Tri-Ponderal Mass Index vs. Fat Mass/Height³ as a Screening Tool for Metabolic Syndrome Prediction in Colombian Children and Young People.

Hugo Carrillo,Antonio García-Hermoso,Jacqueline Schmidt-Riovalle,Robinson Ramírez-Vélez,Emilio González-Jiménez,María Correa-Rodríguez,Jorge Correa-Bautista,Katherine González-Ruíz

doi:10.3390/nu10040412

Abstract

Tri-ponderal mass index (TMI) and fat mass index (FMI) have been proposed as alternative approaches for assessing body fat since BMI does not ensure an accurate screening for obesity and overweight status in children and adolescents. This study proposes thresholds of the TMI and FMI for the prediction of metabolic syndrome (MetS) in children and young people. For this purpose, a cross-sectional study was conducted on 4673 participants (57.1% females), who were 9–25 years of age. As part of the study, measurements of the subjects’ weight, waist circumference, serum lipid indices, blood pressure and fasting plasma glucose were taken. Body composition was measured by bioelectrical impedance analysis (BIA). The TMI and FMI were calculated as weight (kg)/height (m3) and fat mass (kg)/height (m3), respectively. Following the International Diabetes Federation (IDF) definition, MetS is defined as including three or more metabolic abnormalities. Cohort-specific thresholds were established to identify Colombian children and young people at high risk of MetS. The thresholds were applied to the following groups: (i) a cohort of children where the girls’ TMI ≥ 12.13 kg/m3 and the boys’ TMI ≥ 12.10 kg/m3; (ii) a cohort of adolescents where the girls’ TMI ≥ 12.48 kg/m3 and the boys’ TMI ≥ 11.19 kg/m3; (iii) a cohort of young adults where the women’s TMI ≥ 13.21 kg/m3 and the men’s TMI ≥ 12.19 kg/m3. The FMI reference cut-off values used for the different groups were as follows: (i) a cohort of children where the girls’ FMI ≥ 2.59 fat mass/m3 and the boys’ FMI ≥ 1.98 fat mass/m3; (ii) a cohort of adolescents where the girls’ FMI ≥ 3.12 fat mass/m3 and the boys’ FMI ≥ 1.46 fat mass/m3; (iii) a cohort of adults where the women’s FMI ≥ 3.27 kg/m3 and the men’s FMI ≥ 1.65 kg/m3. Our results showed that the FMI and TMI had a moderate discriminatory power to detect MetS in Colombian children, adolescents, and young adults.

Highlights

Metabolic syndrome (MetS) is a set of metabolic abnormalities that are risk factors for cardiovascular disease (CVD), diabetes mellitus type 2 (DM-2), and atherosclerosis [1]
As obesity plays a central role in MetS and since the probability of childhood obesity persisting into adulthood is estimated to increase from ~20% at the age of four to 80% by adolescence, the epidemic of pediatric obesity can result in an increased prevalence of hypertension, DM-2, and CVD in adulthood [9]
In the cohort of children, girls were found to have a significantly lower waist circumference (WC), HDL, and glucose level as well as a greater quantity of body fat (%), fat mass index (FMI), and triglycerides compared to boys (p < 0.05)

Summary

Introduction

Metabolic syndrome (MetS) is a set of metabolic abnormalities that are risk factors for cardiovascular disease (CVD), diabetes mellitus type 2 (DM-2), and atherosclerosis [1]. As obesity plays a central role in MetS and since the probability of childhood obesity persisting into adulthood is estimated to increase from ~20% at the age of four to 80% by adolescence, the epidemic of pediatric obesity can result in an increased prevalence of hypertension, DM-2, and CVD in adulthood [9]. In this context, the over-accumulation of body fat correlates epidemiologically with various pathophysiological sequelae, including a higher incidence of MetS, which is usually associated with CVD mortality [10]. Epidemiological studies have reported an association of fat distribution and metabolic risk factors, including high blood pressure, hyperglycemia, and dyslipidemia, with a risk of MetS in Colombian children and young people [11,12]

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