title: The predictive ability of triglycerides and waist (hypertriglyceridemic waist) in assessing metabolic triad change in obese children and adolescents.
abstract: BACKGROUND
  The metabolic triad [fasting insulin, apolipoprotein B, and low-density lipoporotein (LDL) peak particle density] is characteristic of increased intra-abdominal adipose tissue and insulin resistance and can be predicted by the simple and adoptable screening tool, the hypertriglyceridemic waist. The associations between hypertriglyceridemic waist components [fasting triglycerides (TG) and waist circumference cut-points derived from a child-specific metabolic syndrome definition] with the metabolic triad were examined in obese youth before and after weight loss.
  
  
  METHODS
  A continuous metabolic triad score (MTS) was calculated as a cumulative and standardized residual score of fasting insulin, apolipoprotein B, and LDL peak particle density (z-scores of the metabolic triad variables regressed onto age and sex). The predictive ability of TG and waist in assessing metabolic triad change was undertaken in 75 clinically obese boys and girls, aged 8-18, body mass index (BMI) 34.2±6.4 kg/m(2) before and after weight loss.
  
  
  RESULTS
  Fasting TG concentrations (r(2)=0.216, P<0.0001) and waist circumference (r(2)=0.049, P=0.019) were both significant independent predictors of the cumulative MTS, together accounting for 26.5% of its total variance. All cardiometabolic risk factors [except a reduction in high-density lipoprotein cholesterol (HDL-C)] were favorably modified following weight loss. Fasting TG change was the only significant predictor of the MTS change (r(2)=0.177, P<0.0001). Waist circumference was not a significant predictor of MTS change.
  
  
  CONCLUSIONS
  The reduction in fasting TG concentration (but not waist circumference) was the only significant predictor of MTS change. Fasting TG may be the most important metabolic syndrome component to best characterize the metabolic heterogeneity in obese cohorts and the changes in metabolic risk in clinically obese youth.
authors.affiliation: 1 Department of Academic Endocrinology, Diabetes and Metabolism, Hull York Medical School, University of Hull , Hull, United Kingdom .
authors.forename: James P
authors.initials: JP
authors.lastname: Hobkirk
authors.forename: Roderick F
authors.initials: RF
authors.lastname: King
authors.forename: Paul
authors.initials: P
authors.lastname: Gately
authors.forename: Philip
authors.initials: P
authors.lastname: Pemberton
authors.forename: Alexander
authors.initials: A
authors.lastname: Smith
authors.forename: Julian H
authors.initials: JH
authors.lastname: Barth
authors.forename: Nicola
authors.initials: N
authors.lastname: Harman
authors.forename: Ian
authors.initials: I
authors.lastname: Davies
authors.forename: Sean
authors.initials: S
authors.lastname: Carroll
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001055:Apolipoproteins B / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D001823:Body Composition / Q000502:physiology; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D064250:Hypertriglyceridemic Waist / Q000097:blood*; D007328:Insulin / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D009765:Obesity / Q000097:blood*; D011237:Predictive Value of Tests; D012015:Reference Standards; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference; D015431:Weight Loss / Q000502:physiology
chemical_list: D001055:Apolipoproteins B; D007328:Insulin; D008077:Lipoproteins, LDL; D014280:Triglycerides