Department of Maternal and Child Health and Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China.
Physical Examination Center, The Eastern Hospital of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
J Pediatr Endocrinol Metab. 2022 Mar 22;35(5):617-625. doi: 10.1515/jpem-2021-0307. Print 2022 May 25.
Existing various and complicated metabolic syndrome (MetS) definitions have contributed to the difficulty in assessing MetS in children and adolescents, and therefore it is urgently needed to develop a convenient and effective screening tool for pediatric MetS. This study aimed to identify the optimal adiposity measure to screen for pediatric MetS.
The cross-sectional data was collected from 8,150 children and adolescents aged 7-17 y living in southern China. Anthropometric indices, blood lipids, and serum glucose were determined. Results of two commonly used MetS definitions were compared: International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP) modified by Cook. Receiver operating characteristic curve analyses were performed and areas under the curve (AUCs) were calculated to determine the optimal index for MetS screening.
MetS prevalence assessed by NCEP-ATP was significantly higher than that by IDF (6.2% vs. 1.5%, p<0.001). Waist-to-height ratio (WHtR) showed the highest screening power for MetS defined by both IDF and NCEP-ATP (AUC 0.932 and 0.900, respectively), and its optimal cut-off point was 0.48 by both IDF and NCEP-ATP definition (sensitivity 0.944 and 0.847, specificity 0.800 and 0.830, respectively), regardless of age or sex. When taking sex diversity into account, the optimal WHtR cut-off point was 0.49 (IDF) or 0.50 (NCEP-ATP) in boys, and 0.46 (both definitions) in girls.
Among children and adolescents aged 7-17 y in southern China, a WHtR greater than 0.48 can be a simple but effective screening tool for MetS.
现有的各种复杂的代谢综合征 (MetS) 定义增加了评估儿童和青少年 MetS 的难度，因此迫切需要开发一种方便有效的儿童 MetS 筛查工具。本研究旨在确定最佳肥胖指标来筛查儿童 MetS。
本横断面研究数据来自于居住在中国南方的 8150 名 7-17 岁的儿童和青少年。测量了他们的人体测量学指标、血脂和血清葡萄糖。比较了两种常用的 MetS 定义的结果：国际糖尿病联合会 (IDF) 和经 Cook 改良的美国国家胆固醇教育计划成人治疗专家组第 Ⅲ 版 (NCEP-ATP)。进行了受试者工作特征曲线分析，并计算曲线下面积 (AUC) 以确定用于 MetS 筛查的最佳指标。
使用 NCEP-ATP 定义的 MetS 患病率显著高于使用 IDF 定义的 MetS 患病率 (6.2% vs. 1.5%，p<0.001)。腰围身高比 (WHtR) 对 IDF 和 NCEP-ATP 定义的 MetS 均具有最高的筛查能力(AUC 分别为 0.932 和 0.900)，且无论年龄和性别，其最佳截断点均为 0.48 (IDF 和 NCEP-ATP 定义的灵敏度分别为 0.944 和 0.847，特异性分别为 0.800 和 0.830)。当考虑到性别多样性时，男孩的最佳 WHtR 截断点为 0.49 (IDF) 或 0.50 (NCEP-ATP)，女孩的最佳 WHtR 截断点为 0.46 (两种定义)。
在中国南方 7-17 岁的儿童和青少年中，WHtR 大于 0.48 可以作为一种简单而有效的 MetS 筛查工具。
