Abstract
Body mass index (BMI), usually used as a body fatness marker, does not accurately discriminate between amounts of lean and fat mass, crucial factors in determining metabolic syndrome (MS) risk. We assessed the predictive ability of the estimate of FM (eFM) calculated using the following formula: FM = weight − exp(0.3073 × height2 − 10.0155 ×d-growth-standards/standards/body-mass-index-for-age-bmi-for-age weight− 1 + 0.004571 × weight − 0.9180 × ln(age) + 0.6488 × age0.5 + 0.04723×male + 2.8055) (exp = exponential function, score 1 if child was of black (BA), south Asian (SA), other Asian (AO), or other (other) ethnic origin and score 0 if not, ln = natural logarithmic transformation, male = 1, female = 0), to detect MS in 185 prepubertal obese children compared to other adiposity parameters. The eFM, BMI, waist circumference (WC), body shape index (ABSI), tri-ponderal mass index, and conicity index (C-Index) were calculated. Patients were classified as having MS if they met ≥ 3/5 of the following criteria: WC ≥ 95th percentile; triglycerides ≥ 95th percentile; HDL-cholesterol ≤ 5th percentile; blood pressure ≥ 95th percentile; fasting blood glucose ≥ 100 mg/dL; and/or HOMA-IR ≥ 97.5th percentile. MS occurred in 18.9% of obese subjects (p < 0.001), with a higher prevalence in females vs. males (p = 0.005). The eFM was correlated with BMI, WC, ABSI, and Con-I (p < 0.001). Higher eFM values were present in the MS vs. non-MS group (p < 0.001); the eFM was higher in patients with hypertension and insulin resistance (p < 0.01). The eFM shows a good predictive ability for MS. Additional to BMI, the identification of new parameters determinable with simple anthropometric measures and with a good ability for the early detection of MS, such as the eFM, may be useful in clinical practice, particularly when instrumentation to estimate the body composition is not available.
Highlights
metabolic syndrome (MS) describes the clustering of cardio-metabolic risk factors, such as abdominal obesity, insulin resistance (IR), hypertension, and dyslipidemia, which increases the risk of developing cardiovascular diseases and type 2 diabetes mellitus in adulthood
We retrospectively studied 185 Caucasian obese prepubertal children (110 females and 75 males) aged < 8 years with a Body mass index (BMI) that exceeded the 97th percentile for their age and sex [23]
The estimate of fat mass (FM) (eFM) was correlated with other adiposity indices and metabolic parameters, and a higher eFM was present in MS compared to non-MS subjects
Summary
Childhood obesity is a global health issue with a considerable growth in prevalence in the last four decades [1]. According to a World Health Organization report, in 2016, more than 340 million children and adolescents worldwide were in a condition of excess body weight. The global prevalence of overweight and obesity in males and females aged 5–19 has risen from 4% in 1975 to 18% in 2016 [1,2,3]. Pediatric obesity exposes affected patients to a higher risk of short- and long-term complications [4,5,6], including metabolic syndrome (MS). De Ferranti and Cook reported a 3- to 5-fold higher MS prevalence in pubertal adolescents compared with prepubertal children [8,9] due to the relationship between MS and IR, which is strongly influenced by puberty. The degree of obesity, body composition, and body fat distribution are important factors in determining
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