Utility of the triglycerides/HDL-C index from the first years of age in the diagnosis of metabolic syndrome in obese children

Authors

  • Emilio Cabello
  • Melissa Martínez
  • Ysel Cabrera
  • Susan Villafuerte
  • Isolda González

DOI:

https://doi.org/10.20453/rmh.v30i4.3660

Keywords:

TG / HDL-C ratio, metabolic syndrome, children

Abstract

Objective: To determine the utility of the triglycerides/HDL-C index for the diagnosis of metabolic syndrome (MS) in obese 2-14 years of age children. Methods: Cross-sectional diagnostic study. We included 360 exogenous obese children (199M/161F) divided in three age groups: 2 to <6; 6 to <10 and 10-14 years. MS was defined according to the International Diabetes Federation and the TG/HDL-C index was evaluated using two cutoffs by age group, ≥2.32 and ≥3.5. Chi squared was used accepting a p value <0.05 as statistically significant. Fir each cut-off we determined sensitivity, specificity and predictive values. Results: Frequency of MS was 15.79% in the 2 to <6 years age group; 20.25% in the 6 to<10 years age group and 19.63% in the 10-14 years age group. Among children with SM, 97.1% had low HDL and 83.8% had elevated triglycerides. A statistically significant difference was found in the frequency of the TG/HDL-C index in children with or without MS in all age groups. Sensitivity for all cut-offs was high (86-100%) and specificity was best for the cut-off of ≥3.5 (72-80%). Conclusions: The TG/HDL-C index is a sensitive and specific marker of MS from the first years of age.

References

Pajuelo J. La obesidad en el Perú. An Fac med. 2017; 78(2):179-185.

Falaschetti E, Hingorani A, Jones A, et al. Adiposity and cardiovascular risk factors in a large contemporary population of pre-pubertal children. Eurheartj. 2010; 31 (24): 3063-3072.

Juonala M, Magnussen C, Berenson G, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med. 2011; 365 (20):1876-1885.

Spolidoro V, Pitrez-Filho L, Vargas T, et al. Waist circumference in children and adolescents correlate with metabolic syndrome and fat deposits in young adults. Clin Nutr. 2013; 32 (1): 93-97.

Rochlani Y, Pothineni V, Kovelamudi S, Mehta L. Metabolic syndrome: pathophysiology, management, and modulation by natural compounds. Ther Adv Cardiovasc Dis. 2017; 11(8):215-225.

Sinaiko AR, Steinberger J, Moran A, et al. Relation of body mass index and insulin resistance to cardiovascular risk factors, inflammatory factors, and oxidative stress during adolescence. Circulation. 2005; 111(15):1985-91.

Steinberger J, Daniels SR. Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee. Circulation. 2003;107(10):1448-53.

Tripathy D, Mohanty P, Dhindsa S, et al. Elevation of free fatty acids induces inflammation and impairs vascular reactivity in healthy subjects. Diabetes. 2003; 52 (12): 2882-2887.

Hotamisligil S, Murray L, Choy N, Spiegelman M. Tumor necrosis factor alpha inhibitssignalingfromtheinsulinreceptor. Proc Natl Acad Sci USA. 1994; 91(11):4854-8.

Lindsay RS, Funahashi T, Hanson RL, et al. Adiponectin and development of type 2 diabetes in the Pima Indian population. Lancet. 2002; 360(9326): 57-8. [ Links ]

Vanecková I, Maletínská L, Behuliak M, et al. Obesity-related hypertension: possible pathophysiological mechanisms. J Endocrinol. 2014; 223(3): 63-78. [ Links ]

Magge SN, Goodman E, Armstrong SC. The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering. Pediatrics. 2017;140(2): 1603. [ Links ]

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP). JAMA. 2001;285(19):2486–2497. [ Links ]

Cook S, Weitzman M, Auinger P, et al. Prevalence of a Metabolic Syndrome Phenotype in Adolescents Findings from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med. 2003;157(8):821–827. [ Links ]

Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab. 2004; 89: 108-13. [ Links ]

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in children and adolescents: Summary Report. Pediatrics. 2011;128 (5):213-56. [ Links ]

Zimmet P, Alberti G, Kaufman F, et al. International Diabetes Federation Task Force on Epidemiology and Prevention of Diabetes. The metabolic syndrome in children and adolescents. Lancet. 2007; 369: 2059-2061. [ Links ]

Cabello A, Lozano E, Polar V., et al. Comparison of Criteria of the American Academy of Pediatrics (AAP) and the International Diabetes Federation (IDF) for the Diagnosis of Metabolic Syndrome and Its Relationship with HOMA-IR and Triglycerides/HDLc Ratio in Obese Children 4 to 14 Years Old. Horm Res Paeditr. 2014; 82 (2):25-45. [ Links ]

Magnussen G, Koskinen J, Chen W, et al. Pediatric metabolic syndrome predicts adulthood metabolic syndrome, subclinical atherosclerosis, and type 2 Diabetes Mellitus but is no better than body mass index alone clinical perspective: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study. Circulation. 2010; 122(16):1604-11. [ Links ]

McLaughlin T, Reaven G, Abbasi F, et al. Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease? Am J Cardiol. 2005;96(3):399-404.

Vega GL, Barlow CE, Grundy SM, Leonard D, DeFina LF.Triglyceride–to–high-density- lipoprotein-cholesterol ratio is an index of heart disease mortality and of incidence of type 2 diabetes mellitus in men. J Investig Med. 2014; 62(2):345-9.

de Giorgis T, Marcovecchio L, Di Giovanni I, et al. Triglycerides-to-HDL ratio as a new marker of endothelial dysfunction in obese prepubertal children. Eur J Endocrinol. 2014;170(2):173-80.

Cabello E, Lozano G, Cortez J, et al. Comparison of three diagnostic definitions of metabolic syndrome and their relationship with the homeostatic model assessment (HOMA) index in obese children and adolescents. Horm Res Paediatric. 2011; 76 (4): 1-32.

Di Bonito P, Moio N, Scilla C, et al. Usefulness of the High Triglyceride–to–HDL cholesterol ratio to identify cardiometabolic risk factors and preclinical signs of organ damage in outpatient children. Diabetes Care. 2012;35(1):158-62.

Lozano G, Cabello E, Polar V. Insulin Resistance Index (HOMA-IR) and Triglyceride/ HDL- Cholesterol Ratio as Cardiovascular Risk Markers in Obese Prepubertal and Pubertal Children. Horm Res Paeditr. 2014; 82 (2):1-45. [ Links ]

Friend A, Craig L, Turner S. The prevalence of metabolic syndrome in children: a systematic review of the literature. Metab Syndr Relat Disord. 2013; 11(2):71-80.

Hirschler V, Calcagno ML, Aranda C, et al. Síndrome metabólico en la infancia y su asociación con insulinorresistencia. Arch Argent Pediatr. 2006; 104(6):486-491. [ Links ]

Sangun O, Dündar B, Kosker M, et al. Prevalence of metabolic syndrome in obese children and adolescents using three different criteria and evaluation of risk factors. J Clin Res Pediatr Endocrinol. 2011; 3(2):70-6.

Gardner W, Parker E, Krishnan S, et al. Metabolic syndrome and daily ambulation in children, adolescents, and young adults. Med Sci Sports Exerc. 2013; 45(1):163-9.

Liang J, Fu J, Jiang Y, et al. 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 Pediatr. 2015; 15: 138.

Published

2020-01-13

How to Cite

1.
Cabello E, Martínez M, Cabrera Y, Villafuerte S, González I. Utility of the triglycerides/HDL-C index from the first years of age in the diagnosis of metabolic syndrome in obese children. Rev Med Hered [Internet]. 2020 Jan. 13 [cited 2024 Apr. 18];30(4):249-55. Available from: https://revistas.upch.edu.pe/index.php/RMH/article/view/3660

Issue

Section

ORIGINAL RESEARCH