The ApoB/A-I ratio and metabolic syndrome in prepubertal children

Studies about the relationship of apolipoproteins (apo) and metabolic syndrome in children are scarce. In this study, we analyze apo levels and determine the best cutoff point of the apoB/A-I ratio to diagnose dyslipidemia in prepubertal children with metabolic syndrome.

A community-based, cross-sectional study that enrolled 337 children with Tanner stage 1 and average age and body mass index of 9.7±1.6 years and 19.2±3.8 kg/m(2) was carried out. Diagnosis of acute or chronic illnesses constituted the exclusion criteria; in addition, children undergoing medical treatment or receiving vitamins and/or oral supplements were not included.

Metabolic syndrome was identified in 42 (12.5%) children (19 girls and 23 boys). The mean apoB/A-I ratio in the children with metabolic syndrome was 0.67±0.18. The best cutoff point of the apoB/A-I ratio for recognizing dyslipidemia was 0.60 (area under the receiver operating characteristic curve, 0.778; sensitivity 80%, specificity 55%). A total of 102 children exhibited apoB/A-I ratio ≥0.60. Diagnosis of metabolic syndrome was performed in 42 (41.2%) children. Among children with metabolic syndrome, 38 (90.5%) had hypertriglyceridemia, 34 (81.0%) low high-density lipoprotein cholesterol (HDL-C), 32 (76.2%) hypertriglyceridemia+low HDL-C, and 40 (95.2%) an apoB/A-I ratio ≥0.60.

Our results show that the best cutoff point of the apoB/A-I ratio for recognizing dyslipidemia in prepubertal children is 0.60 and that among children with metabolic syndrome, an apoB/A-I ratio ≥0.60 is the marker of dyslipidemia with the highest frequency.