Background: IDF-2007 MS definition (MS-IDF2007) for children and adolescents has been challenged frequently in clinical practice and should be improved further. Therefore, it becomes imminent to explore an accessible and effective tool to screen obese children with the metabolic syndrome components.
Objective and hypotheses: To investigate the optimal cut-off values and compare the accuracy for the triglycerides and HDL cholesterol ratio and homeostasis model assessment insulin resistance indexes to identify the metabolic syndrome in obese pediatric population in China.
Method: 976 children from 616 years old were recruited and went through a series of medical assessments including a physical examination and investigations of total cholesterol, HDL, LDL, triglycerides, insulin, glucose and an oral glucose tolerance test to identify the components of metabolic syndrome. The validity and accuracy between TG/HDL-C ratio and HOMA-IR were compared by receiver operating characteristics analysis.
Results: TG/HDL-C ratio achieved a larger ROC area under curve (AUC=0.843) than HOMA-IR indexes (0.640, 0.625 for HOMA1-IR, HOMA2-IR respectively) to screen the metabolic syndrome. The cut-off values for MS were: TG/HDL-C ratio >1.25 (sensitivity: 80%; specificity: 75%), HOMA1-IR >4.59 (sensitivity: 58.7%; specificity: 65.5%) and HOMA2-IR >2.76 (sensitivity: 53.2%; specificity: 69.5%). The results kept constant after stratification by gender, age group and pubertal stage.
Conclusion: TG/HDL-C ratio proved to be a better index than HOMA-IR in screening MS for obese children and adolescents. A cutoff of 1.25 for TG/HDL-C ratio might be used in detecting the potential MS in Chinese obese pediatric population.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology