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TriGlycerides and high-density lipoprotein cholesterol ratio compared with homeostasis model assessment insulin resistance indexes in screening for metabolic syndrome in the chinese obese children: a cross section study.

Liang J, Fu J, Jiang Y, Dong G, Wang X, Wu W - BMC Pediatr (2015)

Bottom Line: The cut-off values for MS were: TG/HDL-C ratio > 1.25 (sensitivity: 80%; specificity: 75%), HOMA1-IR > 4.59 (sensitivity: 58.7%; specificity: 65.5%) and HOMA2-IR > 2.76 (sensitivity: 53.2%; specificity: 69.5%).The results kept robust after stratified by gender, age group and pubertal stage.TG/HDL-C ratio has a discriminatory power in detecting potential MS in the Chinese obese pediatric population.

View Article: PubMed Central - PubMed

Affiliation: Biostatistics Unit of the Children's Hospital, Zhejiang University, School of Medicine, Hangzhou, 310003, China. LIANGJIANFENG@ZJU.EDU.CN.

ABSTRACT

Background: Metabolic Syndrome (MS) is prevalant in China, especially according to the pediatric obesity group. Based on the MS-CHN2012 definition for Chinese children and adolescents the need to explore and establish a convienent MS screening become imminent. This study aims to investigate the optimal cut-off values, compare the accuracy for the (TriGlycerides (TG) to High-Density Lipoprotein Cholesterol (HDL-C)) (TG/HDL-C) ratio and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) indexs to identify Metabolic Syndrome in obese pediatric population in China.

Method: A total sample of 976 children (female 286 male 690, BMI > = 95 percentile) aged from 6-16 years underwent a medical assessment including a physical examination and investigations of total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, insulin, glucose, and oral glucose tolerance test to identify the components of Metabolic Syndrome. The validity and accuracy between TG/HDL-C ratio and HOMA-IR were compared by Receiver Operating Characteristics analysis (ROC).

Result: TG/HDL-C ratio achieved a larger ROC Area under Curve (AUC = 0.843) than HOMA-IR indexes (0.640, 0.625 for HOMA1-IR, HOMA2-IR respectively) to screen for Metabolic Syndrome. The cut-off values for MS were: TG/HDL-C ratio > 1.25 (sensitivity: 80%; specificity: 75%), HOMA1-IR > 4.59 (sensitivity: 58.7%; specificity: 65.5%) and HOMA2-IR > 2.76 (sensitivity: 53.2%; specificity: 69.5%). The results kept robust after stratified by gender, age group and pubertal stage.

Discussion: TG/HDL-C ratio was a better indicator than the HOMA-IR to screen for a positive diagnosis for MS. Furthermore, the TG/HDL-C ratio was superior to the HOMA-IR indexes even after the control of possible confusions from the gender, age group and puberty stage.

Conclusion: TG/HDL-C ratio proved a better index than HOMA-IR in screening for MS in obese children and adolescents. TG/HDL-C ratio has a discriminatory power in detecting potential MS in the Chinese obese pediatric population.

No MeSH data available.


Related in: MedlinePlus

ROC comparisons of HOMA-IR and TG/HDL-C stratified by sex, age group and pubertal stage. AUC-ROC Z statistic for pairwise comparison of AUC: HOMA1-IR = HOMA2-IR, p > 0.05; HOMA1-IR < TG/HDL-C, p < 0.05; HOMA2-IR < TG/HDL-C, p < 0.05; When stratified by sex a female, b male; age group c (<10 years), d (> = 10 years); pubertal stage (pre-pubertal stage) (e), (pubertal stage) (f)
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Fig1: ROC comparisons of HOMA-IR and TG/HDL-C stratified by sex, age group and pubertal stage. AUC-ROC Z statistic for pairwise comparison of AUC: HOMA1-IR = HOMA2-IR, p > 0.05; HOMA1-IR < TG/HDL-C, p < 0.05; HOMA2-IR < TG/HDL-C, p < 0.05; When stratified by sex a female, b male; age group c (<10 years), d (> = 10 years); pubertal stage (pre-pubertal stage) (e), (pubertal stage) (f)

Mentions: Figure 1 represents the age group, pubertal stage and sex-specific ROC curve analyses, respectively. The ROC curves visually represent the relationship between sensitivity (true positive rate) and 1-specificity (false positive rate) over the entire range of the index value. All the curves (Fig. 1) were significantly greater than what were expected by chance stratification by the age group, puberty stage and sex. Analysis of the data indicated significant differences in ROC curves, with TG/HDL-C performing reasonably better than HOMA1-IR or HOMA2-IR in identifying MS in obese adolescents, and no difference in ROC curves were found between HOMA1-IR and HOMA2-IR (p > 0.05).Fig. 1


TriGlycerides and high-density lipoprotein cholesterol ratio compared with homeostasis model assessment insulin resistance indexes in screening for metabolic syndrome in the chinese obese children: a cross section study.

Liang J, Fu J, Jiang Y, Dong G, Wang X, Wu W - BMC Pediatr (2015)

ROC comparisons of HOMA-IR and TG/HDL-C stratified by sex, age group and pubertal stage. AUC-ROC Z statistic for pairwise comparison of AUC: HOMA1-IR = HOMA2-IR, p > 0.05; HOMA1-IR < TG/HDL-C, p < 0.05; HOMA2-IR < TG/HDL-C, p < 0.05; When stratified by sex a female, b male; age group c (<10 years), d (> = 10 years); pubertal stage (pre-pubertal stage) (e), (pubertal stage) (f)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4587405&req=5

Fig1: ROC comparisons of HOMA-IR and TG/HDL-C stratified by sex, age group and pubertal stage. AUC-ROC Z statistic for pairwise comparison of AUC: HOMA1-IR = HOMA2-IR, p > 0.05; HOMA1-IR < TG/HDL-C, p < 0.05; HOMA2-IR < TG/HDL-C, p < 0.05; When stratified by sex a female, b male; age group c (<10 years), d (> = 10 years); pubertal stage (pre-pubertal stage) (e), (pubertal stage) (f)
Mentions: Figure 1 represents the age group, pubertal stage and sex-specific ROC curve analyses, respectively. The ROC curves visually represent the relationship between sensitivity (true positive rate) and 1-specificity (false positive rate) over the entire range of the index value. All the curves (Fig. 1) were significantly greater than what were expected by chance stratification by the age group, puberty stage and sex. Analysis of the data indicated significant differences in ROC curves, with TG/HDL-C performing reasonably better than HOMA1-IR or HOMA2-IR in identifying MS in obese adolescents, and no difference in ROC curves were found between HOMA1-IR and HOMA2-IR (p > 0.05).Fig. 1

Bottom Line: The cut-off values for MS were: TG/HDL-C ratio > 1.25 (sensitivity: 80%; specificity: 75%), HOMA1-IR > 4.59 (sensitivity: 58.7%; specificity: 65.5%) and HOMA2-IR > 2.76 (sensitivity: 53.2%; specificity: 69.5%).The results kept robust after stratified by gender, age group and pubertal stage.TG/HDL-C ratio has a discriminatory power in detecting potential MS in the Chinese obese pediatric population.

View Article: PubMed Central - PubMed

Affiliation: Biostatistics Unit of the Children's Hospital, Zhejiang University, School of Medicine, Hangzhou, 310003, China. LIANGJIANFENG@ZJU.EDU.CN.

ABSTRACT

Background: Metabolic Syndrome (MS) is prevalant in China, especially according to the pediatric obesity group. Based on the MS-CHN2012 definition for Chinese children and adolescents the need to explore and establish a convienent MS screening become imminent. This study aims to investigate the optimal cut-off values, compare the accuracy for the (TriGlycerides (TG) to High-Density Lipoprotein Cholesterol (HDL-C)) (TG/HDL-C) ratio and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) indexs to identify Metabolic Syndrome in obese pediatric population in China.

Method: A total sample of 976 children (female 286 male 690, BMI > = 95 percentile) aged from 6-16 years underwent a medical assessment including a physical examination and investigations of total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, insulin, glucose, and oral glucose tolerance test to identify the components of Metabolic Syndrome. The validity and accuracy between TG/HDL-C ratio and HOMA-IR were compared by Receiver Operating Characteristics analysis (ROC).

Result: TG/HDL-C ratio achieved a larger ROC Area under Curve (AUC = 0.843) than HOMA-IR indexes (0.640, 0.625 for HOMA1-IR, HOMA2-IR respectively) to screen for Metabolic Syndrome. The cut-off values for MS were: TG/HDL-C ratio > 1.25 (sensitivity: 80%; specificity: 75%), HOMA1-IR > 4.59 (sensitivity: 58.7%; specificity: 65.5%) and HOMA2-IR > 2.76 (sensitivity: 53.2%; specificity: 69.5%). The results kept robust after stratified by gender, age group and pubertal stage.

Discussion: TG/HDL-C ratio was a better indicator than the HOMA-IR to screen for a positive diagnosis for MS. Furthermore, the TG/HDL-C ratio was superior to the HOMA-IR indexes even after the control of possible confusions from the gender, age group and puberty stage.

Conclusion: TG/HDL-C ratio proved a better index than HOMA-IR in screening for MS in obese children and adolescents. TG/HDL-C ratio has a discriminatory power in detecting potential MS in the Chinese obese pediatric population.

No MeSH data available.


Related in: MedlinePlus