The Abnormal Ratio of Android-Gynoid Fat, Measured by Dual-Energy X-Ray Absorptiometry (DEXA) Scans, is Moderately Useful for Diagnosing Metabolic Syndrome in Children and Adolescents

Background and Aim: Abnormal android to-gynoid-fat ratio (A/G) measured by dual-energy X-ray absorptiometry (DEXA) in children may index cardiometabolic abnormalities including metabolic syndrome (MS) whose diagnosis was not done based on age, sex, and Country specific methods in previous studies. Methodology: Anthropometric measures, blood pressure, liver function, biochemical and lipid and glucose profile were obtained in 82 consecutive children and adolescents (43 girls and 39 boys, aged 5-14 years) out of a consecutive series of 119 of all ages who resided in an urban area and were screened for obesity and/or dyslipidemia during 4 years and submitted to DEXA. The diagnosis of MS was based on Country specific >90th percentile for waist circumference, triglycerides, blood glucose, and systolic or diastolic pressures and <10th percentile for HDL cholesterol and coded 1 when 3 of 5 abnormal components were present. In a different MS definition waist circumference was withhold. Results and Conclusions: There were statistically significant (0.001<0.05) differences among abnormal DEXA values of the A/G mass ratio (>1), consisting in higher BMI, arm, waist and hip circumferences and higher amylase, ALT, gGT, uric acid, ferritin, CRP, insulin, and HOMA levels. Total cholesterol and apolipoprotein-A levels were lower and gynoid fat mass was significantly higher. Among subjects with MS, there were higher height and uric acid levels whereas the A/G ratio was higher but borderline significant (p=0.07). Abnormal A/G ratio was moderately useful to index MS when the diagnosis was performed appropriately, not at all if waist circumference was not included in defining MS.