title: Predicting metabolic syndrome in obese children and adolescents: look, measure and ask.
abstract: OBJECTIVE
  To verify in obese children whether or not the presence of (i) high waist-to-height ratio (WHtR), (ii) family history for type 2 diabetes (T2D) and (iii) acanthosis nigricans (AN), singularly or together, might predict the occurrence of metabolic syndrome or prediabetes.
  
  
  METHODS
  1,080 Italian obese children (567 females) were enrolled. Blood pressure, fasting plasma glucose, insulin, and lipids were measured, and oral glucose tolerance test (OGTT) was performed. The WHtR was calculated, family history for T2D was assessed, and the presence of AN was noticed. The odds ratios for showing metabolic syndrome and/or prediabetes according to the presence of these features were calculated.
  
  
  RESULTS
  The prevalence of metabolic syndrome was 29.2%. AN (OR1.81; p = 0.002) and WHtR higher than 0.60 (OR 2.24; p < 0.0001) were the clinical signs linked to higher risk for showing metabolic syndrome, and the odds raised significantly when these elements occurred simultaneously (OR 3.34; p < 0.0001). T2D family history (OR 2.36; p = 0.01) and WHtR higher than 0.60 (OR 2.32; p = 0.009) were the two features associated with increased odds of showing prediabetes.
  
  
  CONCLUSIONS
  Three simple actions, i.e., looking at the patient, asking about T2D family history, and measuring WHtR, may represent a powerful tool in the hands of pediatricians to identify obese children with high cardiovascular and metabolic risk.
authors: Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
authors: Nicola
authors: N
authors: Santoro
authors: Alessandra
authors: A
authors: Amato
authors: Anna
authors: A
authors: Grandone
authors: Carmine
authors: C
authors: Brienza
authors: Piera
authors: P
authors: Savarese
authors: Nunzia
authors: N
authors: Tartaglione
authors: Pierluigi
authors: P
authors: Marzuillo
authors: Laura
authors: L
authors: Perrone
authors: Emanuele
authors: E
authors: Miraglia Del Giudice
mesh_terms: D000052:Acanthosis Nigricans / Q000453:epidemiology; D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001827:Body Height; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000235:genetics; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008487:Medical History Taking; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016017:Odds Ratio; D010808:Physical Examination; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids