Background: The metabolic syndrome (MS) in pediatrics is controversial. Rather than a dichotomous scale, a continuous metabolic syndrome score (cMets) has been proposed to evaluate MS. The aim of this study was to evaluate the utility of a cMets score among an ethnically diverse cohort of children with acanthosis nigricans (AN).
Methods: A retrospective chart review was used to extract clinical and laboratory information on a cohort of obese children. Criteria for MS components and the cMets score were established using published guidelines. Multiple linear regression evaluated the effect of AN status on MS and cMets. Fisher’s exact test compared the race differential on the presence or absence of MS component disorders.
Results: MS diagnosis was non-significant when considering AN status (p=0.554) and ethnicity (p=0.431). Evaluation of the frequency of component disorders, revealed that Caucasians had significantly higher levels of abnormal triglycerides (TG) (35.1 vs. 10.3%; p<0.001), whereas African Americans had significantly higher homeostatic model assessment of insulin resistance (HOMA-IR) scores (51.3% vs. 22.3%; p<0.001). cMets was sensitive to identifying metabolic risk among Caucasians with AN, only (p=0.029).
Conclusions: This study found differences in health risk among an obese, ethnically diverse sample of children. cMets is a more sensitive marker of metabolic change compared with MS, especially when AN status and race are considered. cMets may pose an opportunity for the clinician to evaluate the interaction of health risks on the health status of obese children.
Thank you to Virginia Quick, PhD RD for her contribution in editing the manuscript.
Author contributions: MBH and RDM contributed equally to the study design. MBH designed the study, collected data, assisted with data interpretation, drafted the initial manuscript and approved the final manuscript as submitted. RDM designed the study, participated in data interpretation, reviewed and revised the manuscript and approved the final manuscript as submitted. GY conducted data analysis and generated figures and tables participated in data interpretation, reviewed and revised the manuscript and approved the final manuscript as submitted. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: MBH and GY report have no financial disclosures. RDM is a consultant for Dannon Company, Cargill Company, Abbot Nutrition and The National Dairy Council.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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