disturbance: An exploratory study. Ital J Pediatr. 2022;48(1):60. https://doi.org/10.1186/s13052-022-01256-z
Abou El Ella SS, Barseem NF, Tawfik MA, Ahmed AF. BMI relationship to the onset of puberty: Assessment of growth parameters and sexual maturity changes in Egyptian children and adolescents of both sexes. J Pediatr Endocrinol Metab. 2020;33(1):121-8. https://doi.org/10.1515/jpem-2019-0119
Adami F, Benedet J, Takahashi LAR, da Silva Lopes A, da Silva Paiva L, de Vasconcelos FAG. Association between pubertal development stages and body adiposity in children and adolescents. Health Qual Life Outcomes. 2020;18(1):93. https://doi.org/10.1186/s12955-020-01342-y
Matsuo LH, Adami F, Silva DAS, de Assis Guedes de Vasconcelos F, Longo GZ, Schoueri JHM, et al. Assessment of the median ages at sexual maturation stages of Brazilian schoolchildren according to overweight status and type of school over a 5-year period: 2007–2012/2013. Am J Hum Biol. 2022;34(4):e23677. https://doi.org/10.1002/ajhb.23677
Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970;45(239):13-23. https://doi.org/10.1136/adc.45.239.13
Daly-Wolfe KM, Jordan KC, Slater H, Beachy JC, Moyer-Mileur LJ. Mid-arm circumference is a reliable method to estimate adiposity in preterm and term infants. Pediatr Res. 2015;78(3):336-41. https://doi.org/10.1038/pr.2015.103
Santos D, Contarato AAPF, Kroll C, Bertoli M, Czarnobay SA, Figueirêdo KBW, et al. Neck circumference as a complementary measure to identify excess body weight in children aged 13-24 months. Rev Bras Saúde Mater Infant. 2015;15(3):301-7. https://doi.org/10.1590/S1519-38292015000300005
Valencia-Sosa E, Chávez-Palencia C, Romero-Velarde E, Larrosa-Haro A, Vásquez-Garibay EM, Ramos-García CO. Neck circumference as an indicator of elevated central adiposity in children. Public Health Nutr. 2019;22(10):1755-61. https://doi.org/10.1017/S1368980019000454
González-Cortés CA, Téran-García M, Luevano-Contreras C, Portales-Pérez DP, Vargas-Morales JM, Cubillas-Tejeda AC, et al. Neck circumference and its association with cardiometabolic risk factors in pediatric population. Medicina (Kaunas). 2019;55(5):183. https://doi.org/10.3390/medicina55050183
Kroll C, Mastroeni S, Czarnobay SA, Ekwaru JP, Veugelers PJ, Mastroeni MF. The accuracy of neck circumference for assessing overweight and obesity: A systematic review and meta-analysis. Ann Hum Biol. 2017;44(8):667-77. https://doi.org/10.1080/03014460.2017.1390153
Czarnobay SA, Kroll C, Correa CB, Mastroeni S, Mastroeni MF. Predictors of excess body weight concurrently affecting mother-child pairs: A 6 year follow-up. J Public Health (Oxf). 2023;45(1):e10-e21. https://doi.org/10.1093/pubmed/fdab399
World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. WHO; 2000 [cited 2015 Jan 22]. Available from: https://apps.who.int/iris/handle/10665/42330?locale-attribute=es&
Institute of Medicine (US) of the National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: National Academic Press; 2009 [cited 2022 May 1]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20669500
Villar J, Ismail LC, Victora CG, Ohuma EO, Bertino E, Altman DG, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: The newborn cross-sectional study of the INTERGROWTH-21st Project. Lancet. 2014;384(9946):857-68. https://doi.org/10.1016/s0140-6736(14)60932-6
de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660-7. https://doi.org/10.2471/blt.07.043497
Sociedade Brasileira de Pediatria. Desenvolvimento Puberal de Tanner. SBP [cited 2022 Jan 15]. Available from: https://www.sbp.com.br/departamentos/endocrinologia/desenvolvimento-puberal-de-tanner/
Han JY, Chung S. Evaluation of agreement of overweight screening criteria in adolescents: Korean National Health and nutrition examination surveys. J Obes Metab Syndr. 2021;30(3):289-95. https://doi.org/10.7570/jomes21008
Oehme NHB, Roelants M, Bruserud IS, Madsen A, Bjerknes R, Rosendahl K, et al. Low BMI, but not high BMI, influences the timing of puberty in boys. Andrology. 2021;9(3):837-45. https://doi.org/10.1111/andr.12985
Tomova A, Robeva R, Kumanov P. Influence of the body weight on the onset and progression of puberty in boys. J Pediatr Endocrinol Metab. 2015;28(7-8):859-65. https://doi.org/10.1515/jpem-2014-0363
Kryst Ł, Żegleń M, Wronka I, Woronkowicz A, Bilińska-Pawlak I, Das R, et al. Anthropometric variations in different BMI and adiposity levels among children, adolescents and young adults in Kolkata, India. J Biosoc Sci. 2019;51(4):603-18. https://doi.org/10.1017/s0021932018000354
McIntyre J, Zago M, Berthoz A, Lacquaniti F. Does the brain model Newton’s laws? Nat Neurosci. 2001;4(7):693-4. https://doi.org/10.1038/89477
Oliveira NA, Guimarães NS, Silva S, Messias AC, Lopes GF, Nascimento-Júnior IBD, et al. Correlations among neck circumference and anthropometric indicators to estimate body adiposity in people living with HIV. Rev Soc Bras Med Trop. 2021;54:e0649-2020. https://doi.org/10.1590/0037-8682-0649-2020
Cao W, Xu Y, Shen Y, Hu T, Xiao Y, Wang Y, et al. Change of neck circumference in relation to visceral fat area: A Chinese community-based longitudinal cohort study. Int J Obes (Lond). 2022;46(9):1633-7. https://doi.org/10.1038/s41366-022-01160-w
Zhao L, Zhu C, Chen Y, Chen C, Cheng J, Xia F, et al. LH/FSH Ratio is associated with visceral adipose dysfunction in chinese women older than 55. Front Endocrinol (Lausanne). 2018;9:419. https://doi.org/10.3389/fendo.2018.00419
Shalitin S, Gat-Yablonski G. Associations of obesity with linear growth and puberty. Horm Res Paediatr. 2022;95(2):120-36. https://doi.org/10.1159/000516171
Durá-Travé T, Gallinas-Victoriano F. Hyper-androgenemia and obesity in early-pubertal girls. J Endocrinol Invest. 2022;45(8):1577-85. https://doi.org/10.1007/s40618-022-01797-4
Schultz LF, Mastroeni S, Rafihi-Ferreira RE, Mastroeni MF. Sleep habits and weight status in Brazilian children aged 4-6 years of age: The PREDI study. Sleep Med. 2021;87:30-7. https://doi.org/10.1016/j.sleep.2021.08.020
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Copyright (c) 2025 Cecilia Burigo Corrêa, Daniela dos Santos, Silmara Salete de Barros Silva Mastroeni, Marco Fabio Mastroeni
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
