Department of Epidemiology and Health Statistics, Medical College of Soochow University, Suzhou, Jiangsu, China.
Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Pediatr Res. 2024 Oct;96(5):1355-1363. doi: 10.1038/s41390-024-03247-8. Epub 2024 May 14.
Early intervention and diagnosis of Metabolic Syndrome (MetS) are crucial for preventing adult cardiovascular disease. However, the optimal indicator for identifying MetS in adolescent remains controversial.
In total,1408 Chinese adolescents and 3550 American adolescents aged 12-17 years were included. MetS was defined according to the modified version for adolescents based on Adult Treatment Panel III (NCEP-ATP III) criteria. Areas under the curve (AUC) and corresponding 95% confidence interval (95% CI) of 8 anthropometric/metabolic indexes, such as waist circumference (WC), body mass index (BMI), a body shape index (ABSI), waist triglyceride index (WTI), were calculated to illustrate their ability to differentiate MetS. Sensitivity analysis using the other MetS criteria was performed.
Under the modified NCEP-ATP III criteria, WTI had the best discriminating ability in overall adolescents, with AUC of 0.922 (95% CI: 0.900-0.945) in Chinese and 0.959 (95% CI: 0.949-0.969) in American. In contrast, ABSI had the lowest AUCs. Results of sensitivity analysis were generally consistent for the whole Chinese and American population, with the AUC for WC being the highest under some criteria, but it was not statistically different from that of WTI.
WTI had relatively high discriminatory power for MetS detection in Chinese and American adolescents, but the performance of ABSI was poor.
While many studies have compared the discriminatory power of some anthropometric indicators for MetS, there are few focused on pediatrics. The current study is the first to compare the discriminating ability of anthropometric/metabolic indicators (WC, BMI, TMI, ABSI, WHtR, VAI, WTI, and TyG) for MetS in adolescents. WTI remains the optimal indicator in screening for MetS in adolescents. WC was also a simple and reliable indicator when screening for MetS in adolescents, but the performance of ABSI was poor. This study provides a theoretical basis for the early identification of MetS in adolescents by adopting effective indicators.
代谢综合征（MetS）的早期干预和诊断对于预防成人心血管疾病至关重要。然而，确定青少年代谢综合征的最佳指标仍存在争议。
共纳入 1408 名中国青少年和 3550 名 12-17 岁的美国青少年。根据基于成人治疗小组 III（NCEP-ATP III）标准的青少年改良版标准，定义代谢综合征。计算 8 个体型/代谢指标（腰围[WC]、体重指数[BMI]、体型指数[ABSI]、腰甘油三酯指数[WTI]）的曲线下面积（AUC）和相应的 95%置信区间（95%CI），以说明其区分代谢综合征的能力。使用其他代谢综合征标准进行了敏感性分析。
在改良的 NCEP-ATP III 标准下，WTI 在整体青少年中具有最佳的区分能力，中国青少年的 AUC 为 0.922（95%CI：0.900-0.945），美国青少年的 AUC 为 0.959（95%CI：0.949-0.969）。相比之下，ABSI 的 AUC 最低。对于整个中国和美国人群的敏感性分析结果基本一致，根据某些标准，WC 的 AUC 最高，但与 WTI 相比没有统计学差异。
WTI 对中国和美国青少年代谢综合征的检测具有较高的判别能力，但 ABSI 的表现较差。
虽然许多研究比较了一些人体测量指标对代谢综合征的判别能力，但很少有研究集中在儿科。本研究首次比较了人体测量/代谢指标（WC、BMI、TMI、ABSI、WHtR、VAI、WTI 和 TyG）在青少年代谢综合征中的判别能力。WTI 仍然是筛查青少年代谢综合征的最佳指标。当筛查青少年代谢综合征时，WC 也是一种简单可靠的指标，但 ABSI 的表现较差。本研究为采用有效指标早期识别青少年代谢综合征提供了理论依据。
