TriGlycerides and high-density lipoprotein cholesterol ratio compared with homeostasis model assessment insulin resistance indexes in screening for metabolic syndrome in the chinese obese children: a cross section study

BMC Pediatrics

Wei Wu¹  Xiumin Wang¹  Guanping Dong¹  Youyun Jiang¹  Junfen Fu¹  Jianfeng Liang² 

[1] Endocrinology Department of the Children’s Hospital, Zhejiang University, School of Medicine, 57 Zhugan Avenue, Hangzhou 310003, China;Biostatistics Unit of the Children’s Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China

关键词: Homeostasis Model Assessment Insulin Resistance (HOMA-IR);    TriGlycerides (TG) to High-Density Lipoprotein Cholesterol (HDL-C) ratio;    Biomarker;    Metabolic syndrome;    Child obesity;   

Others  :  1227556
DOI  :  10.1186/s12887-015-0456-y

 received in 2014-10-01, accepted in 2015-09-14,  发布年份 2015

【 摘 要 】

Background

Metabolic Syndrome (MS) is prevalant in China, especially according to the pediatric obesity group. Based on the MS-CHN2012 definition for Chinese children and adolescents the need to explore and establish a convienent MS screening become imminent. This study aims to investigate the optimal cut-off values, compare the accuracy for the (TriGlycerides (TG) to High-Density Lipoprotein Cholesterol (HDL-C)) (TG/HDL-C) ratio and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) indexs to identify Metabolic Syndrome in obese pediatric population in China.

Method

A total sample of 976 children (female286 male690, BMI > =95percentile) aged from 6–16 years underwent a medical assessment including a physical examination and investigations of total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, insulin, glucose, and 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 (ROC).

Result

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 for 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 robust after stratified by gender, age group and pubertal stage.

Discussion

TG/HDL-C ratio was a better indicator than the HOMA-IR to screen for a positive diagnosis for MS. Furthermore, the TG/HDL-C ratio was superior to the HOMA-IR indexes even after the control of possible confusions from the gender, age group and puberty stage.

Conclusion

TG/HDL-C ratio proved a better index than HOMA-IR in screening for MS in obese children and adolescents. TG/HDL-C ratio has a discriminatory power in detecting potential MS in the Chinese obese pediatric population.

【 授权许可】

   
2015 Liang et al.

【 图 表 】

Fig. 1.

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