Metabolic syndrome. Association of biochemical components with the stratified waist-height ratio in obese pediatric patients

Lilia Mayrel Santiago Lagunes1, Paul Tadeo Ríos Gallardo1, Arturo Perea Martínez1, María De los Ángeles Hernández López1, Aranza Lilian Perea Caballero1, Ariadna Guadalupe Lara Campos1, Miriam Mercedes Padrón Martínez1, Ana Lidia González Valadez1, Verónica García Osorio1


1National Institute of Pediatrics, Clinical Obesity and Non Communicable Disease, México, Mexico


Objectives and Study:


To determine the association of metabolic syndrome components with the stratified waist-height ratio in obese paediatric patients. Descriptive, transversal, observational and retrospective study.




698 individuals between 5 and 18 years old were attended for the Obesity and Adolescents Clinic of the National Institute of Paediatrics (COAINP) with a diagnosis of overweight (Z score of Body Mass Index [BMI] above +1 Standard Deviation [SD] and up to +1.99 DE for age/sex) and obesity (BMI Z score above +2 SD for age/sex) according to international standards without presenting any
intercurrent pathology. The waist-height ratio (W/H ratio) was stratified at different parameters. Hyperglycaemia was defined as >100 mg/dl. The values of total cholesterol, High-Density Lipoprotein cholesterol (HDL-C), Low-Density Lipoprotein cholesterol (LDL-C) and Non-HDL-cholesterol (Non-HDL-C) were according to National Cholesterol Education Program and Adult Treatment Panel III (NCEP-ATP III). Triglycerides were evaluated at >100 mg/dl for < 10 years old and >130 mg/dl for >10 years old. Software IBM SPSS Statistics V.24.




Hyperglycaemia ranged from 0 to 50%, with a W/H ratio stratum with a value equal to or greater than 0.80, this is with the highest association but the lowest number of cases. Hypertriglyceridemia occurred in more than 50% of the strata cases from 0.55 onwards; the highest value was in a W/H ratio stratum from 0.65 to 0.69 with a percentage of 68.5%. HDL-C was consistently low in all individuals with a W/H ratio higher than 0.50, being more frequent according to a higher W/H ratio value, reaching 75% in individuals with values higher than 0.70. Results have a tendency that positively describes the direct relation of the increasing value of W/H ratio with a higher number of metabolic syndrome components in abnormal values. In some cases, the trend was not supported, which does not exclude the previous assertion, since it could have been a bias related to the number of cases in each stratum.




Several studies have shown that W/H ratio is a useful index for evaluating abdominal visceral fat associated with metabolic risk factors. Also, this ratio results in easier and more rapid identification in children and adolescents with obesity. In the present study, the W/H ratio value above 0.50 as a concept of central obesity, relates in a general way to a higher probability of presenting the biochemical abnormalities of the metabolic syndrome.

metabolic alterations

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Volume 68, Supplement 1, May 2019.