Oselka Noa, Dubnov-Raz Gal, Ziv-Baran Tomer
School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Sheba Medical Center, Ramat-Gan, Israel.
Pediatr Res. 2025 Feb;97(3):994-1000. doi: 10.1038/s41390-024-03465-0. Epub 2024 Aug 12.
The increasing prevalence of metabolic syndrome (MetS) among adolescents necessitates a simple and easy-to-use screening tool. This study aimed to develop and validate a simple model based on age, sex, race, and weight-for-age or BMI-for-age to identify adolescents with MetS.
A cross-sectional study of adolescents (aged 12-18 years) who participated in the American National Health and Nutrition Examination Survey (NHANES) was performed. Participants with pre-existing hypertension, diabetes or dyslipidemia were excluded. Data from 2005-2018 were randomly divided into training (70%) and validation (30%) sets. Anthropometric, demographic data, and MetS criteria were extracted.
The training group included 1974 adolescents (52% boys, median age 15 years), and the validation group included 848 adolescents (50% boys, median age 14 years). Both weight- and BMI-for-age demonstrated good discrimination ability in the training group (AUC = 0.897 and 0.902, respectively), with no significant difference between them (p = 0.344). Multivariable models showed similar discrimination ability. Therefore, weight-for-age was chosen and using Youden's index, the 93rd weight-for-age percentile (SDS 1.5) was identified as the optimal cut-off value for MetS. Similar values were observed in the validation group.
Among adolescents aged 12-18 years, weight-for-age percentiles are an easy-to-use primary screening indicator for the presence of MetS.
The prevalence of metabolic syndrome in adolescents is increasing. An early detection screening tool is required to prevent related adulthood morbidity. Screening adolescents for metabolic syndrome is challenging. This study suggests the use of weight-for-age as a single criterion for primary screening of adolescents aged 12-18. Using weight-for-age as a single predictor of metabolic syndrome is expected to increase screening rates compared to using BMI-for-age, due to its simplicity.
青少年代谢综合征（MetS）患病率日益上升，因此需要一种简单易用的筛查工具。本研究旨在开发并验证一种基于年龄、性别、种族以及年龄别体重或年龄别BMI的简单模型，以识别患有MetS的青少年。
对参加美国国家健康与营养检查调查（NHANES）的12至18岁青少年进行了一项横断面研究。排除既往患有高血压、糖尿病或血脂异常的参与者。将2005年至2018年的数据随机分为训练集（70%）和验证集（30%）。提取人体测量学、人口统计学数据以及MetS标准。
训练组包括1974名青少年（52%为男孩，中位年龄15岁），验证组包括848名青少年（50%为男孩，中位年龄14岁）。年龄别体重和年龄别BMI在训练组中均表现出良好的鉴别能力（AUC分别为0.897和0.902），两者之间无显著差异（p = 0.344）。多变量模型显示出相似的鉴别能力。因此，选择了年龄别体重，并使用约登指数确定年龄别体重第93百分位数（SDS 1.5）为MetS的最佳截断值。在验证组中观察到了类似的值。
在12至18岁的青少年中，年龄别体重百分位数是用于筛查MetS存在情况的一种简单易用的主要指标。
青少年代谢综合征的患病率正在上升。需要一种早期检测筛查工具来预防相关的成年期发病。筛查青少年的代谢综合征具有挑战性。本研究建议将年龄别体重作为12至18岁青少年初级筛查的单一标准。与使用年龄别BMI相比，由于其简单性，使用年龄别体重作为代谢综合征的单一预测指标有望提高筛查率。
