Background
Methods
Subjects
Clinical and anthropometric measurements
Laboratory measurement
Definitions
Statistical analysis
Results
Descriptive statistics
Boys | Girls | |||||
---|---|---|---|---|---|---|
Normal weight | Overweight | Obese | Normal weight | Overweight | Obese | |
N | 629 | 319 | 769 | 912 | 318 | 426 |
Age (ys) | 11.7 ± 3.1a
| 12.7 ± 3.1b
| 11.4 ± 2.9a
| 12.3 ± 3.1a
| 12.9 ± 2.9b
| 11.2 ± 2.9c
|
Tanner stage | 2.1 ± 1.2a
| 2.6 ± 1.3b
| 2.1 ± 1.2a
| 3.1 ± 1.3a
| 3.8 ± 1.4b
| 3.1 ± 1.5a
|
BMI (kg m-2) | 17.7 ± 2.4a
| 23.3 ± 2.7b
| 26.9 ± 3.6c
| 18.0 ± 2.4a
| 23.4 ± 2.3b
| 25.9 ± 3.8c
|
WC (cm) | 63.3 ± 7.6a
| 78.2 ± 8.8b
| 86.1 ± 10.8c
| 62.1 ± 6.6a
| 74.0 ± 6.3b
| 79.5 ± 9.7c
|
SBP (mm Hg) | 103 ± 13a
| 114 ± 14b
| 116 ± 13c
| 101 ± 12a
| 109 ± 10b
| 111 ± 11c
|
DBP (mm Hg) | 64 ± 10a
| 70 ± 10b
| 72 ± 9c
| 64 ± 9a
| 69 ± 8b
| 71 ± 9c
|
TC (mmol/L) | 4.03 ± 0.84 | 4.03 ± 0.76 | 4.11 ± 0.75 | 4.18 ± 0.86a
| 4.05 ± 0.77b
| 4.04 ± 0.73b
|
TG (mmol/L)#
| 0.79 ± 0.39a
| 1.08 ± 0.58b
| 1.20 ± 0.63c
| 0.96 ± 0.50a
| 1.05 ± 0.54b
| 1.18 ± 0.63c
|
HDL-C (mmol/L) | 1.55 ± 0.36a
| 1.33 ± 0.32b
| 1.27 ± 0.26c
| 1.52 ± 0.30a
| 1.34 ± 0.26b
| 1.26 ± 0.26c
|
LDL-C (mmol/L) | 2.40 ± 0.76a
| 2.52 ± 0.67a
| 2.65 ± 0.66b
| 2.56 ± 0.80 | 2.56 ± 0.70 | 2.58 ± 0.66 |
Glucose (mmol/L) | 5.12 ± 0.66 | 5.17 ± 0.47 | 5.19 ± 0.48 | 4.96 ± 0.44a
| 5.15 ± 1.02b
| 5.11 ± 0.50b
|
Insulin (mU/L) #
| 6.2 ± 4.3a
| 10.6 ± 7.7b
| 14.8 ± 13.9c
| 7.3 ± 4.9a
| 11.6 ± 6.9b
| 15.4 ± 12.5c
|
HOMA-IR#
| 1.42 ± 1.01a
| 2.50 ± 2.09b
| 3.52 ± 3.80c
| 1.65 ± 1.20a
| 2.67 ± 1.62b
| 3.57 ± 3.34c
|
Leptin (ng/ml)#
| 1.7 ± 2.5a
| 7.9 ± 9.1b
| 15.6 ± 12.3c
| 5.3 ± 5.8a
| 14.6 ± 10.8b
| 20.5 ± 14.0c
|
Adiponectin (μg/L)#
| 15.1 ± 8.7a
| 11.4 ± 7.3b
| 10.3 ± 5.8b
| 15.0 ± 7.8a
| 11.5 ± 5.8b
| 10.6 ± 5.3b
|
Leptin/Adiponectin#
| 0.18 ± 0.39a
| 0.95 ± 1.24b
| 2.04 ± 1.99c
| 0.55 ± 0.95a
| 1.74 ± 2.21b
| 2.63 ± 2.83c
|
Prevalence of MetS and individual MetS abnormalities
IDF 2007 definition | Modified ATPIII definition | |||||||
---|---|---|---|---|---|---|---|---|
Normal weight | Overweight | Obese | P | Normal weight | Overweight | Obese | P | |
Boys (n) | 464 | 269 | 546 | 464 | 269 | 546 | ||
Hyper-TG | 13(2.8%) | 34(12.6%) | 91(16.7%) | <0.001 | 43(9.3%) | 82(30.5%) | 205(37.5%) | <0.001 |
Low-HDL | 24(5.2%) | 40(14.9%) | 113(20.7%) | <0.001 | 26(5.6%) | 42(15.6%) | 120(22.0%) | <0.001 |
IFG | 74(15.9%) | 39(14.5%) | 86(15.8%) | NS | 74(15.9%) | 39(14.5%) | 86(15.8%) | NS |
Elevated BP | 22(4.7%) | 36(13.4%) | 139(25.5%) | <0.001 | 32(6.9%) | 54(20.1%) | 202(37.0%) | <0.001 |
Central obesity | 0 | 30(11.2%) | 412(75.5%) | <0.001 | 0 | 41(15.2%) | 416(76.2%) | <0.001 |
MetS (%) | 0 | 7(2.6%) | 80(14.7%) | <0.001 | 2(0.4%) | 22(8.2%) | 184(33.7%) | <0.001 |
Girls (n) | 725 | 268 | 292 | 725 | 268 | 292 | ||
Hyper-TG | 54(7.4%) | 29(10.8%) | 43(14.7%) | 0.002 | 151(20.8%) | 66(24.6%) | 102(34.9%) | <0.001 |
Low-HDL | 63(8.7%) | 52(19.4%) | 70(24.0%) | <0.001 | 32(4.4%) | 31(11.6%) | 55(18.8%) | <0.001 |
IFG | 56(7.7%) | 33(12.3%) | 35(12.0%) | 0.029 | 56(7.7%) | 33(12.3%) | 35(12.0%) | 0.029 |
Elevated BP | 16(2.2%) | 10(3.7%) | 32(11.0%) | <0.001 | 61(8.4%) | 44(16.4%) | 104(35.6%) | <0.001 |
Central obesity | 8(1.1%) | 96(35.8%) | 260(89.0%) | <0.001 | 8(1.1%) | 110(41.0%) | 260(89.0%) | <0.001 |
MetS (%) | 0 | 13(4.9%) | 40(13.7%) | <0.001 | 10(1.4%) | 24(9.0%) | 89(30.5%) | <0.001 |
IDF 2007 definition | Modified ATPIII definition | |||||||
---|---|---|---|---|---|---|---|---|
Normal weight | Over-weight | Obese | P | Normal weight | Over-weight | Obese | P | |
Boys (n) | 165 | 50 | 223 | 165 | 50 | 223 | ||
Hyper-TG | 7(4.2%) | 5(10.0%) | 34(15.2%) | 0.002 | 16(9.7%) | 10(20.0%) | 73(32.7%) | <0.001 |
Low-HDL | 2(1.2%) | 2(4.0%) | 14(6.3%) | 0.043 | 2(1.2%) | 2 (4.0%) | 14(6.3%) | 0.034 |
IFG | 18(10.9%) | 9(18.0%) | 33(14.8%) | NS | 18(10.9%) | 9 (18.0%) | 33(14.8%) | NS |
Elevated BP | 4(2.4%) | 1(2.0%) | 15(6.7%) | NS | 14(8.5%) | 6(12.0%) | 60(26.9%) | <0.001 |
Central obesity | 4(2.4%) | 5(10.0%) | 181(81.2%) | <0.001 | 4(2.4%) | 5(10.0%) | 181(81.2%) | <0.001 |
MetS (%) | 0 | 0 | 14(6.3%) | <0.001 | 2(1.2%) | 3(6.0%) | 42(18.8%) | <0.001 |
Girls (n) | 187 | 50 | 134 | 187 | 50 | 134 | ||
Hyper-TG | 6(3.2%) | 1(2.0%) | 13(9.7%) | 0.032 | 23(12.3%) | 8(16.0%) | 43(32.1%) | <0.001 |
Low-HDL | 6(3.2%) | 4(8.0%) | 16(11.9%) | 0.008 | 7(3.7%) | 4 (8.0%) | 18(13.4%) | 0.005 |
IFG | 3(1.6%) | 5(10.0%) | 10(7.5%) | 0.005 | 3(1.6%) | 5 (10.0%) | 10(7.5%) | 0.005 |
Elevated BP | 5(2.7%) | 3(6.0%) | 6(4.5%) | NS | 17(9.1%) | 11 (22.0%) | 38(28.4%) | <0.001 |
Central obesity | 8(4.3%) | 21(42.0%) | 114(85.1%) | <0.001 | 8(4.3%) | 21 (42.0%) | 114(85.1%) | <0.001 |
MetS (%) | 0 | 0 | 8(6.0%) | <0.001 | 2(1.1%) | 0 | 36(26.9%) | <0.001 |
Analysis of correlation
Exploratory factor analysis
Variable | Conventional variables | Conventional variables | ||||
---|---|---|---|---|---|---|
+leptin + adiponectin | ||||||
Factor 1 | Factor 2 | Factor 3 | Factor 1 | Factor 2 | Factor 3 | |
Boys (n = 1717) | ||||||
WC |
0.616
|
0.557
| 0.158 |
0.701
|
0.495
| 0.136 |
SBP | 0.246 |
0.876
| 0.143 | 0.287 |
0.864
| 0.140 |
DBP | 0.110 |
0.906
| 0.087 | 0.143 |
0.898
| 0.110 |
TG# |
0.753
| 0.095 | 0.037 |
0.696
| 0.060 | 0.072 |
HDL-C |
−0.752
| −0.223 | 0.166 |
−0.695
| −0.213 | 0.184 |
Glucose | −0.149 | 0.092 |
0.831
| −0.127 | 0.118 |
0.819
|
HOMA-IR#
|
0.648
| 0.210 |
0.676
|
0.670
| 0.171 |
0.650
|
Insulin#
|
0.689
| 0.207 |
0.600
|
0.710
| 0.163 |
0.574
|
Leptin#
|
0.707
| 0.160 | 0.239 | |||
Adiponectin#
|
−0.546
| −0.237 | 0.159 | |||
Variance explained (%) | 31.275 | 25.651 | 19.874 | 33.284 | 19.987 | 15.937 |
Cumulative variance (%) | 31.275 | 56.926 | 76.800 | 33.284 | 53.271 | 69.208 |
Girls (n = 1656) | ||||||
WC |
0.419
|
0.510
|
0.447
|
0.425
|
0.547
|
0.469
|
SBP | 0.167 |
0.891
| 0.093 | 0.173 | 0.139 |
0.877
|
DBP | 0.127 |
0.891
| 0.031 | 0.147 | 0.059 |
0.883
|
TG#
| 0.180 | −0.057 |
0.763
| 0.248 |
0.625
| −0.130 |
HDL-C | 0.017 | −0.205 |
−0.805
| 0.002 |
−0.759
| −0.127 |
Glucose |
0.681
| 0.018 | −0.131 |
0.670
| −0.169 | 0.035 |
HOMA-IR#
|
0.859
| 0.280 | 0.321 |
0.852
| 0.340 | 0.246 |
Insulin#
|
0.803
| 0.288 | 0.356 |
0.797
| 0.381 | 0.250 |
Leptin#
|
0.491
|
0.529
| 0.350 | |||
Adiopnectin#
| −0.008 |
−0.614
| −0.173 | |||
Variance explained (%) | 26.228 | 25.699 | 21.097 | 23.449 | 22.352 | 20.796 |
Cumulative variance (%) | 26.228 | 51.927 | 73.024 | 23.449 | 45.801 | 66.597 |
Boys (n = 1717) | Girls (n = 1656) | |||
---|---|---|---|---|
Conventional variables | Conventional variables + Leptin/Adiponectin | Conventional variables | Conventional variables + Leptin/Adiponectin | |
Variable | Factor 1 | Factor 1 | Factor 1 | Factor 1 |
WC | 0.873 | 0.890 | 0.851 | 0.875 |
MAP | 0.737 | 0.675 | 0.693 | 0.635 |
TG/HDL-C#
| 0.792 | 0.786 | 0.820 | 0.804 |
Leptin/Adiponectin#
| - | 0.842 | - | 0.869 |
Variance explained (%) | 61.7 | 61.7 | 55.8 | 58.0 |