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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">Doen&#231;as cardiovasculares apresentam&#8208;se como a principal causa de morte no Brasil<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> e no mundo&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> Fatores de risco cardiovascular&#44; como obesidade total e visceral&#44; dislipidemias&#44; hipertens&#227;o arterial&#44; hiperglicemia e hiperinsulinemia&#44; t&#234;m sido considerados determinantes para o desenvolvimento de doen&#231;as cardiovasculares&#46; A s&#237;ndrome metab&#243;lica &#40;SM&#41;&#44; caracterizada pela presen&#231;a de tr&#234;s ou mais desses fatores de risco&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> tem ganhado import&#226;ncia devido &#224; sua consistente associa&#231;&#227;o com a morbimortalidade cardiovascular&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A presen&#231;a de fatores de risco cardiovascular e da SM tem sido observada tanto em adultos<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> quanto em crian&#231;as e adolescentes&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> Nos &#250;ltimos anos&#44; a preocupa&#231;&#227;o com o diagn&#243;stico e a interven&#231;&#227;o precoce desses dist&#250;rbios metab&#243;licos tem aumentado devido a evid&#234;ncias de que fatores de risco observados na inf&#226;ncia e adolesc&#234;ncia tendem a permanecer e se agravar na fase adulta&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Para al&#233;m da aferi&#231;&#227;o da press&#227;o arterial e do per&#237;metro de cintura&#44; an&#225;lises bioqu&#237;micas das fra&#231;&#245;es sangu&#237;neas de HDL&#8208;c&#44; triglicer&#237;deos e glicose devem ser feitas para o diagn&#243;stico da SM&#46; Coleta sangu&#237;nea constitui t&#233;cnica invasiva&#44; dispendiosa e de dif&#237;cil acesso&#44; principalmente para crian&#231;as e adolescentes&#46; Por outro lado&#44; o uso de m&#233;todos pr&#225;ticos e de baixo custo pode ser uma importante op&#231;&#227;o para triagem da SM em n&#237;vel populacional&#46; Nesse sentido&#44; o uso de dobras cut&#226;neas &#40;DC&#41; apresenta&#8208;se como promissora ferramenta para triagem da SM na popula&#231;&#227;o pedi&#225;trica devido sua forte correla&#231;&#227;o com adiposidade subcut&#226;nea&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> De acordo com Ali et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> o ac&#250;mulo de adiposidade subcut&#226;nea &#233; um forte preditor de resist&#234;ncia a insulina e de hipertrigliceridemia em crian&#231;as e adolescentes e foi o mais forte preditor de fatores de risco cardiometab&#243;lico do que a gordura visceral&#46; Ainda&#44; a influ&#234;ncia da adiposidade subcut&#226;nea sobre o risco de SM &#233; presente em crian&#231;as e adolescentes&#44; mas n&#227;o em adultos&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Curvas percent&#237;licas de DC foram desenvolvidas com amostras de jovens americanos&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> poloneses<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> e indianos&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> Vale ressaltar que a Organiza&#231;&#227;o Mundial da Sa&#250;de<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> apresentou em 2007 importante publica&#231;&#227;o em que curvas de refer&#234;ncia para medidas antropom&#233;tricas&#44; inclusive as dobras cut&#226;neas triciptal e subescapular&#44; foram desenhadas como refer&#234;ncia internacional para uma popula&#231;&#227;o multipa&#237;ses &#40;Brasil&#44; Estados Unidos&#44; Gana&#44; &#205;ndia&#44; Noruega e Om&#227;&#41;&#46; Contudo&#44; at&#233; o nosso conhecimento&#44; curvas percent&#237;licas de DC n&#227;o foram propostas para crian&#231;as brasileiras&#44; bem como n&#227;o h&#225; curvas percentil&#237;cas de DC que possam ser usadas na predi&#231;&#227;o de SM em popula&#231;&#227;o pedi&#225;trica&#46; Curvas de refer&#234;ncias de outras popula&#231;&#245;es podem n&#227;o ser aplic&#225;veis para crian&#231;as brasileiras devido a diferen&#231;as &#233;tnicas&#44; culturais e socioecon&#244;micas&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Nesse sentido&#44; os objetivos do presente estudo foram 1&#41; desenhar curvas de refer&#234;ncia de quatro DC &#40;subescapular&#44; suprail&#237;aca&#44; b&#237;ceps&#44; tr&#237;ceps&#41; e 2&#41; determinar pontos de corte para predizer o risco de SM em crian&#231;as de seis a 10 anos&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudo epidemiol&#243;gico de base populacional&#44; corte transversal&#44; com amostra probabil&#237;stica de crian&#231;as de seis a 10 anos&#44; oriundas de escolas p&#250;blicas e privadas nas zonas urbana e rural do munic&#237;pio de Uberaba &#40;MG&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Para o c&#225;lculo amostral considerou&#8208;se o n&#250;mero de crian&#231;as matriculadas no ensino fundamental &#40;1&#176; ao 9&#176; ano&#41;&#44; preval&#234;ncia da SM de 50&#37; &#40;preval&#234;ncia desconhecida no munic&#237;pio&#41;&#44; erro toler&#225;vel de 3&#44;5&#37; e n&#237;vel de confian&#231;a de 95&#37;&#46; O n&#250;mero m&#237;nimo amostral foi de 768 crian&#231;as e&#44; ap&#243;s acr&#233;scimo de 10&#37; para compensar perdas e recusas e 20&#37; para minimizar fatores de confundimento&#44; totalizou 1&#46;014 crian&#231;as&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Para sele&#231;&#227;o da amostra&#44; as escolas foram estratificadas de acordo com o seguimento de ensino em municipal&#44; estadual e privada&#46; A Organiza&#231;&#227;o Mundial da Sa&#250;de<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> recomenda que para levantamentos epidemiol&#243;gicos sejam usados de 10 a 15 pontos de coleta da amostra &#40;escolas&#41; e que o n&#250;mero de sujeitos da pesquisa em cada faixa et&#225;ria deve variar entre 25 e 50 para cada local&#46; Dessa forma&#44; foram aleatoriamente selecionadas&#44; com aux&#237;lio da Tabela de N&#250;meros Aleat&#243;rios&#44; 15 das 90 escolas eleg&#237;veis do munic&#237;pio de Uberaba&#46; Para adequa&#231;&#227;o e representatividade da popula&#231;&#227;o local&#44; o n&#250;mero de crian&#231;as em cada estrato foi determinado proporcionalmente ao n&#250;mero de matr&#237;culas&#44; segundo dados fornecidos pela Secretaria de Educa&#231;&#227;o do estado&#46; As escolas municipais representavam 43&#44;6&#37; das matr&#237;culas&#44; 41&#44;9&#37; dos estudantes matriculados estavam em escolas estaduais e 14&#44;5&#37; em escolas privadas&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Ap&#243;s aprova&#231;&#227;o do Comit&#234; de &#201;tica em Pesquisa com Seres Humanos da Universidade Federal do Tri&#226;ngulo Mineiro &#40;Protocolo CEP&#47;UFTM&#58; 1710&#41;&#44; os diretores escolares foram contatados a fim de se obter autoriza&#231;&#227;o e agendamento das coletas&#46; Os alunos que preencheram os crit&#233;rios de inclus&#227;o e com interesse em participar da pesquisa receberam o Termo de Consentimento Livre e Esclarecido para conhecimento e assinatura de seus pais e&#47;ou respons&#225;veis&#46; Antropometria e as coletas de sangue foram feitas na pr&#243;pria escola&#44; seguiram protocolos espec&#237;ficos&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">As dobras cut&#226;neas &#40;DC&#41; biciptal &#40;DCB&#41;&#44; triciptal &#40;DCT&#41;&#44; subescapular &#40;DCSe&#41; e suprail&#237;aca &#40;DCSi&#41; foram obtidas com adip&#244;metro Lange Skinfold Caliper&#44; Inglaterra&#44; que exerce press&#227;o constante de 10<span class="elsevierStyleHsp" style=""></span>g&#47;mm<span class="elsevierStyleSup">2</span>&#46; As medi&#231;&#245;es foram feitas no lado direito do corpo&#44; em tr&#234;s repeti&#231;&#245;es n&#227;o consecutivas para cada medida&#46; A medida final foi obtida pela m&#233;dia dos tr&#234;s valores&#46; Todas as medidas foram feitas por dois avaliadores qualificados que passaram por treinamento pr&#233;vio e calibra&#231;&#227;o&#46; Os resultados foram interpretados isoladamente&#44; bem como pelo somat&#243;rio das quatro DC avaliadas&#44; com os resultados expressos em mil&#237;metros &#40;mm&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A press&#227;o arterial foi aferida com esfigmoman&#244;metro de coluna de merc&#250;rio &#40;Unitec&#44; S&#227;o Paulo&#44; Brasil&#41; com manguitos de tamanhos apropriados para a circunfer&#234;ncia dos bra&#231;os das crian&#231;as de acordo com as normas propostas pelas VI Diretrizes Brasileiras de Hipertens&#227;o Arterial&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> Foram feitas tr&#234;s aferi&#231;&#245;es da PA na primeira visita&#44; descartou&#8208;se a primeira e considerou&#8208;se a m&#233;dia das duas &#250;ltimas&#46; Quando a crian&#231;a apresentou altera&#231;&#227;o da PA sist&#243;lica ou diast&#243;lica acima do percentil 90 houve aferi&#231;&#227;o em mais outros dois dias de coletas diferentes com o mesmo procedimento do primeiro dia&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Os volunt&#225;rios foram convidados a se deslocar da escola&#44; seguir jejum de 12 horas&#44; nos dias e hor&#225;rios determinados&#44; acompanhado de seus respons&#225;veis&#46; Profissionais de enfermagem coletaram amostras de sangue &#40;8<span class="elsevierStyleHsp" style=""></span>mL&#41; em tubos a v&#225;cuo <span class="elsevierStyleItalic">BD Vacutainer</span><span class="elsevierStyleSup">&#174;</span> &#40;Becton&#44; Dickinson and Company&#44; Nova Jersey&#44; EUA&#41;&#46; Amostras de soro foram analisadas para a determina&#231;&#227;o do HDL&#8208;c e triglicer&#237;deos e plasma para glicemia&#46; Foi usado o analisador semiautomatizado Bio 200F &#40;Bioplus&#44; S&#227;o Paulo&#44; Brasil&#41;&#46; M&#233;todos padronizados determinaram quantitativamente as vari&#225;veis sangu&#237;neas&#44; de acordo com as normas e especifica&#231;&#245;es t&#233;cnicas dos reagentes usados&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">O diagn&#243;stico da SM<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> foi determinado pela presen&#231;a de pelo menos tr&#234;s das seguintes altera&#231;&#245;es&#58; triglicer&#237;deos &#8805; 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; HDL&#8208; c<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; glicemia &#8805; 110<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; per&#237;metro de cintura &#8805; percentil 75 para idade e sexo&#59; altera&#231;&#227;o na press&#227;o arterial &#40;diast&#243;lica ou sist&#243;lica&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>percentil 90 ajustado para idade&#44; estatura e sexo&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Vari&#225;veis foram testadas quanto a sua normalidade pelo teste de Kolmogorov&#8208;Smirnov<span class="elsevierStyleItalic">&#46;</span> Os <span class="elsevierStyleItalic">outliers</span> foram identificados e retirados pelo m&#233;todo de intervalo entre quartis&#46; O teste U de Mann&#8208;Whitney foi usado para compara&#231;&#227;o de grupos independentes com distribui&#231;&#227;o n&#227;o param&#233;trica&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Para comparabilidade com outros estudos&#44; os percentis 5&#44; 10&#44; 25&#44; 50&#44; 75&#44; 90&#44; e 95 foram escolhidos como valores de refer&#234;ncia&#46; Foram delineadas curvas de refer&#234;ncia por meio do m&#233;todo de Cole LMS&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> O m&#233;todo LMS presume que&#44; para dados independentes com valores positivos&#44; a transforma&#231;&#227;o Box&#8208;Cox idade&#8208;espec&#237;fica pode ser empregada para torn&#225;&#8208;los normalmente distribu&#237;dos&#59; os valores L&#44; M e S s&#227;o <span class="elsevierStyleItalic">natural cubics plines</span> com <span class="elsevierStyleItalic">knot s</span>em cada intervalo et&#225;rio&#46; A amostra&#44; em cada sexo&#44; foi separada em faixas et&#225;rias com 100 ou mais indiv&#237;duos&#44; n&#250;mero considerado o m&#237;nimo adequado para o m&#233;todo LMS&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">A curva <span class="elsevierStyleItalic">Receiver Operating Characteristic</span> &#40;ROC&#41; foi usada na avalia&#231;&#227;o da capacidade preditiva de testes diagn&#243;sticos&#46; As &#225;reas abaixo das curvas ROC &#40;AUC&#41; foram calculadas para avaliar o poder discriminat&#243;rio das DC na indica&#231;&#227;o de altera&#231;&#245;es metab&#243;licas componentes da SM&#46; Os valores de sensibilidade e especificidade dos indicadores antropom&#233;tricos foram calculados para cada ponto de corte presente na amostra&#46; O ponto de corte que apresentou maior equil&#237;brio entre sensibilidade e especificidade foi o escolhido para aprimorar a rela&#231;&#227;o entre esses dois par&#226;metros&#44; apresentou maior acur&#225;cia &#40;menor quantidade de falsos negativos e falsos positivos&#41;&#46; A signific&#226;ncia estat&#237;stica de cada an&#225;lise foi verificada pela &#225;rea sob a curva ROC &#40;AUC&#41; e pelo limite inferior do intervalo de confian&#231;a a 95&#37;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;5&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0085" class="elsevierStylePara elsevierViewall">Participaram do presente estudo 1&#46;480 escolares do ensino fundamental do munic&#237;pio de Uberaba &#40;MG&#41; &#40;zona urbana e rural&#41;&#44; com m&#233;dia de 8&#44;55 anos &#40;desvio padr&#227;o<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;53&#41;&#44; 52&#44;2&#37; do sexo feminino&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Meninas apresentaram maior preval&#234;ncia de SM &#40;12&#44;6&#37; <span class="elsevierStyleItalic">vs</span>&#46; 8&#44;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; e maiores valores de DC&#44; em todos os pontos anat&#244;micos avaliados &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; em compara&#231;&#227;o com os meninos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Delinearam&#8208;se curvas percent&#237;licas &#40;p5&#44; p10&#44; p25&#44; p50&#44; p75&#44; p90 e p95&#41; das quatro DC avaliadas&#44; bem como para o somat&#243;rio delas&#44; para ambos os sexos &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; De forma geral&#44; todas as DC apresentaram aumento linear de acordo com a idade e o sexo&#44; com valores superiores para meninas&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">As quatro DC avaliadas e seu somat&#243;rio foram acurados na predi&#231;&#227;o da SM para meninas &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41; e meninos &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46; A maioria dos valores sugeridos encontra&#8208;se acima do percentil 75 para idade e sexo&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discuss&#227;o</span><p id="par0105" class="elsevierStylePara elsevierViewall">O presente estudo apresenta curvas percent&#237;licas de DC das regi&#245;es central e perif&#233;rica do corpo&#44; bem como do somat&#243;rio de quatro DC para predi&#231;&#227;o do risco de SM&#44; de acordo com idade e sexo&#44; em crian&#231;as brasileiras&#46; As curvas aqui delineadas podem representar uma estrat&#233;gia &#250;til para preven&#231;&#227;o do risco de s&#237;ndrome metab&#243;lica na inf&#226;ncia com possibilidade de uso em escolas&#44; unidades de sa&#250;de da fam&#237;lia&#44; cl&#237;nicas e hospitais&#46; De acordo com nossos achados&#44; tanto as DC de adiposidade central quanto as de adiposidade perif&#233;rica e o somat&#243;rio de quatro DC apresentaram pontos de corte com elevados valores de sensibilidade e de especificidade para predizer o risco de SM em crian&#231;as&#46; Aproximadamente&#44; 75&#37; das crian&#231;as do presente estudo&#44; com valores de DC acima do percentil 75&#44; independentemente da DC analisada&#44; apresentaram s&#237;ndrome metab&#243;lica&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de SM em crian&#231;as e adolescentes brasileiros variou de 0&#37; a 42&#44;4&#37;&#44; dados de uma revis&#227;o sistem&#225;tica&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> No presente estudo a SM foi prevalente em 12&#44;6&#37; das meninas e 8&#44;5&#37; dos meninos&#44; com diferen&#231;a significativa entre os sexos&#46; A heterogeneidade de defini&#231;&#245;es e de pontos de corte para os componentes da SM pode explicar&#44; ao menos em parte&#44; as diferentes preval&#234;ncias relatadas na literatura&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> No entanto&#44; &#233; fato que a preval&#234;ncia de SM tem aumentado entre crian&#231;as e adolescentes&#44; com propor&#231;&#227;o significativamente maior entre os obesos&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Distribui&#231;&#227;o percent&#237;lica das dobras cut&#226;neas triciptal e subescapular foram feitas em 8&#46;568 escolares chineses de sete a 18 anos<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> e 32&#46;783 crian&#231;as e adolescentes americanos&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> Os valores percent&#237;licos para as DC&#8208;Tri e DC&#8208;Sub de crian&#231;as chinesas e americanas foram inferiores aos percentis correspondentes de meninos e meninas do presente estudo&#46; Esse resultado &#233; preocupante devido &#224; associa&#231;&#227;o entre as DC e obesidade central&#44; perfil lip&#237;dico desfavor&#225;vel&#44; n&#237;veis de insulina aumentados&#44; press&#227;o arterial e massa ventricular esquerda&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> Ac&#250;mulo de gordura subcut&#226;nea&#44; traduzido em altos valores de DC&#44; aumentam as chances de as crian&#231;as apresentarem altera&#231;&#245;es metab&#243;licas&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Crian&#231;as mexicanas pr&#233;&#8208;p&#250;beres de seis a 10 anos apresentaram tr&#234;s vezes mais chances para altera&#231;&#245;es nos componentes da SM&#44; quando a distribui&#231;&#227;o da DC&#8208;Sub encontrava&#8208;se no quarto quartil da amostra baixos n&#237;veis de HDL&#8208;c &#91;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;16 &#40;IC<span class="elsevierStyleInf">95&#37;</span>&#58; 1&#44;41&#8208;7&#44;10&#41; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#93; e elevados n&#237;veis de triglicer&#237;deos &#91;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;27 &#40;IC<span class="elsevierStyleInf">95&#37;</span>&#58; 2&#44;02&#8208;5&#44;29&#41; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> N&#227;o obstante&#44; altos valores do &#8721; 3 DC &#40;DC&#8208;Tri<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Dc&#8208;Bi&#43; DC&#8208;Sub&#41; &#40;&#62; percentil 90&#41; em crian&#231;as alem&#227;s de tr&#234;s a 11 anos aumentaram as chances em 1&#44;6 vez &#40;IC<span class="elsevierStyleInf">95&#37;</span>&#58; 1&#44;1 &#8208; 2&#44;2&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; de ter tr&#234;s ou mais fatores de riscos cardiovasculares e 1&#44;7 vez em ser portador de hipertens&#227;o arterial &#91;&#40;IC<span class="elsevierStyleInf">95&#37;</span>&#58;1&#44;1 &#8208; 2&#44;7&#41;&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#93;&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> Os resultados do presente estudo demonstraram que todas as medidas de DC isoladas predizem o risco de SM em ambos os sexos&#46; Nas investiga&#231;&#245;es cient&#237;ficas relativas ao tema&#44; observa&#8208;se predomin&#226;ncia de estudos com as DC&#8208;Tri e DC&#8208;Sub&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#44;13&#44;21&#44;25</span></a> Muitos estudos usaram DC de forma isolada como preditora da quantidade de gordura corporal<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25&#8211;29</span></a> e de fatores de risco cardiometab&#243;lico isolados&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">12&#44;30</span></a> Por outro lado&#44; estudos que investigaram o poder da DC de predizer SM na popula&#231;&#227;o pedi&#225;trica permanecem escassos&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">O uso da soma de valores absolutos das DC pode se tornar interessante preditor de SM na medida em que minimiza os vieses presentes em equa&#231;&#245;es preditivas de composi&#231;&#227;o corporal&#44; al&#233;m de sugerir valores que demonstram equil&#237;brio&#47;desequil&#237;brio da distribui&#231;&#227;o da gordura corporal &#40;DC&#8208;Tri<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>DC&#8208;Bi &#43;DC&#8208;Sub<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Dc&#8208;Supra&#41;&#46; Dentre diferentes medidas antropom&#233;tricas testadas&#44; o &#8721;4DC foi o mais acurado preditor de SM em meninas e meninos brasileiros&#44; com AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;908 e AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;897&#44; respectivamente&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> No presente estudo&#44; o &#8721; 4DC apresentou AUC de 0&#44;859 para meninas e 0&#44;879 para meninos&#44; os pontos de corte sugeridos apresentaram altos valores de sensibilidade &#40;&#62; 80&#37;&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">De nosso conhecimento&#44; este &#233; o primeiro estudo com curvas percent&#237;licas de DC da regi&#227;o central e perif&#233;rica&#44; bem como do somat&#243;rio de quatro DC&#44; para predi&#231;&#227;o de SM em uma amostra representativa de base escolar brasileira&#46; No entanto&#44; este estudo teve desenho transversal&#44; fato que n&#227;o permite estabelecer se mudan&#231;as na adiposidade subcut&#226;nea refletem altera&#231;&#245;es nos componentes da SM&#46; Assim&#44; estudos longitudinais s&#227;o necess&#225;rios para definir a rela&#231;&#227;o causal entre a SM e adiposidade subcut&#226;nea&#46; &#201; valido ressaltar que embora a popula&#231;&#227;o do estudo tenha sido delimitada entre escolares do 1&#176; ao 5&#176; ano de ensino&#44; a Secretaria de Educa&#231;&#227;o de educa&#231;&#227;o cedeu dados atualizados de todo o ensino fundamental&#44; o que pode ter superestimado o c&#225;lculo amostral&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Curvas de refer&#234;ncia oriundas de outros pa&#237;ses podem tanto subestimar quanto superestimar a doen&#231;a&#44; devido a diferen&#231;as &#233;tnicas&#44; socioecon&#244;micas e culturais&#46; O desenvolvimento de curvas percent&#237;licas com popula&#231;&#245;es de diferentes &#225;reas geogr&#225;ficas &#233; um desafio relevante para possibilitar a triagem mais acurada da SM em jovens por meio da avalia&#231;&#227;o de DC&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Financiamento</span><p id="par0140" class="elsevierStylePara elsevierViewall">Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de Minas Gerais &#40;Fapemig&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflitos de interesse</span><p id="par0145" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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            1 => "Metabolic syndrome X"
            2 => "Cross&#8208;sectional studies"
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          "palabras" => array:4 [
            0 => "Antropometria"
            1 => "S&#237;ndrome X"
            2 => "Estudos de corte transversal"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To draw skinfold &#40;SF&#41; reference curves &#40;subscapular&#44; suprailiac&#44; biceps&#44; triceps&#41; and to determine SF cutoff points for predicting the risk of metabolic syndrome &#40;MetS&#41; in children aged 6&#8211;10 years old&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This was a cross&#8208;sectional study with a random sample of 1480 children aged 6&#8211;10 years old&#44; 52&#46;2&#37; females&#44; from public and private schools located in the urban and rural areas of the municipality of Uberaba &#40;MG&#41;&#46; Anthropometry&#44; blood pressure&#44; and fasting blood samples were taken at school&#44; following specific protocols&#46; The LMS method was used to draw the reference curves and ROC curve analysis to determine the accuracy and cutoff points for the evaluated skinfolds&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The four SF evaluated &#40;subscapular&#44; suprailiac&#44; biceps&#44; and triceps&#41; and their sum &#40;&#8721;4SF&#41; were accurate in predicting MetS for both girls and boys&#46; Additionally&#44; cutoffs have been proposed and percentile curves &#40;p5&#44; p10&#44; p25&#44; p50&#44; p75&#44; p90&#44; and p95&#41; were outlined for the four SF and &#8721;4SF&#44; for both genders&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">SF measurements were accurate in predicting metabolic syndrome in children aged 6&#8211;10 years old&#46; Age&#8208; and gender&#8208;specific smoothed percentiles curves of SF provide a reference for the detection of risk for MetS in children&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Desenhar curvas de refer&#234;ncia de quatro dobras cut&#226;neas &#40;subescapular&#44; suprail&#237;aca&#44; b&#237;ceps&#44; tr&#237;ceps&#41; e determinar pontos de corte para predizer o risco de SM em crian&#231;as de seis a 10 anos&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo epidemiol&#243;gico de base populacional&#44; corte transversal&#44; com amostra probabil&#237;stica&#44; estratificada por segmento de ensino&#44; com 1&#46;480 crian&#231;as de seis a 10 anos idade&#44; 52&#44;2&#37; do sexo feminino&#44; oriundas de escolas p&#250;blicas e privadas nas zonas urbana e rural do munic&#237;pio de Uberaba &#40;MG&#41;&#46; Antropometria &#40;dobras cut&#226;neas&#41;&#44; press&#227;o arterial e as coletas de sangue em jejum foram feitas em espa&#231;o reservado na escola&#44; seguiram protocolos espec&#237;ficos&#46; O m&#233;todo LMS foi usado para desenhar as curvas de refer&#234;ncia e an&#225;lise de curva ROC para determinar a acur&#225;cia e os pontos de corte para as dobras cut&#226;neas avaliadas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">As quatro DC avaliadas &#40;subescapular&#44; suprail&#237;aca&#44; b&#237;ceps e tr&#237;ceps&#41; e o seu somat&#243;rio &#40;&#8721;4DC&#41; foram acurados na predi&#231;&#227;o da SM para meninas e meninos&#46; Adicionalmente&#44; pontos de corte foram propostos e curvas percent&#237;licas &#40;p5&#44; p10&#44; p25&#44; p50&#44; p75&#44; p90 e p95&#41; foram delineadas para as quatro DC e o &#8721;4DC&#44; para ambos os sexos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Medidas de DC foram acuradas em predizer SM em escolares de seis a 10 anos&#46; As curvas percent&#237;licas de DC desenhadas por idade e sexo fornecem refer&#234;ncia na detec&#231;&#227;o do risco de SM em crian&#231;as&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Andaki AC&#44; Quadros TM&#44; Gordia AP&#44; Mota J&#44; Tin&#244;co AL&#44; Mendes EL&#46; Skinfold reference curves and their use in predicting metabolic syndrome risk in children&#46; J Pediatr &#40;Rio J&#41;&#46; 2017&#59;93&#58;490&#8211;6&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Pesquisa vinculada &#224; Universidade Federal do Tri&#226;ngulo Mineiro&#44; Uberaba&#44; MG&#44; Brasil&#46;</p>"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">&#8721;4DC&#44; soma das quatro dobras cut&#226;neas avaliadas&#59; DC&#8208;Bi&#44; dobra cut&#226;nea biciptal&#59; DC&#8208;Sub&#44; dobra cut&#226;nea subescapular&#59; DC&#8208;Supra&#44; dobra cut&#226;nea suprail&#237;aca&#59; DC&#8208;Tri&#44; dobra cut&#226;nea triciptal&#59; dp&#44; desvio padr&#227;o&#59; max&#44; valor m&#225;ximo&#59; min&#44; valor m&#237;nimo&#59; n&#44; n&#250;mero amostral&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Nota&#58; Diferen&#231;a significativa entre os sexos p &#8804; 0&#44;05 teste de Mann Whitney&#46;</p>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;45 &#40;5&#44;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;33 &#40;5&#44;00 &#8208; 35&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;71 &#40;6&#44;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;67 &#40;5&#44;00 &#8208; 35&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Sub &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;77 &#40;7&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;00 &#40;4&#44;00 &#8208; 44&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;85 &#40;7&#44;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;00 &#40;4&#44;00&#8208; 44&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;40 &#40;10&#44;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;67 &#40;3&#44;00 &#8208; 51&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;12 &#40;10&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;67 &#40;3&#44;00&#8208; 50&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721; 4 DC &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#44;93 &#40;28&#44;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;0 &#40;10&#44;00 &#8208;163&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;37 &#40;29&#44;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#44;00 &#40;11&#44;00 &#8208; 202&#44;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas descritivas de dobras cut&#226;neas de escolares de seis a 10 anos&#44; munic&#237;pio de Uberaba &#40;MG&#41;&#44; por sexo</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">&#8721;4DC&#44; soma das quatro dobras cut&#226;neas avaliadas&#59; AUC&#44; &#225;rea sob a curva ROC&#59; DC&#8208;Bi&#44; dobra cut&#226;nea biciptal&#59; DC&#8208;Sub&#44; dobra cut&#226;nea subescapular&#59; DC&#8208;Supra&#44; dobra cut&#226;nea suprail&#237;aca&#59; DC&#8208;Tri&#44; dobra cut&#226;nea triciptal&#59; E&#44; especificidade&#59; IC 95&#37;&#44; intervalo de confian&#231;a a 95&#37;&#59; S&#44; sensibilidade&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Idade &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Preditores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AUC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">IC 95&#37;</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ponto de corte &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">6</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;832&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;709&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;955&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;771&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;566&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;977&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;864&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;760&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;805&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;666&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;943&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;833&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;708&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;959&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">7</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;894&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;977&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;927&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;874&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;924&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;871&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;978&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;909&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;841&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;977&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;927&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;872&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;982&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">8</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;803&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;705&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;902&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;838&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;751&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;924&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;929&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;858&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;770&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;945&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;951&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;959&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;752&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;927&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;788&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;954&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;756&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;884&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr></tbody></table>
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          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Pontos de corte de dobras cut&#226;neas para predi&#231;&#227;o de s&#237;ndrome metab&#243;lica em meninas&#44; por idade&#44; munic&#237;pio de Uberaba &#40;MG&#41;</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">&#8721;4DC&#44; soma das quatro dobras cut&#226;neas avaliadas&#59; AUC&#44; &#225;rea sob a curva ROC&#59; DC&#8208;Bi&#44; dobra cut&#226;nea biciptal&#59; DC&#8208;Sub&#44; dobra cut&#226;nea subescapular&#59; DC&#8208;Supra&#44; dobra cut&#226;nea suprail&#237;aca&#59; DC&#8208;Tri&#44; dobra cut&#226;nea triciptal&#59; E&#44; especificidade&#59; IC 95&#37;&#44; intervalo de confian&#231;a a 95&#37;&#59; S&#44; sensibilidade&#46;</p>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;893&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;854&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;807&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;997&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">7</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;726&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;994&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;681&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;969&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;789&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;635&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">8</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;641&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;048&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;626&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;025&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;756&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;821&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;761&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">9</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;767&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;955&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;769&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;954&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;868&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;980&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
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                          "etal" => true
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                            0 => "B&#46; Isomaa"
                            1 => "P&#46; Almgren"
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                      "titulo" => "Predictability of childhood adiposity and insulin for developing insulin resistance syndrome &#40;syndrome X&#41; in young adulthood&#58; the Bogalusa Heart Study"
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                            4 => "J&#46;P&#46; Despres"
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                        0 => array:2 [
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                            3 => "A&#46; Grajda"
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Artigo Original
Skinfold reference curves and their use in predicting metabolic syndrome risk in children
Curvas de referência de dobras cutâneas e sua utilização na predição do risco de síndrome metabólica em crianças
Alynne C.R. Andakia,
Autor para correspondência
alynneandaki@yahoo.com.br

Autor para correspondência.
, Teresa M.B. de Quadrosb, Alex P. Gordiab, Jorge Motac, Adelson L.A. Tinôcod, Edmar L. Mendesa
a Universidade Federal do Triângulo Mineiro (UFTM), Departamento de Ciências do Esporte, Uberaba, MG, Brasil
b Universidade Federal do Recôncavo da Bahia (UFRB), Centro de Formação de Professores, Cruz das Almas, BA, Brasil
c Universidade do Porto, Faculdade do Desporto, Porto, Portugal
d Universidade Federal de Viçosa (UFV), Departamento de Nutrição e Saúde, Viçosa, MG, Brasil
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          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curvas percent&#237;licas &#40;p5&#44; p10&#44; p25&#44; p50&#44; p75&#44; p90 e p95&#41; das dobras cut&#226;neas tricipital&#44; bicipital&#44; subescapular e suprail&#237;aca&#44; bem como para o somat&#243;rio delas&#44; de meninas e meninos de seis a10 anos&#44; Uberaba &#40;MG&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">Doen&#231;as cardiovasculares apresentam&#8208;se como a principal causa de morte no Brasil<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> e no mundo&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> Fatores de risco cardiovascular&#44; como obesidade total e visceral&#44; dislipidemias&#44; hipertens&#227;o arterial&#44; hiperglicemia e hiperinsulinemia&#44; t&#234;m sido considerados determinantes para o desenvolvimento de doen&#231;as cardiovasculares&#46; A s&#237;ndrome metab&#243;lica &#40;SM&#41;&#44; caracterizada pela presen&#231;a de tr&#234;s ou mais desses fatores de risco&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> tem ganhado import&#226;ncia devido &#224; sua consistente associa&#231;&#227;o com a morbimortalidade cardiovascular&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A presen&#231;a de fatores de risco cardiovascular e da SM tem sido observada tanto em adultos<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> quanto em crian&#231;as e adolescentes&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> Nos &#250;ltimos anos&#44; a preocupa&#231;&#227;o com o diagn&#243;stico e a interven&#231;&#227;o precoce desses dist&#250;rbios metab&#243;licos tem aumentado devido a evid&#234;ncias de que fatores de risco observados na inf&#226;ncia e adolesc&#234;ncia tendem a permanecer e se agravar na fase adulta&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Para al&#233;m da aferi&#231;&#227;o da press&#227;o arterial e do per&#237;metro de cintura&#44; an&#225;lises bioqu&#237;micas das fra&#231;&#245;es sangu&#237;neas de HDL&#8208;c&#44; triglicer&#237;deos e glicose devem ser feitas para o diagn&#243;stico da SM&#46; Coleta sangu&#237;nea constitui t&#233;cnica invasiva&#44; dispendiosa e de dif&#237;cil acesso&#44; principalmente para crian&#231;as e adolescentes&#46; Por outro lado&#44; o uso de m&#233;todos pr&#225;ticos e de baixo custo pode ser uma importante op&#231;&#227;o para triagem da SM em n&#237;vel populacional&#46; Nesse sentido&#44; o uso de dobras cut&#226;neas &#40;DC&#41; apresenta&#8208;se como promissora ferramenta para triagem da SM na popula&#231;&#227;o pedi&#225;trica devido sua forte correla&#231;&#227;o com adiposidade subcut&#226;nea&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> De acordo com Ali et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> o ac&#250;mulo de adiposidade subcut&#226;nea &#233; um forte preditor de resist&#234;ncia a insulina e de hipertrigliceridemia em crian&#231;as e adolescentes e foi o mais forte preditor de fatores de risco cardiometab&#243;lico do que a gordura visceral&#46; Ainda&#44; a influ&#234;ncia da adiposidade subcut&#226;nea sobre o risco de SM &#233; presente em crian&#231;as e adolescentes&#44; mas n&#227;o em adultos&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Curvas percent&#237;licas de DC foram desenvolvidas com amostras de jovens americanos&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> poloneses<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> e indianos&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> Vale ressaltar que a Organiza&#231;&#227;o Mundial da Sa&#250;de<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> apresentou em 2007 importante publica&#231;&#227;o em que curvas de refer&#234;ncia para medidas antropom&#233;tricas&#44; inclusive as dobras cut&#226;neas triciptal e subescapular&#44; foram desenhadas como refer&#234;ncia internacional para uma popula&#231;&#227;o multipa&#237;ses &#40;Brasil&#44; Estados Unidos&#44; Gana&#44; &#205;ndia&#44; Noruega e Om&#227;&#41;&#46; Contudo&#44; at&#233; o nosso conhecimento&#44; curvas percent&#237;licas de DC n&#227;o foram propostas para crian&#231;as brasileiras&#44; bem como n&#227;o h&#225; curvas percentil&#237;cas de DC que possam ser usadas na predi&#231;&#227;o de SM em popula&#231;&#227;o pedi&#225;trica&#46; Curvas de refer&#234;ncias de outras popula&#231;&#245;es podem n&#227;o ser aplic&#225;veis para crian&#231;as brasileiras devido a diferen&#231;as &#233;tnicas&#44; culturais e socioecon&#244;micas&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Nesse sentido&#44; os objetivos do presente estudo foram 1&#41; desenhar curvas de refer&#234;ncia de quatro DC &#40;subescapular&#44; suprail&#237;aca&#44; b&#237;ceps&#44; tr&#237;ceps&#41; e 2&#41; determinar pontos de corte para predizer o risco de SM em crian&#231;as de seis a 10 anos&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudo epidemiol&#243;gico de base populacional&#44; corte transversal&#44; com amostra probabil&#237;stica de crian&#231;as de seis a 10 anos&#44; oriundas de escolas p&#250;blicas e privadas nas zonas urbana e rural do munic&#237;pio de Uberaba &#40;MG&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Para o c&#225;lculo amostral considerou&#8208;se o n&#250;mero de crian&#231;as matriculadas no ensino fundamental &#40;1&#176; ao 9&#176; ano&#41;&#44; preval&#234;ncia da SM de 50&#37; &#40;preval&#234;ncia desconhecida no munic&#237;pio&#41;&#44; erro toler&#225;vel de 3&#44;5&#37; e n&#237;vel de confian&#231;a de 95&#37;&#46; O n&#250;mero m&#237;nimo amostral foi de 768 crian&#231;as e&#44; ap&#243;s acr&#233;scimo de 10&#37; para compensar perdas e recusas e 20&#37; para minimizar fatores de confundimento&#44; totalizou 1&#46;014 crian&#231;as&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Para sele&#231;&#227;o da amostra&#44; as escolas foram estratificadas de acordo com o seguimento de ensino em municipal&#44; estadual e privada&#46; A Organiza&#231;&#227;o Mundial da Sa&#250;de<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> recomenda que para levantamentos epidemiol&#243;gicos sejam usados de 10 a 15 pontos de coleta da amostra &#40;escolas&#41; e que o n&#250;mero de sujeitos da pesquisa em cada faixa et&#225;ria deve variar entre 25 e 50 para cada local&#46; Dessa forma&#44; foram aleatoriamente selecionadas&#44; com aux&#237;lio da Tabela de N&#250;meros Aleat&#243;rios&#44; 15 das 90 escolas eleg&#237;veis do munic&#237;pio de Uberaba&#46; Para adequa&#231;&#227;o e representatividade da popula&#231;&#227;o local&#44; o n&#250;mero de crian&#231;as em cada estrato foi determinado proporcionalmente ao n&#250;mero de matr&#237;culas&#44; segundo dados fornecidos pela Secretaria de Educa&#231;&#227;o do estado&#46; As escolas municipais representavam 43&#44;6&#37; das matr&#237;culas&#44; 41&#44;9&#37; dos estudantes matriculados estavam em escolas estaduais e 14&#44;5&#37; em escolas privadas&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Ap&#243;s aprova&#231;&#227;o do Comit&#234; de &#201;tica em Pesquisa com Seres Humanos da Universidade Federal do Tri&#226;ngulo Mineiro &#40;Protocolo CEP&#47;UFTM&#58; 1710&#41;&#44; os diretores escolares foram contatados a fim de se obter autoriza&#231;&#227;o e agendamento das coletas&#46; Os alunos que preencheram os crit&#233;rios de inclus&#227;o e com interesse em participar da pesquisa receberam o Termo de Consentimento Livre e Esclarecido para conhecimento e assinatura de seus pais e&#47;ou respons&#225;veis&#46; Antropometria e as coletas de sangue foram feitas na pr&#243;pria escola&#44; seguiram protocolos espec&#237;ficos&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">As dobras cut&#226;neas &#40;DC&#41; biciptal &#40;DCB&#41;&#44; triciptal &#40;DCT&#41;&#44; subescapular &#40;DCSe&#41; e suprail&#237;aca &#40;DCSi&#41; foram obtidas com adip&#244;metro Lange Skinfold Caliper&#44; Inglaterra&#44; que exerce press&#227;o constante de 10<span class="elsevierStyleHsp" style=""></span>g&#47;mm<span class="elsevierStyleSup">2</span>&#46; As medi&#231;&#245;es foram feitas no lado direito do corpo&#44; em tr&#234;s repeti&#231;&#245;es n&#227;o consecutivas para cada medida&#46; A medida final foi obtida pela m&#233;dia dos tr&#234;s valores&#46; Todas as medidas foram feitas por dois avaliadores qualificados que passaram por treinamento pr&#233;vio e calibra&#231;&#227;o&#46; Os resultados foram interpretados isoladamente&#44; bem como pelo somat&#243;rio das quatro DC avaliadas&#44; com os resultados expressos em mil&#237;metros &#40;mm&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A press&#227;o arterial foi aferida com esfigmoman&#244;metro de coluna de merc&#250;rio &#40;Unitec&#44; S&#227;o Paulo&#44; Brasil&#41; com manguitos de tamanhos apropriados para a circunfer&#234;ncia dos bra&#231;os das crian&#231;as de acordo com as normas propostas pelas VI Diretrizes Brasileiras de Hipertens&#227;o Arterial&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> Foram feitas tr&#234;s aferi&#231;&#245;es da PA na primeira visita&#44; descartou&#8208;se a primeira e considerou&#8208;se a m&#233;dia das duas &#250;ltimas&#46; Quando a crian&#231;a apresentou altera&#231;&#227;o da PA sist&#243;lica ou diast&#243;lica acima do percentil 90 houve aferi&#231;&#227;o em mais outros dois dias de coletas diferentes com o mesmo procedimento do primeiro dia&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Os volunt&#225;rios foram convidados a se deslocar da escola&#44; seguir jejum de 12 horas&#44; nos dias e hor&#225;rios determinados&#44; acompanhado de seus respons&#225;veis&#46; Profissionais de enfermagem coletaram amostras de sangue &#40;8<span class="elsevierStyleHsp" style=""></span>mL&#41; em tubos a v&#225;cuo <span class="elsevierStyleItalic">BD Vacutainer</span><span class="elsevierStyleSup">&#174;</span> &#40;Becton&#44; Dickinson and Company&#44; Nova Jersey&#44; EUA&#41;&#46; Amostras de soro foram analisadas para a determina&#231;&#227;o do HDL&#8208;c e triglicer&#237;deos e plasma para glicemia&#46; Foi usado o analisador semiautomatizado Bio 200F &#40;Bioplus&#44; S&#227;o Paulo&#44; Brasil&#41;&#46; M&#233;todos padronizados determinaram quantitativamente as vari&#225;veis sangu&#237;neas&#44; de acordo com as normas e especifica&#231;&#245;es t&#233;cnicas dos reagentes usados&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">O diagn&#243;stico da SM<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> foi determinado pela presen&#231;a de pelo menos tr&#234;s das seguintes altera&#231;&#245;es&#58; triglicer&#237;deos &#8805; 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; HDL&#8208; c<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; glicemia &#8805; 110<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; per&#237;metro de cintura &#8805; percentil 75 para idade e sexo&#59; altera&#231;&#227;o na press&#227;o arterial &#40;diast&#243;lica ou sist&#243;lica&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>percentil 90 ajustado para idade&#44; estatura e sexo&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Vari&#225;veis foram testadas quanto a sua normalidade pelo teste de Kolmogorov&#8208;Smirnov<span class="elsevierStyleItalic">&#46;</span> Os <span class="elsevierStyleItalic">outliers</span> foram identificados e retirados pelo m&#233;todo de intervalo entre quartis&#46; O teste U de Mann&#8208;Whitney foi usado para compara&#231;&#227;o de grupos independentes com distribui&#231;&#227;o n&#227;o param&#233;trica&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Para comparabilidade com outros estudos&#44; os percentis 5&#44; 10&#44; 25&#44; 50&#44; 75&#44; 90&#44; e 95 foram escolhidos como valores de refer&#234;ncia&#46; Foram delineadas curvas de refer&#234;ncia por meio do m&#233;todo de Cole LMS&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> O m&#233;todo LMS presume que&#44; para dados independentes com valores positivos&#44; a transforma&#231;&#227;o Box&#8208;Cox idade&#8208;espec&#237;fica pode ser empregada para torn&#225;&#8208;los normalmente distribu&#237;dos&#59; os valores L&#44; M e S s&#227;o <span class="elsevierStyleItalic">natural cubics plines</span> com <span class="elsevierStyleItalic">knot s</span>em cada intervalo et&#225;rio&#46; A amostra&#44; em cada sexo&#44; foi separada em faixas et&#225;rias com 100 ou mais indiv&#237;duos&#44; n&#250;mero considerado o m&#237;nimo adequado para o m&#233;todo LMS&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">A curva <span class="elsevierStyleItalic">Receiver Operating Characteristic</span> &#40;ROC&#41; foi usada na avalia&#231;&#227;o da capacidade preditiva de testes diagn&#243;sticos&#46; As &#225;reas abaixo das curvas ROC &#40;AUC&#41; foram calculadas para avaliar o poder discriminat&#243;rio das DC na indica&#231;&#227;o de altera&#231;&#245;es metab&#243;licas componentes da SM&#46; Os valores de sensibilidade e especificidade dos indicadores antropom&#233;tricos foram calculados para cada ponto de corte presente na amostra&#46; O ponto de corte que apresentou maior equil&#237;brio entre sensibilidade e especificidade foi o escolhido para aprimorar a rela&#231;&#227;o entre esses dois par&#226;metros&#44; apresentou maior acur&#225;cia &#40;menor quantidade de falsos negativos e falsos positivos&#41;&#46; A signific&#226;ncia estat&#237;stica de cada an&#225;lise foi verificada pela &#225;rea sob a curva ROC &#40;AUC&#41; e pelo limite inferior do intervalo de confian&#231;a a 95&#37;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;5&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0085" class="elsevierStylePara elsevierViewall">Participaram do presente estudo 1&#46;480 escolares do ensino fundamental do munic&#237;pio de Uberaba &#40;MG&#41; &#40;zona urbana e rural&#41;&#44; com m&#233;dia de 8&#44;55 anos &#40;desvio padr&#227;o<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;53&#41;&#44; 52&#44;2&#37; do sexo feminino&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Meninas apresentaram maior preval&#234;ncia de SM &#40;12&#44;6&#37; <span class="elsevierStyleItalic">vs</span>&#46; 8&#44;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; e maiores valores de DC&#44; em todos os pontos anat&#244;micos avaliados &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; em compara&#231;&#227;o com os meninos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Delinearam&#8208;se curvas percent&#237;licas &#40;p5&#44; p10&#44; p25&#44; p50&#44; p75&#44; p90 e p95&#41; das quatro DC avaliadas&#44; bem como para o somat&#243;rio delas&#44; para ambos os sexos &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; De forma geral&#44; todas as DC apresentaram aumento linear de acordo com a idade e o sexo&#44; com valores superiores para meninas&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">As quatro DC avaliadas e seu somat&#243;rio foram acurados na predi&#231;&#227;o da SM para meninas &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41; e meninos &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46; A maioria dos valores sugeridos encontra&#8208;se acima do percentil 75 para idade e sexo&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discuss&#227;o</span><p id="par0105" class="elsevierStylePara elsevierViewall">O presente estudo apresenta curvas percent&#237;licas de DC das regi&#245;es central e perif&#233;rica do corpo&#44; bem como do somat&#243;rio de quatro DC para predi&#231;&#227;o do risco de SM&#44; de acordo com idade e sexo&#44; em crian&#231;as brasileiras&#46; As curvas aqui delineadas podem representar uma estrat&#233;gia &#250;til para preven&#231;&#227;o do risco de s&#237;ndrome metab&#243;lica na inf&#226;ncia com possibilidade de uso em escolas&#44; unidades de sa&#250;de da fam&#237;lia&#44; cl&#237;nicas e hospitais&#46; De acordo com nossos achados&#44; tanto as DC de adiposidade central quanto as de adiposidade perif&#233;rica e o somat&#243;rio de quatro DC apresentaram pontos de corte com elevados valores de sensibilidade e de especificidade para predizer o risco de SM em crian&#231;as&#46; Aproximadamente&#44; 75&#37; das crian&#231;as do presente estudo&#44; com valores de DC acima do percentil 75&#44; independentemente da DC analisada&#44; apresentaram s&#237;ndrome metab&#243;lica&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de SM em crian&#231;as e adolescentes brasileiros variou de 0&#37; a 42&#44;4&#37;&#44; dados de uma revis&#227;o sistem&#225;tica&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> No presente estudo a SM foi prevalente em 12&#44;6&#37; das meninas e 8&#44;5&#37; dos meninos&#44; com diferen&#231;a significativa entre os sexos&#46; A heterogeneidade de defini&#231;&#245;es e de pontos de corte para os componentes da SM pode explicar&#44; ao menos em parte&#44; as diferentes preval&#234;ncias relatadas na literatura&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> No entanto&#44; &#233; fato que a preval&#234;ncia de SM tem aumentado entre crian&#231;as e adolescentes&#44; com propor&#231;&#227;o significativamente maior entre os obesos&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Distribui&#231;&#227;o percent&#237;lica das dobras cut&#226;neas triciptal e subescapular foram feitas em 8&#46;568 escolares chineses de sete a 18 anos<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> e 32&#46;783 crian&#231;as e adolescentes americanos&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> Os valores percent&#237;licos para as DC&#8208;Tri e DC&#8208;Sub de crian&#231;as chinesas e americanas foram inferiores aos percentis correspondentes de meninos e meninas do presente estudo&#46; Esse resultado &#233; preocupante devido &#224; associa&#231;&#227;o entre as DC e obesidade central&#44; perfil lip&#237;dico desfavor&#225;vel&#44; n&#237;veis de insulina aumentados&#44; press&#227;o arterial e massa ventricular esquerda&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> Ac&#250;mulo de gordura subcut&#226;nea&#44; traduzido em altos valores de DC&#44; aumentam as chances de as crian&#231;as apresentarem altera&#231;&#245;es metab&#243;licas&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Crian&#231;as mexicanas pr&#233;&#8208;p&#250;beres de seis a 10 anos apresentaram tr&#234;s vezes mais chances para altera&#231;&#245;es nos componentes da SM&#44; quando a distribui&#231;&#227;o da DC&#8208;Sub encontrava&#8208;se no quarto quartil da amostra baixos n&#237;veis de HDL&#8208;c &#91;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;16 &#40;IC<span class="elsevierStyleInf">95&#37;</span>&#58; 1&#44;41&#8208;7&#44;10&#41; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#93; e elevados n&#237;veis de triglicer&#237;deos &#91;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;27 &#40;IC<span class="elsevierStyleInf">95&#37;</span>&#58; 2&#44;02&#8208;5&#44;29&#41; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> N&#227;o obstante&#44; altos valores do &#8721; 3 DC &#40;DC&#8208;Tri<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Dc&#8208;Bi&#43; DC&#8208;Sub&#41; &#40;&#62; percentil 90&#41; em crian&#231;as alem&#227;s de tr&#234;s a 11 anos aumentaram as chances em 1&#44;6 vez &#40;IC<span class="elsevierStyleInf">95&#37;</span>&#58; 1&#44;1 &#8208; 2&#44;2&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; de ter tr&#234;s ou mais fatores de riscos cardiovasculares e 1&#44;7 vez em ser portador de hipertens&#227;o arterial &#91;&#40;IC<span class="elsevierStyleInf">95&#37;</span>&#58;1&#44;1 &#8208; 2&#44;7&#41;&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#93;&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> Os resultados do presente estudo demonstraram que todas as medidas de DC isoladas predizem o risco de SM em ambos os sexos&#46; Nas investiga&#231;&#245;es cient&#237;ficas relativas ao tema&#44; observa&#8208;se predomin&#226;ncia de estudos com as DC&#8208;Tri e DC&#8208;Sub&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#44;13&#44;21&#44;25</span></a> Muitos estudos usaram DC de forma isolada como preditora da quantidade de gordura corporal<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25&#8211;29</span></a> e de fatores de risco cardiometab&#243;lico isolados&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">12&#44;30</span></a> Por outro lado&#44; estudos que investigaram o poder da DC de predizer SM na popula&#231;&#227;o pedi&#225;trica permanecem escassos&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">O uso da soma de valores absolutos das DC pode se tornar interessante preditor de SM na medida em que minimiza os vieses presentes em equa&#231;&#245;es preditivas de composi&#231;&#227;o corporal&#44; al&#233;m de sugerir valores que demonstram equil&#237;brio&#47;desequil&#237;brio da distribui&#231;&#227;o da gordura corporal &#40;DC&#8208;Tri<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>DC&#8208;Bi &#43;DC&#8208;Sub<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Dc&#8208;Supra&#41;&#46; Dentre diferentes medidas antropom&#233;tricas testadas&#44; o &#8721;4DC foi o mais acurado preditor de SM em meninas e meninos brasileiros&#44; com AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;908 e AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;897&#44; respectivamente&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> No presente estudo&#44; o &#8721; 4DC apresentou AUC de 0&#44;859 para meninas e 0&#44;879 para meninos&#44; os pontos de corte sugeridos apresentaram altos valores de sensibilidade &#40;&#62; 80&#37;&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">De nosso conhecimento&#44; este &#233; o primeiro estudo com curvas percent&#237;licas de DC da regi&#227;o central e perif&#233;rica&#44; bem como do somat&#243;rio de quatro DC&#44; para predi&#231;&#227;o de SM em uma amostra representativa de base escolar brasileira&#46; No entanto&#44; este estudo teve desenho transversal&#44; fato que n&#227;o permite estabelecer se mudan&#231;as na adiposidade subcut&#226;nea refletem altera&#231;&#245;es nos componentes da SM&#46; Assim&#44; estudos longitudinais s&#227;o necess&#225;rios para definir a rela&#231;&#227;o causal entre a SM e adiposidade subcut&#226;nea&#46; &#201; valido ressaltar que embora a popula&#231;&#227;o do estudo tenha sido delimitada entre escolares do 1&#176; ao 5&#176; ano de ensino&#44; a Secretaria de Educa&#231;&#227;o de educa&#231;&#227;o cedeu dados atualizados de todo o ensino fundamental&#44; o que pode ter superestimado o c&#225;lculo amostral&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Curvas de refer&#234;ncia oriundas de outros pa&#237;ses podem tanto subestimar quanto superestimar a doen&#231;a&#44; devido a diferen&#231;as &#233;tnicas&#44; socioecon&#244;micas e culturais&#46; O desenvolvimento de curvas percent&#237;licas com popula&#231;&#245;es de diferentes &#225;reas geogr&#225;ficas &#233; um desafio relevante para possibilitar a triagem mais acurada da SM em jovens por meio da avalia&#231;&#227;o de DC&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Financiamento</span><p id="par0140" class="elsevierStylePara elsevierViewall">Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de Minas Gerais &#40;Fapemig&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflitos de interesse</span><p id="par0145" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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            2 => "Cross&#8208;sectional studies"
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            0 => "Antropometria"
            1 => "S&#237;ndrome X"
            2 => "Estudos de corte transversal"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To draw skinfold &#40;SF&#41; reference curves &#40;subscapular&#44; suprailiac&#44; biceps&#44; triceps&#41; and to determine SF cutoff points for predicting the risk of metabolic syndrome &#40;MetS&#41; in children aged 6&#8211;10 years old&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This was a cross&#8208;sectional study with a random sample of 1480 children aged 6&#8211;10 years old&#44; 52&#46;2&#37; females&#44; from public and private schools located in the urban and rural areas of the municipality of Uberaba &#40;MG&#41;&#46; Anthropometry&#44; blood pressure&#44; and fasting blood samples were taken at school&#44; following specific protocols&#46; The LMS method was used to draw the reference curves and ROC curve analysis to determine the accuracy and cutoff points for the evaluated skinfolds&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The four SF evaluated &#40;subscapular&#44; suprailiac&#44; biceps&#44; and triceps&#41; and their sum &#40;&#8721;4SF&#41; were accurate in predicting MetS for both girls and boys&#46; Additionally&#44; cutoffs have been proposed and percentile curves &#40;p5&#44; p10&#44; p25&#44; p50&#44; p75&#44; p90&#44; and p95&#41; were outlined for the four SF and &#8721;4SF&#44; for both genders&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">SF measurements were accurate in predicting metabolic syndrome in children aged 6&#8211;10 years old&#46; Age&#8208; and gender&#8208;specific smoothed percentiles curves of SF provide a reference for the detection of risk for MetS in children&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Desenhar curvas de refer&#234;ncia de quatro dobras cut&#226;neas &#40;subescapular&#44; suprail&#237;aca&#44; b&#237;ceps&#44; tr&#237;ceps&#41; e determinar pontos de corte para predizer o risco de SM em crian&#231;as de seis a 10 anos&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo epidemiol&#243;gico de base populacional&#44; corte transversal&#44; com amostra probabil&#237;stica&#44; estratificada por segmento de ensino&#44; com 1&#46;480 crian&#231;as de seis a 10 anos idade&#44; 52&#44;2&#37; do sexo feminino&#44; oriundas de escolas p&#250;blicas e privadas nas zonas urbana e rural do munic&#237;pio de Uberaba &#40;MG&#41;&#46; Antropometria &#40;dobras cut&#226;neas&#41;&#44; press&#227;o arterial e as coletas de sangue em jejum foram feitas em espa&#231;o reservado na escola&#44; seguiram protocolos espec&#237;ficos&#46; O m&#233;todo LMS foi usado para desenhar as curvas de refer&#234;ncia e an&#225;lise de curva ROC para determinar a acur&#225;cia e os pontos de corte para as dobras cut&#226;neas avaliadas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">As quatro DC avaliadas &#40;subescapular&#44; suprail&#237;aca&#44; b&#237;ceps e tr&#237;ceps&#41; e o seu somat&#243;rio &#40;&#8721;4DC&#41; foram acurados na predi&#231;&#227;o da SM para meninas e meninos&#46; Adicionalmente&#44; pontos de corte foram propostos e curvas percent&#237;licas &#40;p5&#44; p10&#44; p25&#44; p50&#44; p75&#44; p90 e p95&#41; foram delineadas para as quatro DC e o &#8721;4DC&#44; para ambos os sexos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Medidas de DC foram acuradas em predizer SM em escolares de seis a 10 anos&#46; As curvas percent&#237;licas de DC desenhadas por idade e sexo fornecem refer&#234;ncia na detec&#231;&#227;o do risco de SM em crian&#231;as&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Andaki AC&#44; Quadros TM&#44; Gordia AP&#44; Mota J&#44; Tin&#244;co AL&#44; Mendes EL&#46; Skinfold reference curves and their use in predicting metabolic syndrome risk in children&#46; J Pediatr &#40;Rio J&#41;&#46; 2017&#59;93&#58;490&#8211;6&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Pesquisa vinculada &#224; Universidade Federal do Tri&#226;ngulo Mineiro&#44; Uberaba&#44; MG&#44; Brasil&#46;</p>"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">&#8721;4DC&#44; soma das quatro dobras cut&#226;neas avaliadas&#59; DC&#8208;Bi&#44; dobra cut&#226;nea biciptal&#59; DC&#8208;Sub&#44; dobra cut&#226;nea subescapular&#59; DC&#8208;Supra&#44; dobra cut&#226;nea suprail&#237;aca&#59; DC&#8208;Tri&#44; dobra cut&#226;nea triciptal&#59; dp&#44; desvio padr&#227;o&#59; max&#44; valor m&#225;ximo&#59; min&#44; valor m&#237;nimo&#59; n&#44; n&#250;mero amostral&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Nota&#58; Diferen&#231;a significativa entre os sexos p &#8804; 0&#44;05 teste de Mann Whitney&#46;</p>"
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Bi &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;14 &#40;5&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;00 &#40;3&#44;00 &#8208; 29&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;57 &#40;5&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;67 &#40;3&#44;00 &#8208; 28&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;45 &#40;5&#44;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;33 &#40;5&#44;00 &#8208; 35&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;71 &#40;6&#44;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;67 &#40;5&#44;00 &#8208; 35&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Sub &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;77 &#40;7&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;00 &#40;4&#44;00 &#8208; 44&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;85 &#40;7&#44;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;00 &#40;4&#44;00&#8208; 44&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;40 &#40;10&#44;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;67 &#40;3&#44;00 &#8208; 51&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;12 &#40;10&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;67 &#40;3&#44;00&#8208; 50&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721; 4 DC &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#44;93 &#40;28&#44;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;0 &#40;10&#44;00 &#8208;163&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;37 &#40;29&#44;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#44;00 &#40;11&#44;00 &#8208; 202&#44;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas descritivas de dobras cut&#226;neas de escolares de seis a 10 anos&#44; munic&#237;pio de Uberaba &#40;MG&#41;&#44; por sexo</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">&#8721;4DC&#44; soma das quatro dobras cut&#226;neas avaliadas&#59; AUC&#44; &#225;rea sob a curva ROC&#59; DC&#8208;Bi&#44; dobra cut&#226;nea biciptal&#59; DC&#8208;Sub&#44; dobra cut&#226;nea subescapular&#59; DC&#8208;Supra&#44; dobra cut&#226;nea suprail&#237;aca&#59; DC&#8208;Tri&#44; dobra cut&#226;nea triciptal&#59; E&#44; especificidade&#59; IC 95&#37;&#44; intervalo de confian&#231;a a 95&#37;&#59; S&#44; sensibilidade&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Idade &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Preditores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AUC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">IC 95&#37;</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ponto de corte &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">6</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;832&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;709&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;955&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;771&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;566&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;977&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;864&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;760&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;805&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;666&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;943&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;833&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;708&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;959&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">7</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;894&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;977&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;927&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;874&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;924&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;871&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;978&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;909&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;841&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;977&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;927&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;872&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;982&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">8</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;803&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;705&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;902&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;838&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;751&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;924&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;874&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;775&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;974&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;727&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;929&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;858&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;770&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;945&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;773&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;951&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;788&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;954&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;756&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Pontos de corte de dobras cut&#226;neas para predi&#231;&#227;o de s&#237;ndrome metab&#243;lica em meninas&#44; por idade&#44; munic&#237;pio de Uberaba &#40;MG&#41;</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">&#8721;4DC&#44; soma das quatro dobras cut&#226;neas avaliadas&#59; AUC&#44; &#225;rea sob a curva ROC&#59; DC&#8208;Bi&#44; dobra cut&#226;nea biciptal&#59; DC&#8208;Sub&#44; dobra cut&#226;nea subescapular&#59; DC&#8208;Supra&#44; dobra cut&#226;nea suprail&#237;aca&#59; DC&#8208;Tri&#44; dobra cut&#226;nea triciptal&#59; E&#44; especificidade&#59; IC 95&#37;&#44; intervalo de confian&#231;a a 95&#37;&#59; S&#44; sensibilidade&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">6</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;902&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;893&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;854&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;807&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;997&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">7</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;726&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;994&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;681&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;969&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;789&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;635&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">8</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;641&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;048&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;626&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dc&#8208;Sub&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;025&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;756&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Supra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;821&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8721;4DC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;761&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">9</td><td class="td" title="table-entry  " align="left" valign="top">DC&#8208;Bic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;767&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;955&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DC&#8208;Tri&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;769&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;954&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#44;8&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Pontos de corte de dobras cut&#226;neas para predi&#231;&#227;o de s&#237;ndrome metab&#243;lica em meninos&#44; por idade&#44; munic&#237;pio de Uberaba &#40;MG&#41;</p>"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Cardiovascular morbidity and mortality associated with the metabolic syndrome"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Isomaa"
                            1 => "P&#46; Almgren"
                            2 => "T&#46; Tuomi"
                            3 => "B&#46; Forsen"
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                      "titulo" => "Predictability of childhood adiposity and insulin for developing insulin resistance syndrome &#40;syndrome X&#41; in young adulthood&#58; the Bogalusa Heart Study"
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                            4 => "J&#46;P&#46; Despres"
                            5 => "C&#46; Bouchard"
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                      "titulo" => "High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning&#44; abdominal adiposity and excess body fat"
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                          "etal" => true
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                            1 => "N&#46;K&#46; Vikram"
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                          "etal" => false
                          "autores" => array:6 [
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                    0 => array:2 [
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Informação do artigo
ISSN: 22555536
Idioma original: Português
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