The Relationship Between Tri-ponderal Mass Index and Metabolic Syndrome and Its Components in Youth Aged 10\u201320 Years

Young Suk Shim

doi:10.1038/s41598-019-50987-3

Abstract

The current study aimed to evaluate the distribution of the tri-ponderal mass index (TMI) according to sex and age and the relationship of obesity groups according to sex- and age-specific TMI with metabolic syndrome (MetS) and its components. A total of 8,464 subjects aged 10–20 years were classified into 4 groups according to sex- and age-specific TMI: (i) underweight, (ii) normal weight, (iii) overweight, and (iv) obese. The range of the 50th percentiles of TMI was from 13.24 kg/m3 at 10 years to 12.94 kg/m3 at 20 years among males and from 12.19 kg/m3 to 12.84 kg/m3 among females. In the analysis of covariance, obesity groups according to sex- and age-specific TMI were positively correlated with waist circumference (WC) standard deviation score; systolic blood pressure (BP); diastolic BP; and levels of glucose, total cholesterol, triglycerides (TGs), and low-density lipoprotein cholesterol, but for both sexes, the obesity groups were negatively related to high-density lipoprotein cholesterol (HDL-C). In the multiple logistic regression, subjects in the overweight group had higher odds ratios (ORs) for elevated WC (29.18), elevated BP (1.33), elevated TGs (2.55), reduced HDL-C (2.31), and MetS (8.93) than those with normal weight. Participants in the obesity group had increased ORs for elevated WC (154.67), elevated BP (2.22), elevated glucose (3.54), elevated TGs (4.12), reduced HDL-C (3.69), and MetS (25.57) compared to participants with normal weight after adjustment for confounders. Our results suggest that sex- and age-specific TMI may be applicable in the clinical setting as a useful screening tool.

Highlights

To date, body mass index (BMI), which is the ratio of body weight to height squared, has been used for the classification of excess body fat in children, adolescents and adults
The boys and men in the obesity group according to sex and age-specific tri-ponderal mass index (TMI) had a higher mean weight standard deviation score (SDS) (P < 0.001), waist circumference (WC) SDS (P < 0.001), BMI SDS (P < 0.001), TMI SDS (P < 0.001), systolic blood pressure (BP) (SBP) (P < 0.001), diastolic BP (DBP) (P < 0.001), glucose level (P < 0.001), total cholesterol (T-C) level (P < 0.001), TG level (P < 0.001), and low-density lipoprotein cholesterol (LDLC) level (P < 0.001), whereas they had a lower mean high-density lipoprotein cholesterol (HDL-C) level (P < 0.001)
A covariance analysis revealed that obesity groups categorized according to sex- and age-specific TMI were positively correlated with WC SDS; SBP; DBP; and levels of www.nature.com/scientificreports

Summary

Introduction

Body mass index (BMI), which is the ratio of body weight to height squared (kg/m2), has been used for the classification of excess body fat in children, adolescents and adults. Instead of BMI values, the standard deviation score (SDS) of BMI is used for the classification of obesity among children and adolescents. This approach is considered to have difficulties taking into account that both body proportions and body fat levels change during the adolescent growth period. A recent study suggested that the tri-ponderal mass index (TMI), which is the ratio of body weight to height cubed (kg/m3), is apparently stable during adolescence and could estimate body fat levels more accurately than BMI, especially in children and adolescents[8]. We aimed to evaluate the distribution of TMI according to sex and age and the relationship between obesity groups according to sex- and age-specific TMI and MetS and its components, which are considered a surrogate for cardiometabolic risk factors, using nationally representative data in youth aged 10–20 years

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