Sert Sadiye, Büyükinan Muammer, Yılmaz Ahmet Fatih
Department of Paediatrics, Konya Beyhekim Training and Research Hospital, Konya, Turkey.
Department of Paediatric Endocrinology, Selcuk University Medical School, Konya, Turkey.
Metab Syndr Relat Disord. 2025 Mar;23(2):114-127. doi: 10.1089/met.2024.0197. Epub 2025 Feb 3.
The objective of this study was to evaluate the utility of wrist circumference (WrC) as a predictor of abnormal cardiometabolic risk (CMR) in children and adolescents with obesity. A cross-sectional study was conducted from July 2024 to September 2024. Children with obesity (aged 5-17.9 years) were categorized into metabolic syndrome (MetS) and non-MetS groups according to the International Diabetes Federation consensus criteria for pediatric MetS. Participants were divided into three groups based on their pubertal stages: pre-pubertal, pubertal, and post-pubertal. A total of 307 children and adolescents with obesity were analyzed, comprising 160 females and 147 males, with a median age of 12.9 years (interquartile range 4.2). MetS was diagnosed in 94 participants (30.6%). Participants with MetS demonstrated significantly higher waist circumference, WrC, body mass index (BMI), blood pressure, serum triglycerides, fasting plasma glucose, insulin levels, and homeostasis model assessment of insulin resistance, alongside lower high-density lipoprotein-cholesterol (HDL-C) levels compared with those without MetS. In correlation analyses, WrC positively correlated with age, BMI, and various metabolic parameters, while it negatively correlated with HDL-C levels. Logistic regression analysis identified the pubertal stage and WrC as the strongest independent predictors of MetS. In the mid-pubertal group, a cutoff of 1.795 (96.2nd percentile) for the WrC z-score effectively predicted MetS in children with obesity. In the post-pubertal group, a cutoff of 1.805 (96.7th percentile) for the WrC z-score effectively predicted MetS in children with obesity. Participants with increased WrC presented significantly higher rates of hypertension and MetS in both the mid-pubertal and post-pubertal groups. This study demonstrates that WrC is significantly elevated in children with obesity diagnosed with MetS compared with their non-MetS counterparts. Furthermore, findings indicate that mid-pubertal and post-pubertal subjects with increased WrC are at a greater risk of presenting CMR factors than those with normal WrC values.
本研究的目的是评估腕围（WrC）作为肥胖儿童和青少年心脏代谢风险（CMR）异常预测指标的效用。于2024年7月至2024年9月进行了一项横断面研究。肥胖儿童（5至17.9岁）根据国际糖尿病联盟小儿代谢综合征共识标准被分为代谢综合征（MetS）组和非MetS组。参与者根据青春期阶段分为三组：青春期前、青春期和青春期后。共分析了307名肥胖儿童和青少年，其中160名女性和147名男性，中位年龄为12.9岁（四分位间距4.2）。94名参与者（30.6%）被诊断为MetS。与非MetS参与者相比，MetS参与者的腰围、WrC、体重指数（BMI）、血压、血清甘油三酯、空腹血糖、胰岛素水平以及胰岛素抵抗的稳态模型评估显著更高，而高密度脂蛋白胆固醇（HDL-C）水平更低。在相关性分析中，WrC与年龄、BMI和各种代谢参数呈正相关，而与HDL-C水平呈负相关。逻辑回归分析确定青春期阶段和WrC是MetS最强的独立预测因素。在青春期中期组中，WrC z评分的截断值为1.795（第96.2百分位数）可有效预测肥胖儿童的MetS。在青春期后期组中，WrC z评分的截断值为1.805（第96.7百分位数）可有效预测肥胖儿童的MetS。在青春期中期和后期组中，WrC增加的参与者患高血压和MetS的比例显著更高。本研究表明，与非MetS肥胖儿童相比，被诊断为MetS的肥胖儿童的WrC显著升高。此外，研究结果表明，青春期中期和后期WrC增加的受试者比WrC值正常的受试者出现CMR因素的风险更大。
