title: Triglycerides-to-HDL cholesterol ratio as screening tool for impaired glucose tolerance in obese children and adolescents.
abstract: OBJECTIVE
  To identify metabolic phenotypes at increased risk of impaired glucose tolerance (IGT) in Italian overweight/obese children (n = 148, age 5-10 years) and adolescents (n = 531, age 10-17.9 year).
  
  
  METHODS
  Phenotypes were defined as follows: obesity by the 95th cut-points of the Center for Disease Control body mass index reference standards, impaired fasting glucose (fasting plasma glucose ≥100 mg/dl), high circulating triglycerides (TG), TG/HDL cholesterol ≥2.2, waist-to-height ratio (WTHR) >0.6, and combination of the latter with high TG or TG/HDL cholesterol ≥2.2.
  
  
  RESULTS
  In the 148 obese children, TG/HDL-C ≥ 2.2 (OR 20.19; 95 % CI 2.50-163.28, p = 0.005) and the combination of TG/HDL-C ≥ 2.2 and WTHR > 0.60 (OR 14.97; 95 % CI 2.18-102.76, p = 0.006) were significantly associated with IGT. In the 531 adolescents, TG/HDL-C ≥ 2.2 (OR 1.991; 95 % CI 1.243-3.191, p = 0.004) and the combination with WTHR > 0.60 (OR 2.24; 95 % CI 1.29-3.87, p = 0.004) were associated with significantly increased risk of IGT. In the whole sample, having high TG levels according to the NIH National Heart, Lung and Blood Institute Expert Panel was not associated with an increased risk of presenting IGT.
  
  
  CONCLUSIONS
  TG/HDL-C ratio can be useful, particularly in children, to identify obese young patients at risk of IGT. Its accuracy as screening tool in a general population needs to be verified. The combination of TG/HDL-C ratio and WTHR > 0.6 did not improve prediction. Having high TG according to the NIH definition was not associated with increased risk of developing IGT.
authors.affiliation: Area di Ricerca Malattie Multifattoriali, Obesità e Diabete, Ospedale Pediatrico Bambino Gesù, Rome, Italy. melaniamanco@tiscali.it.
authors.forename: Melania
authors.initials: M
authors.lastname: Manco
authors.affiliation: Divisione di Auxologia, Istituto Auxologico Italiano, Piancavallo, Verbania, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Grugni
authors.affiliation: Dipartimento materno-infantile, Ospedale San Liberatore, Atri, Teramo, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Di Pietro
authors.affiliation: Dipartimento di Scienze Mediche e Chirurgiche, Programma di Endocrinologia Pediatrica, Unità Operativa di Pediatria, Università di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Balsamo
authors.affiliation: Dipartimento di Pediatria, Istituto Scientifico San Raffaele, Milano and Azienda Sanitaria Locale 2, Melegnano, Milan, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Di Candia
authors.affiliation: Area di Ricerca Malattie Multifattoriali, Obesità e Diabete, Ospedale Pediatrico Bambino Gesù, Rome, Italy.
authors.forename: Giuseppe Stefano
authors.initials: GS
authors.lastname: Morino
authors.affiliation: Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Franzese
authors.affiliation: Dipartimento di Medicina Interna, Ospedale Santa Maria delle Grazie, Pozzuoli, Napoli, Italy.
authors.forename: Procolo
authors.initials: P
authors.lastname: Di Bonito
authors.affiliation: Pediatria ad Indirizzo Diabetologico e Malattie del Metabolismo, Università di Verona, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Maffeis
authors.affiliation: Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Naples, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Valerio
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D007558:Italy; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009765:Obesity / Q000097:blood* / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; C034396:HDL-triglyceride; D008075:Lipoproteins, HDL; D014280:Triglycerides
keywords: Children; Impaired glucose tolerance; Pediatric obesity; Triglycerides-to-HDL cholesterol ratio; Waist