Search results for: Surrogate%20Fuel

Authors: Varsha Gupta, Priya Datta, Gursimran Mohi, Jagdish Chander

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Fluoroquinolones form the mainstay of therapy for the treatment of infections due to Salmonella enterica subsp. enterica. There is a complex interplay between several resistance mechanisms for quinolones and various fluoroquinolones discs, giving varying results, making detection and interpretation of fluoroquinolone resistance difficult. For detection of fluoroquinolone resistance in Salmonella ssp., we compared the use of pefloxacin and nalidixic acid discs as surrogate marker. Using MIC for ciprofloxacin as the gold standard, 43.5% of strains showed MIC as ≥1 μg/ml and were thus resistant to fluoroquinoloes. Based on the performance of nalidixic acid and pefloxacin discs as surrogate marker for ciprofloxacin resistance, both the discs could correctly detect all the resistant phenotypes; however, use of nalidixic acid disc showed false resistance in the majority of the sensitive phenotypes. We have also tested newer antimicrobial agents like cefixime, imipenem, tigecycline and azithromycin against Salmonella spp. Moreover, there was a comeback of susceptibility to older antimicrobials like ampicillin, chloramphenicol, and cotrimoxazole. We can also use cefixime, imipenem, tigecycline and azithromycin in the treatment of multidrug resistant S. typhi due to their high susceptibility.

Keywords: Pefloxacin, salmonella, surrogate marker.

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Authors: Sanga Monthatipkul, Pio Iovenitti, Igor Sbarski

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Bicycle usage for exercise, recreation, and commuting to work in Australia shows that pedal cycling is the fourth most popular activity with 10.6% increase in participants between 2001 and 2007. As with other means of transport, accident and injury becomes common although mandatory bicycle helmet wearing has been introduced. The research aims to develop a face surrogate made of sandwich of rigid foam and rubber sheets to represent human facial bone under blunt impact. The facial surrogate will serve as an important test device for further development of facial-impact protection for cyclist. A test procedure was developed to simulate the energy of impact and record data to evaluate the effect of impact on facial bones. Drop tests were performed to establish a suitable combination of materials. It was found that the sandwich structure of rigid extruded-polystyrene foam (density of 40 kg/m3 with a pattern of 6-mm-holes), Neoprene rubber sponge, and Abrasaflex rubber backing, had impact characteristics comparable to that of human facial bone. In particular, the foam thickness of 30 mm and 25 mm was found suitable to represent human zygoma (cheekbone) and maxilla (upper-jaw bone), respectively.

Keywords: Facial impact protection, face surrogate, cyclist, accident prevention

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Authors: M. R. Ghasemi, R. Ghiasi, H. Varaee

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Surrogate model has received increasing attention for use in detecting damage of structures based on vibration modal parameters. However, uncertainties existing in the measured vibration data may lead to false or unreliable output result from such model. In this study, an efficient approach based on Monte Carlo simulation is proposed to take into account the effect of uncertainties in developing a surrogate model. The probability of damage existence (PDE) is calculated based on the probability density function of the existence of undamaged and damaged states. The kriging technique allows one to genuinely quantify the surrogate error, therefore it is chosen as metamodeling technique. Enhanced version of ideal gas molecular movement (EIGMM) algorithm is used as main algorithm for model updating. The developed approach is applied to detect simulated damage in numerical models of 72-bar space truss and 120-bar dome truss. The simulation results show the proposed method can perform well in probability-based damage detection of structures with less computational effort compared to direct finite element model.

Keywords: Enhanced ideal gas molecular movement, Kriging, probability-based damage detection, probability of damage existence, surrogate modeling, uncertainty quantification.

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Authors: Tunjo Peric, Zoran Babic

Abstract:

The authors of this work indicate by means of a concrete example that it is possible to apply efficaciously the method of multiple criteria programming in dealing with the problem of determining the optimal production plan for a certain period of time. The work presents: (1) the selection of optimization criteria, (2) the setting of the problem of determining an optimal production plan, (3) the setting of the model of multiple criteria programming in finding a solution to a given problem, (4) the revised surrogate trade-off method, (5) generalized multicriteria model for solving production planning problem and problem of choosing technological variants in the metal manufacturing industry. In the final part of this work the authors reflect on the application of the method of multiple criteria programming while determining the optimal production plan in manufacturing enterprises.

Keywords: multi-criteria programming, production planning, technological variant, Surrogate Worth Trade-off Method.

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Authors: I. S. Jung, W. H. Jung, S. H. Baek, S. Kang

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This paper describes the shape optimization of impeller blades for a anti-heeling bidirectional axial flow pump used in ships. In general, a bidirectional axial pump has an efficiency much lower than the classical unidirectional pump because of the symmetry of the blade type. In this paper, by focusing on a pump impeller, the shape of blades is redesigned to reach a higher efficiency in a bidirectional axial pump. The commercial code employed in this simulation is CFX v.13. CFD result of pump torque, head, and hydraulic efficiency was compared. The orthogonal array (OA) and analysis of variance (ANOVA) techniques and surrogate model based optimization using orthogonal polynomial, are employed to determine the main effects and their optimal design variables. According to the optimal design, we confirm an effective design variable in impeller blades and explain the optimal solution, the usefulness for satisfying the constraints of pump torque and head.

Keywords: Bidirectional axial flow pump, Impeller blade, CFD, Analysis of variance, Polynomial surrogate model

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Authors: Bekir O. Bartin, Kaan Ozbay, Sandeep Mudigonda, Hong Yang

Abstract:

The use of microscopic traffic simulation in evaluating the operational and safety conditions at toll plazas is demonstrated. Two toll plazas in New Jersey are selected as case studies and were developed and validated in Paramics traffic simulation software. In order to simulate drivers’ lane selection behavior in Paramics, a utility-based lane selection approach is implemented in Paramics Application Programming Interface (API). For each vehicle approaching the toll plaza, a utility value is assigned to each toll lane by taking into account the factors that are likely to impact drivers’ lane selection behavior, such as approach lane, exit lane and queue lengths. The results demonstrate that similar operational conditions, such as lane-by-lane toll plaza traffic volume can be attained using this approach. In addition, assessment of safety at toll plazas is conducted via a surrogate safety measure. In particular, the crash index (CI), an improved surrogate measure of time-to-collision (TTC), which reflects the severity of a crash is used in the simulation analyses. The results indicate that the spatial and temporal frequency of observed crashes can be simulated using the proposed methodology. Further analyses can be conducted to evaluate and compare various different operational decisions and safety measures using microscopic simulation models.

Keywords: Microscopic simulation, toll plaza, surrogate safety, application programming interface.

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Authors: Abdulaziz H. El-Sinawi

Abstract:

Some of the polycyclic aromatic hydrocarbons (PAHs) are the strongest known carcinogens compounds; the majority of them are mostly produced by the incomplete combustion of fossil fuels; Motor vehicles are a significant source of polycyclic aromatic hydrocarbon (PAH) where diesel emission is one of the main sources of such compounds available in the ambient air. There is a big concern about the increasing concentration of PAHs in the environment. Researchers are trying to explore optimal methods to reduce those pollutants and improve the quality of air. Water blended fuel is one of the possible approaches to reduce emission of PAHs from the combustion of diesel in urban and domestic vehicles. In this work a modeling study was conducted using CHEMKIN-PRO software to simulate spray combustion at similar diesel engine conditions. Surrogate fuel of (80 % n-heptane and 20 % toluene) was used due to detailed kinetic and thermodynamic data needed for modeling is available for this kind of fuel but not available for diesel. An emulsified fuel with 3, 5, 8, 10 and 20 % water by volume is used as an engine feed for this study. The modeling results show that water has a significant effect on reducing engine soot and PAHs precursors formation up to certain extent.

Keywords: Polycyclic Aromatic Hydrocarbons (PAHs), DieselEngine, Emission, Surrogate Fuel, Emulsified Fuel, Soot precursors, Combustion

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Authors: Abdulbaset Saad, Adel Younis, Zuomin Dong

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For design optimization with high-dimensional expensive problems, an effective and efficient optimization methodology is desired. This work proposes a series of modification to the Differential Evolution (DE) algorithm for solving computation Intensive Black-Box Problems. The proposed methodology is called Radial Basis Meta-Model Algorithm Assisted Differential Evolutionary (RBF-DE), which is a global optimization algorithm based on the meta-modeling techniques. A meta-modeling assisted DE is proposed to solve computationally expensive optimization problems. The Radial Basis Function (RBF) model is used as a surrogate model to approximate the expensive objective function, while DE employs a mechanism to dynamically select the best performing combination of parameters such as differential rate, cross over probability, and population size. The proposed algorithm is tested on benchmark functions and real life practical applications and problems. The test results demonstrate that the proposed algorithm is promising and performs well compared to other optimization algorithms. The proposed algorithm is capable of converging to acceptable and good solutions in terms of accuracy, number of evaluations, and time needed to converge.

Keywords: Differential evolution, engineering design, expensive computations, meta-modeling, radial basis function, optimization.

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Authors: Muqdad Al-Juboori, Bithin Datta

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Hydraulic structures such as gravity dams are classified as essential structures, and have the vital role in providing strong and safe water resource management. Three major aspects must be considered to achieve an effective design of such a structure: 1) The building cost, 2) safety, and 3) accurate analysis of seepage characteristics. Due to the complexity and non-linearity relationships of the seepage process, many approximation theories have been developed; however, the application of these theories results in noticeable errors. The analytical solution, which includes the difficult conformal mapping procedure, could be applied for a simple and symmetrical problem only. Therefore, the objectives of this paper are to: 1) develop a surrogate model based on numerical simulated data using SEEPW software to approximately simulate seepage process related to a hydraulic structure, 2) develop and solve a linked simulation-optimization model based on the developed surrogate model to describe the seepage occurring under a concrete gravity dam, in order to obtain optimum and safe design at minimum cost. The result shows that the linked simulation-optimization model provides an efficient and optimum design of concrete gravity dams.

Keywords: Artificial neural network, concrete gravity dam, genetic algorithm, seepage analysis.

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Authors: David Lindström

Abstract:

We evaluate the performance of a numerical method for global optimization of expensive functions. The method is using a response surface to guide the search for the global optimum. This metamodel could be based on radial basis functions, kriging, or a combination of different models. We discuss how to set the cyclic parameters of the optimization method to get a balance between local and global search. We also discuss the eventual problem with Runge oscillations in the response surface.

Keywords: Expensive function, infill sampling criterion, kriging, global optimization, response surface, Runge phenomenon.

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Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Association between insulin resistance (IR) and hematological parameters has long been a matter of interest. Within this context, body mass index (BMI), red blood cells, white blood cells and platelets were involved in this discussion. Parameters related to platelets associated with IR may be useful indicators for the identification of IR. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) are being questioned for their possible association with IR. The aim of this study was to investigate the association between platelet (PLT) count as well as PLT indices and the surrogate indices used to determine IR in morbid obese (MO) children. A total of 167 children participated in the study. Three groups were constituted. The number of cases was 34, 97 and 36 children in the normal BMI, MO and metabolic syndrome (MetS) groups, respectively. Sex- and age-dependent BMI-based percentile tables prepared by World Health Organization were used for the definition of morbid obesity. MetS criteria were determined. BMI values, homeostatic model assessment for IR (HOMA-IR), alanine transaminase-to-aspartate transaminase ratio (ALT/AST) and diagnostic obesity notation model assessment laboratory (DONMA-lab) index values were computed. PLT count and indices were analyzed using automated hematology analyzer. Data were collected for statistical analysis using SPSS for Windows. Arithmetic mean and standard deviation were calculated. Mean values of PLT-related parameters in both control and study groups were compared by one-way ANOVA followed by Tukey post hoc tests to determine whether a significant difference exists among the groups. The correlation analyses between PLT as well as IR indices were performed. Statistically significant difference was accepted as p-value < 0.05. Increased values were detected for PLT (p < 0.01) and PCT (p > 0.05) in MO group compared to those observed in children with N-BMI. Significant increases for PLT (p < 0.01) and PCT (p < 0.05) were observed in MetS group in comparison with the values obtained in children with N-BMI (p < 0.01). Significantly lower MPV and PDW values were obtained in MO group compared to the control group (p < 0.01). HOMA-IR (p < 0.05), DONMA-lab index (p < 0.001) and ALT/AST (p < 0.001) values in MO and MetS groups were significantly increased compared to the N-BMI group. On the other hand, DONMA-lab index values also differed between MO and MetS groups (p < 0.001). In the MO group, PLT was negatively correlated with MPV and PDW values. These correlations were not observed in the N-BMI group. None of the IR indices exhibited a correlation with PLT and PLT indices in the N-BMI group. HOMA-IR showed significant correlations both with PLT and PCT in the MO group. All of the three IR indices were well-correlated with each other in all groups. These findings point out the missing link between IR and PLT activation. In conclusion, PLT and PCT may be related to IR in addition to their identities as hemostasis markers during morbid obesity. Our findings have suggested that DONMA-lab index appears as the best surrogate marker for IR due to its discriminative feature between morbid obesity and MetS.

Keywords: Children, insulin resistance, metabolic syndrome, plateletcrit, platelet indices.

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Authors: Zhu Xiong-feng, Hou Zhong-xi, Guo Zheng, Liu Zhao-Wei

Abstract:

A method of dynamic mesh based airfoil optimization is proposed according to the drawbacks of surrogate model based airfoil optimization. Programs are designed to achieve the dynamic mesh. Boundary condition is add by integrating commercial software Pointwise, meanwhile the CFD calculation is carried out by commercial software Fluent. The data exchange and communication between the software and programs referred above have been accomplished, and the whole optimization process is performed in iSIGHT platform. A simplified airfoil optimization study case is brought out to show that aerodynamic performances of airfoil have been significantly improved, even save massive repeat operations and increase the robustness and credibility of the optimization result. The case above proclaims that dynamic mesh based airfoil optimization is an effective and high efficient method.

Keywords: unmanned air vehicles, dynamic mesh, airfoil optimization, CFD, genetic algorithm

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Authors: Shumin Hou, Yourong Li, Sanxing Zhao

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Much time series data is generally from continuous dynamic system. Firstly, this paper studies the detection of the nonlinearity of time series from continuous dynamics systems by applying the Phase-randomized surrogate algorithm. Then, the Delay Vector Variance (DVV) method is introduced into nonlinearity test. The results show that under the different sampling conditions, the opposite detection of nonlinearity is obtained via using traditional test statistics methods, which include the third-order autocovariance and the asymmetry due to time reversal. Whereas the DVV method can perform well on determining nonlinear of Lorenz signal. It indicates that the proposed method can describe the continuous dynamics signal effectively.

Keywords: Nonlinearity, Time series, continuous dynamics system, DVV method

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Authors: Ali Emad

Abstract:

Enhancement of the performance of a reverse osmosis (RO) unit through periodic control is studied. The periodic control manipulates the feed pressure and flow rate of the RO unit. To ensure the periodic behavior of the inputs, the manipulated variables (MV) are transformed into the form of sinusoidal functions. In this case, the amplitude and period of the sinusoidal functions become the surrogate MV and are thus regulated via nonlinear model predictive control algorithm. The simulation results indicated that the control system can generate cyclic inputs necessary to enhance the closedloop performance in the sense of increasing the permeate production and lowering the salt concentration. The proposed control system can attain its objective with arbitrary set point for the controlled outputs. Successful results were also obtained in the presence of modeling errors.

Keywords: Reverse osmosis, water desalination, periodic control, model predictive control.

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Authors: Maria Kalinina, Aron Larsson, Leif Olsson

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In the multi objective optimization, in the case when generated set of Pareto optimal solutions is large, occurs the problem to select of the best solution from this set. In this paper, is suggested a method to order of Pareto set. Ordering the Pareto optimal set carried out in conformity with the introduced distance function between each solution and selected reference point, where the reference point may be adjusted to represent the preferences of a decision making agent. Preference information about objective weights from a decision maker may be expressed imprecisely. The developed elicitation procedure provides an opportunity to obtain surrogate numerical weights for the objectives, and thus, to manage impreciseness of preference. The proposed method is a scalable to many objectives and can be used independently or as complementary to the various visualization techniques in the multidimensional case.

Keywords: Imprecise weights, Multiple objectives, Pareto optimality, Visualization.

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Authors: A. Tamošiūnas, P. Valatkevičius, V. Grigaitiene, V. Valinčius

Abstract:

The atmospheric pressure plasma torch with a direct current arc discharge stabilized by water vapor vortex was experimentally investigated. Overheated up to 450K water vapor was used as plasma forming gas. Plasma torch design is one of the most important factors leading to a stable operation of the device. The electrical and thermal characteristics of the plasma torch were determined during the experimental investigations. The design and the basic characteristics of the water vapor plasma torch are presented in the paper. Plasma torches with the electric arc stabilized by water vapor vortex provide special performance characteristics in some plasma processing applications such as thermal plasma neutralization and destruction of organic wastes enabling to extract high caloric value synthesis gas as by-product of the process. Syngas could be used as a surrogate fuel partly replacing the dependence on the fossil fuels or used as a feedstock for hydrogen, methanol production.

Keywords: Arc discharge, atmospheric pressure thermal plasma, plasma torch, water vapor.

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Authors: Lihui Ma, Kunlun Xin, Suiqing Liu

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Modern managements of water distribution system (WDS) need water quality models that are able to accurately predict the dynamics of water quality variations within the distribution system environment. Before water quality models can be applied to solve system problems, they should be calibrated. Although former researchers use GA solver to calibrate relative parameters, it is difficult to apply on the large-scale or medium-scale real system for long computational time. In this paper a new method is designed which combines both macro and detailed model to optimize the water quality parameters. This new combinational algorithm uses radial basis function (RBF) metamodeling as a surrogate to be optimized for the purpose of decreasing the times of time-consuming water quality simulation and can realize rapidly the calibration of pipe wall reaction coefficients of chlorine model of large-scaled WDS. After two cases study this method is testified to be more efficient and promising, and deserve to generalize in the future.

Keywords: Metamodeling, model calibration, radial basisfunction, water distribution system, water quality model.

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Authors: H. N. Mehmanparast, J.M. Mac-Thiong., Y. Petit

Abstract:

Transpedicular screw fixation in spinal fractures, degenerative changes, or deformities is a well-established procedure. However, important rate of fixation failure due to screw bending, loosening, or pullout are still reported particularly in weak bone stock in osteoporosis. To overcome the problem, mechanism of failure has to be fully investigated in vitro. Post-mortem human subjects are less accessible and animal cadavers comprise limitations due to different geometry and mechanical properties. Therefore, the development of a synthetic model mimicking the realistic human vertebra is highly demanded. A bone surrogate, composed of Polyurethane (PU) foam analogous to cancellous bone porous structure, was tested for 3 different densities in this study. The mechanical properties were investigated under uniaxial compression test by minimizing the end artifacts on specimens. The results indicated that PU foam of 0.32 g.cm-3 density has comparable mechanical properties to human cancellous bone in terms of young-s modulus and yield strength. Therefore, the obtained information can be considered as primary step for developing a realistic cancellous bone of human vertebral body. Further evaluations are also recommended for other density groups.

Keywords: Cancellous bone, Pedicle screw, Polyurethane foam, Synthetic bone

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Authors: K. Krishna Veni, S. Raja Balachandar

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This paper presents a heuristic to solve large size 0-1 Multi constrained Knapsack problem (01MKP) which is NP-hard. Many researchers are used heuristic operator to identify the redundant constraints of Linear Programming Problem before applying the regular procedure to solve it. We use the intercept matrix to identify the zero valued variables of 01MKP which is known as redundant variables. In this heuristic, first the dominance property of the intercept matrix of constraints is exploited to reduce the search space to find the optimal or near optimal solutions of 01MKP, second, we improve the solution by using the pseudo-utility ratio based on surrogate constraint of 01MKP. This heuristic is tested for benchmark problems of sizes upto 2500, taken from literature and the results are compared with optimum solutions. Space and computational complexity of solving 01MKP using this approach are also presented. The encouraging results especially for relatively large size test problems indicate that this heuristic can successfully be used for finding good solutions for highly constrained NP-hard problems.

Keywords: 0-1 Multi constrained Knapsack problem, heuristic, computational complexity, NP-Hard problems.

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Authors: Maumita Bhattacharya

Abstract:

Optimization is often a critical issue for most system design problems. Evolutionary Algorithms are population-based, stochastic search techniques, widely used as efficient global optimizers. However, finding optimal solution to complex high dimensional, multimodal problems often require highly computationally expensive function evaluations and hence are practically prohibitive. The Dynamic Approximate Fitness based Hybrid EA (DAFHEA) model presented in our earlier work [14] reduced computation time by controlled use of meta-models to partially replace the actual function evaluation by approximate function evaluation. However, the underlying assumption in DAFHEA is that the training samples for the meta-model are generated from a single uniform model. Situations like model formation involving variable input dimensions and noisy data certainly can not be covered by this assumption. In this paper we present an enhanced version of DAFHEA that incorporates a multiple-model based learning approach for the SVM approximator. DAFHEA-II (the enhanced version of the DAFHEA framework) also overcomes the high computational expense involved with additional clustering requirements of the original DAFHEA framework. The proposed framework has been tested on several benchmark functions and the empirical results illustrate the advantages of the proposed technique.

Keywords: Evolutionary algorithm, Fitness function, Optimization, Meta-model, Stochastic method.

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Authors: Diah Tri Widayati

Abstract:

Various assisted reproductive techniques have been developed and refined to obtain a large number of offspring from genetically superior animals or obtain offspring from infertile (or subfertile) animals. The embryo transfer is one assisted reproductive technique developed well, aimed at increased productivity of selected females, disease control, importation and exportation of livestock, rapid screening of AI sires for genetically recessive characteristics, treatment or circumvention of certain types of infertility. Embryo transfer also is a useful research tool for evaluating fetal and maternal interactions. This technique has been applied to nearly every species of domestic animal and many species of wildlife and exotic animals, including humans and non-human primates. The successful of embryo transfers have been limited to within-animal, homologous replacement of the embryos. There are several examples of interspecific and intergeneric embryo transfers in which embryos implanted but did not develop to term: sheep and goat, mouse and rat. An immunological rejections and placental incompatibility between the embryo and the surrogate mother appear to restrict interspecific embryo transfer/interspecific pregnancy. Recently, preimplantation embryo manipulation procedures have been applied, such as technique of inner cell mass transfer. This technique will possible to overcome the reproductive barrier interspecific embryo transfer/interspecific pregnancy, if there is a protective mechanism which prevents recognition of the foreign fetus by the mother of the other species

Keywords: Embryo Transfer, Assisted Reproductive Techology, Intraspesific-Interspesific Pregnancy, Inner cell mass.

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Authors: Y. Z. Wu, Z. Dong, S. K. You

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Global approximation using metamodel for complex mathematical function or computer model over a large variable domain is often needed in sensibility analysis, computer simulation, optimal control, and global design optimization of complex, multiphysics systems. To overcome the limitations of the existing response surface (RS), surrogate or metamodel modeling methods for complex models over large variable domain, a new adaptive and regressive RS modeling method using quadratic functions and local area model improvement schemes is introduced. The method applies an iterative and Latin hypercube sampling based RS update process, divides the entire domain of design variables into multiple cells, identifies rougher cells with large modeling error, and further divides these cells along the roughest dimension direction. A small number of additional sampling points from the original, expensive model are added over the small and isolated rough cells to improve the RS model locally until the model accuracy criteria are satisfied. The method then combines local RS cells to regenerate the global RS model with satisfactory accuracy. An effective RS cells sorting algorithm is also introduced to improve the efficiency of model evaluation. Benchmark tests are presented and use of the new metamodeling method to replace complex hybrid electrical vehicle powertrain performance model in vehicle design optimization and optimal control are discussed.

Keywords: Global approximation, polynomial response surface, domain decomposition, domain combination, multiphysics modeling, hybrid powertrain optimization

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

A well-defined insulin resistance (IR) is one of the requirements for the good understanding and evaluation of metabolic syndrome (MetS). However, underlying causes for the development of IR are not clear. Endothelial dysfunction also participates in the pathogenesis of this disease. IR indices are being determined in various obesity groups and also in diagnosing MetS. Components of MetS have been well established and used in adult studies. However, there are some ambiguities particularly in the field of pediatrics. The aims of this study were to compare the performance of fasting blood glucose (FBG), one of MetS components, with some other IR indices and check whether FBG may be replaced by some other parameter or ratio for a better evaluation of pediatric MetS. Five-hundred and forty-nine children were involved in the study. Five groups were constituted. Groups 109, 40, 100, 166, 110, 24 children were included in normal-body mass index (N-BMI), overweight (OW), obese (OB), morbid obese (MO), MetS with two components (MetS2) and MetS with three components (MetS3) groups, respectively. Age and sex-adjusted BMI percentiles tabulated by World Health Organization were used for the classification of obesity groups. MetS components were determined. Aside from one of the MetS components-FBG, eight measures of IR [homeostatic model assessment of IR (HOMA-IR), homeostatic model assessment of beta cell function (HOMA-%β), alanine transaminase-to-aspartate transaminase ratio (ALT/AST), alanine transaminase (ALT), insulin (INS), insulin-to-FBG ratio (INS/FBG), the product of fasting triglyceride and glucose (TyG) index, McAuley index] were evaluated. Statistical analyses were performed. A p value less than 0.05 was accepted as the statistically significance degree. Mean values for BMI of the groups were 15.7 kg/m², 21.0 kg/m², 24.7 kg/m², 27.1 kg/m², 28.7 kg/m², 30.4 kg/m² for N-BMI, OW, OB, MO, MetS2, MetS3, respectively. Differences between the groups were significant (p < 0.001). The only exception was MetS2-MetS3 couple, in spite of an increase detected in MetS3 group. Waist-to-hip circumference ratios significantly differed only for N-BMI vs, OB, MO, MetS2; OW vs MO; OB vs MO, MetS2 couples. ALT and ALT/AST did not differ significantly among MO-MetS2-MetS3. HOMA-%β differed only between MO and MetS2. INS/FBG, McAuley index and TyG were not significant between MetS2 and MetS3. HOMA-IR and FBG were not significant between MO and MetS2. INS was the only parameter, which showed statistically significant differences between MO-MetS2, MO-MetS3, and MetS2-MetS3. In conclusion, these findings have suggested that FBG presently considered as one of the five MetS components, may be replaced by INS during the evaluation of pediatric morbid obesity and MetS.

Keywords: Children, insulin resistance indices, metabolic syndrome, obesity.

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Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Morbid obesity is a health threatening condition particularly in children. Generally, it leads to the development of metabolic syndrome (MetS) characterized by central obesity, elevated fasting blood glucose (FBG), triglyceride (TRG), blood pressure values and suppressed high density lipoprotein cholesterol (HDL-C) levels. However, some ambiguities exist during the diagnosis of MetS in children below 10 years of age. Therefore, clinicians are in the need of some surrogate markers for the laboratory assessment of pediatric MetS. In this study, the aim is to develop an index, which will be more helpful during the evaluation of further risks detected in morbid obese (MO) children. A total of 235 children with normal body mass index (N-BMI), with varying degrees of obesity; overweight (OW), obese (OB), MO as well as MetS participated in this study. The study was approved by the Institutional Ethical Committee. Informed consent forms were obtained from the parents of the children. Obesity states of the children were classified using BMI percentiles adjusted for age and sex. For the purpose, tabulated data prepared by WHO were used. MetS criteria were defined. Systolic and diastolic blood pressure values were measured. Parameters related to glucose and lipid metabolisms were determined. FBG, insulin (INS), HDL-C, TRG concentrations were determined. Diagnostic Obesity Notation Model Assessment Laboratory (DONMA_LAB) Index [ln TRG/HDL-C*INS] was introduced. Commonly used insulin resistance (IR) indices such as Homeostatic Model Assessment for IR (HOMA-IR) as well as ratios such as TRG/HDL-C, TRG/HDL-C*INS, HDL-C/TRG*INS, TRG/HDL-C*INS/FBG, log, and ln versions of these ratios were calculated. Results were interpreted using statistical package program (SPSS Version 16.0) for Windows. The data were evaluated using appropriate statistical tests. The degree for statistical significance was defined as 0.05. 35 N, 20 OW, 47 OB, 97 MO children and 36 with MetS were investigated. Mean ± SD values of TRG/HDL-C were 1.27 ± 0.69, 1.86 ± 1.08, 2.15 ± 1.22, 2.48 ± 2.35 and 4.61 ± 3.92 for N, OW, OB, MO and MetS children, respectively. Corresponding values for the DONMA_LAB index were 2.17 ± 1.07, 3.01 ± 0.94, 3.41 ± 0.93, 3.43 ± 1.08 and 4.32 ± 1.00. TRG/HDL-C ratio significantly differed between N and MetS groups. On the other hand, DONMA_LAB index exhibited statistically significant differences between N and all the other groups except the OW group. This index was capable of discriminating MO children from those with MetS. Statistically significant elevations were detected in MO children with MetS (p < 0.05). Multiple parameters are commonly used during the assessment of MetS. Upon evaluation of the values obtained for N, OW, OB, MO groups and for MO children with MetS, the [ln TRG/HDL-C*INS] value was unique in discriminating children with MetS.

Keywords: Children, index, laboratory, metabolic syndrome, obesity.

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