Sert Sadiye, Büyükinan Muammer, Yılmaz Ahmet Fatih
Department of Pediatrics, Konya Beyhekim Training and Research Hospital, Konya, Turkey.
Department of Pediatric Endocrinology, Selcuk University Medical School, Konya, Turkey.
Metab Syndr Relat Disord. 2025 Feb;23(1):53-62. doi: 10.1089/met.2024.0186. Epub 2024 Sep 27.
The HEPAKID index, a novel diagnostic tool with a sensitivity of 82% and specificity of 62% for detecting nonalcoholic fatty liver disease in obese adolescents. Our study aimed to explore the potential relationship between the HEPAKID index and risk factors contributing to the development of cardiovascular disease in obese adolescents with metabolic syndrome. This prospective cross-sectional study, conducted at two medical centers from December 2023 to March 2024, included 208 obese adolescents, with a median age of 14.5 years and an average body mass index (BMI) of 30.57 kg/m. Elevated HEPAKID index values were found in obese adolescents with metabolic syndrome, showing positive associations with BMI, waist and hip circumferences, alanine aminotransferase level, fasting insulin, and homeostasis model assessment for insulin resistance. In those with metabolic syndrome, waist circumference (WC) and homeostasis model assessment for insulin resistance were significant independent variables linked to the HEPAKID index, while WC was the sole influencer in the nonmetabolic syndrome group. Multivariate logistic regression highlighted systolic and diastolic blood pressures, triglycerides, high-density lipoprotein cholesterol, and the HEPAKID index as reliable predictors of metabolic syndrome. A predictive cutoff value of 60.84 for the HEPAKID index showed 61.7% sensitivity and 59.1% specificity in identifying metabolic syndrome. Our study highlighted the potential value of the HEPAKID index in combination with other clinical parameters for predicting metabolic syndrome in obese adolescents, underscoring its role as a valuable screening tool. Furthermore, our findings revealed a correlation between the HEPAKID index and insulin sensitivity in this high-risk population.
HEPAKID指数是一种新型诊断工具,用于检测肥胖青少年的非酒精性脂肪性肝病时,其灵敏度为82%,特异性为62%。我们的研究旨在探讨HEPAKID指数与导致肥胖且患有代谢综合征的青少年发生心血管疾病的危险因素之间的潜在关系。这项前瞻性横断面研究于2023年12月至2024年3月在两个医疗中心进行,纳入了208名肥胖青少年,中位年龄为14.5岁,平均体重指数(BMI)为30.57kg/m。在患有代谢综合征的肥胖青少年中发现HEPAKID指数值升高,显示出与BMI、腰围和臀围、丙氨酸转氨酶水平、空腹胰岛素以及胰岛素抵抗的稳态模型评估呈正相关。在患有代谢综合征的青少年中,腰围(WC)和胰岛素抵抗的稳态模型评估是与HEPAKID指数相关的显著独立变量,而在非代谢综合征组中,WC是唯一的影响因素。多变量逻辑回归强调收缩压和舒张压、甘油三酯、高密度脂蛋白胆固醇以及HEPAKID指数是代谢综合征的可靠预测指标。HEPAKID指数的预测临界值为60.84时,在识别代谢综合征方面显示出61.7%的灵敏度和59.1%的特异性。我们的研究强调了HEPAKID指数与其他临床参数相结合在预测肥胖青少年代谢综合征方面的潜在价值,突出了其作为一种有价值筛查工具的作用。此外,我们的研究结果揭示了在这一高危人群中HEPAKID指数与胰岛素敏感性之间的相关性。