Grugni Graziano, Lupi Fiorenzo, Bonetti Mirko, Bocchini Sarah, Bucolo Carmen, Corica Domenico, Crinò Antonino, Faienza Maria Felicia, Fintini Danilo, Licenziati Maria Rosaria, Maghnie Mohamad, Mozzillo Enza, Pajno Roberta, Zampino Giuseppe, Sartorio Alessandro, Radetti Giorgio
Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Piancavallo, 28824 Verbania, Italy.
Division of Neonatology/NICU, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), 39100 Bolzano, Italy.
J Clin Med. 2025 Jul 3;14(13):4716. doi: 10.3390/jcm14134716.
Currently, there is a lack of data regarding the reliability of different anthropometric, instrumental, and biochemical indexes in detecting metabolic syndrome (MetS) in pediatric patients with Prader-Willi syndrome (PWS). Therefore, this study aimed to compare the accuracy of different indices to identify the simplest and most accurate predictor of MetS in this at-risk population. We conducted a multicenter study involving 124 children and adolescents with PWS (61 males and 63 females), aged 13.6 ± 3.7 years. For each participant, we assessed all components of MetS, defined according to either the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study or the International Diabetes Federation (IDF) criteria, based on age. The following indexes were calculated: Body Mass Index (BMI), BMI standard deviation score (BMI-SDS), tri-ponderal mass index, body mass fat index, fat mass index, fat-free mass index, body shape index, visceral adiposity index, waist-to-height ratio, cardiometabolic index, total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio, and triglycerides/HDL-C (TG/HDL-C) ratio. MetS was identified in 24 subjects (9 females and 15 males), representing 19.4% of the sample. When comparing the receiver operating characteristic (ROC) curves, the TG/HDL-C ratio and cardiometabolic index demonstrated significantly better performance than the other indices in detecting MetS, with no difference between the two. As a result, we focused on the TG/HDL-C ratio since it is the simplest measure, requiring no additional anthropometric data compared to the cardiometabolic index. Additionally, applying age- and gender-specific thresholds can further improve its accuracy. The TG/HDL-C ratio, which requires only two standard biochemical markers, provides the same accuracy as more complex indexes in detecting MetS in children and adolescents with PWS, making it the optimal predictor for MetS in this population.
目前，关于不同人体测量学、仪器测量和生化指标在检测普拉德-威利综合征（PWS）儿科患者代谢综合征（MetS）方面的可靠性，缺乏相关数据。因此，本研究旨在比较不同指标的准确性，以确定该高危人群中代谢综合征最简单、最准确的预测指标。我们进行了一项多中心研究，纳入了124名患有PWS的儿童和青少年（61名男性和63名女性），年龄为13.6±3.7岁。对于每位参与者，我们根据年龄，按照儿童和婴儿饮食与生活方式诱发健康效应的识别与预防（IDEFICS）研究或国际糖尿病联盟（IDF）标准，评估了代谢综合征的所有组成部分。计算了以下指标：体重指数（BMI）、BMI标准差评分（BMI-SDS）、三重量指数、身体脂肪质量指数、脂肪质量指数、无脂肪质量指数、身体形状指数、内脏脂肪指数、腰高比、心脏代谢指数、总胆固醇/高密度脂蛋白胆固醇（HDL-C）比值以及甘油三酯/HDL-C（TG/HDL-C）比值。在24名受试者（9名女性和15名男性）中识别出了代谢综合征，占样本的19.4%。比较受试者工作特征（ROC）曲线时，TG/HDL-C比值和心脏代谢指数在检测代谢综合征方面的表现明显优于其他指标，两者之间无差异。因此，我们关注TG/HDL-C比值，因为它是最简单的测量指标，与心脏代谢指数相比，无需额外的人体测量数据。此外，应用年龄和性别特异性阈值可进一步提高其准确性。TG/HDL-C比值仅需两个标准生化指标，在检测患有PWS的儿童和青少年的代谢综合征方面，与更复杂的指标具有相同的准确性，使其成为该人群中代谢综合征的最佳预测指标。
