title: The predictive value of the individual components of the metabolic syndrome for insulin resistance in obese children.
abstract: OBJECTIVE
  The usefulness of the concept of the metabolic syndrome (MS) in its current form has recently been questioned, and its association with insulin resistance is unknown. We assessed whether a multivariate model based on all components of MS expressed on a continuous scale would be a better predictor of a common marker of insulin resistance than the current dichotomous MS definitions.
  
  
  METHODS
  Data from 78 obese Dutch teenagers (age 13.0 ± 2.1 years) were used for model development, and the model was validated in 40 obese Hindustani children (age 12.6 ± 2.0 years). MS components and homeostasis model assessment-insulin resistance (HOMA-IR) were expressed as standard deviation scores (SDSs), based on gender- and age-specific reference values.
  
  
  RESULTS
  Using the three dichotomous models, the prevalence of MS was found to be 36, 65 and 18%, with low mutual agreement. None of these dichotomous models was a significant predictor for increased HOMA-IR SDS. The multivariate model incorporating MS components expressed as SDSs explained 58% of the variance of increased HOMA-IR SDS. In the validation group, the predicted and observed HOMA-IR SDS (2.4 ± 1.2 vs. 2.6 ± 2.2) did not differ significantly.
  
  
  CONCLUSIONS
  A multivariate prediction model based on MS components expressed as SDSs has a good predictive value for increased HOMA-IR SDS.
authors.affiliation: Department of Pediatrics, Juliana Children's Hospital/Haga Hospital, The Netherlands. r.vos@hagaziekenhuis.nl
authors.forename: Rimke C
authors.initials: RC
authors.lastname: Vos
authors.forename: Euphemia C A M
authors.initials: EC
authors.lastname: Houdijk
authors.forename: Hetty J
authors.initials: HJ
authors.lastname: van der Kamp
authors.forename: Hanno
authors.initials: H
authors.lastname: Pijl
authors.forename: Jan M
authors.initials: JM
authors.lastname: Wit
mesh_terms: D000293:Adolescent; D002648:Child; D003940:Diagnostic Techniques, Endocrine; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D009426:Netherlands; D009765:Obesity / Q000150:complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors