Metabolic Syndrome Indices in the Prediction of Cardiometabolic Risk in Children with Morbid Obesity and Metabolic Syndrome

Authors: Mustafa M. Donma

Abstract:

Metabolic syndrome (MetS) is characterized, in the first instance, by central obesity accompanied by disturbed blood pressure, glucose and certain lipid fractions. Pediatric MetS is the predictor of MetS in adulthood commonly associated with cardiovascular diseases (CVDs). Since MetS is such a complicated health problem, attempts have been made to eliminate this problem. For this, many formulas have been developed. However, most of them require sophisticated mathematical expressions, which make their usage in clinics difficult. Out of the overall complications, the most important problem, which draws attention was the possibility of developing CVDs. Alanine aminotransferase-to-aspartate aminotransferase (ALT/AST) ratio is proven to be linked to cardiometabolic risk. The aim of this study was to introduce the possible association of an easily applicable formula with ALT/AST. The study population was composed of 88 morbid obese (MO) children. The first group was MO group, second group was MetS group. Each group consisted of 44 children. Ethics Committee Approval and Informed Consent Forms were taken. World Health Organization Obesity Criteria and International Diabetes Federation Metabolic Syndrome Criteria were used for the selection of the participants in groups. Blood pressure values were determined. Routine laboratory tests were performed. ALT/AST, homeostatic model assessment for insulin resistance (HOMA-IR), metabolic syndrome insulin resistance index (MetS-IR), diagnostic obesity notation model assessment metabolic syndrome index (DMetSI) were calculated. Statistical evaluation of the data was performed. All indices exhibited increased values in MetS group compared to those calculated for MO group. Increase in the median values for MetS-IR in MetS group was less than two-fold. On the other hand, about a three-fold increase was observed for DMetSI in MetS group in comparison with the value obtained in MO group. Correlation between ALT/AST ratio and DMetSI was stronger than correlation between ALT/AST and MetS-IR. Besides, DMetSI had no sophisticated mathematical expressions in the formula. In conclusion, two indices, MetS-IR and DMetSI, which were found to be much higher in MetS group and associations of both with ALT/AST ratio have indicated their potential as the tools for use in differential diagnosis of MO and MetS. However, much higher association with ALT/AST, both an insulin resistance as well as a cardiometabolic ratio, easily applicable nature of the equation and striking difference between median values of groups suggested that DMetSI showed much higher performance during the selection of MetS cases from MO population of children than the other index.

Keywords: Cardiometabolic risk, childhood, metabolic syndrome, metabolic syndrome index, morbid obesity.

References:

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