RESUMEN
OBJECTIVE: To estimate sensitivity, specificity, and positive and negative predictive values of components of the metabolic syndrome (MetS) during childhood for MetS and type 2 diabetes (T2D) in adulthood. STUDY DESIGN: Data from 3 major studies-the Fels Longitudinal Study, the Muscatine Study, and the Princeton Follow-up Study-were combined to examine how thresholds of metabolic components during childhood determine adult MetS and T2D. Available metabolic components examined in the 1789 subjects included high-density lipoprotein, triglyceride levels, glucose, and percentiles for body mass index, waist circumference, triglycerides, and systolic and diastolic blood pressures. Sensitivity, specificity, and positive and negative predictive values for a refined set of component threshold values were examined individually and in combination. RESULTS: Sensitivity and positive predictive values remained low for adult MetS and T2D for individual components. However, specificity and negative predictive values were fairly high for MetS and exceptionally so for T2D. In combination, having 1 or more of the components showed the highest sensitivity over any individual component and high negative predictive value. Overall, specificity and negative predictive values remained high whether considering individual or combined components for T2D. CONCLUSIONS: Sensitivity and positive predictive values on the basis of childhood measures remained relatively low, but specificity and negative predictive values were consistently higher, especially for T2D. This indicates that these components, when examined during childhood, may provide a useful screening approach to identifying children not at risk so that further attention can be focused on those who may be in need of future intervention.
Asunto(s)
Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Tamizaje Masivo/métodos , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Adolescente , Adulto , Factores de Edad , Glucemia , Presión Sanguínea , Índice de Masa Corporal , Niño , Diabetes Mellitus Tipo 2/sangre , Femenino , Humanos , Lipoproteínas HDL/sangre , Estudios Longitudinales , Masculino , Síndrome Metabólico/sangre , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Valores de Referencia , Sensibilidad y Especificidad , Triglicéridos/sangre , Circunferencia de la Cintura , Adulto JovenRESUMEN
OBJECTIVE: To determine whether waist circumference (WC) and family history of disease increase the predictive utility of body mass index (BMI) for adult metabolic syndrome (MetS). STUDY DESIGN: A subsample of 161 men and women from the Fels Longitudinal Study with childhood and adulthood measures were analyzed. Using logistic regression, childhood BMI categories (50th, 75th, and 85th percentiles), WC categories (75th and 90th percentiles), and family history of type 2 diabetes mellitus or cardiovascular disease were modeled separately and in combinations to predict adult MetS. Predicted probabilities and c-statistics were compared across models. RESULTS: The addition of family history to BMI improved the predicted probability of adult MetS from 29% to 52% (Deltac-statistic = 0.13). The combination of WC and BMI was more predictive than BMI alone but did not outperform the combination of family history and BMI. In 3 of the 4 models with a combination of family history, WC, and BMI, the predicted probability of adult MetS did not exceed that from the combination of family history and BMI. CONCLUSIONS: Family history of type 2 diabetes or cardiovascular disease is a useful addition to BMI in childhood to predict the future risk of adult MetS.
Asunto(s)
Índice de Masa Corporal , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Linaje , Circunferencia de la Cintura , Adolescente , Adulto , Factores de Edad , Niño , Femenino , Humanos , Modelos Logísticos , Estudios Longitudinales , Masculino , Síndrome Metabólico/genética , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Medición de Riesgo , Factores de Riesgo , Estados Unidos/epidemiología , Adulto JovenRESUMEN
OBJECTIVES: To ascertain the influence of such a prolonged juvenile state on delaying the onset of the metabolic syndrome, cardiovascular disease, and type 2 diabetes mellitus later in life. STUDY DESIGN: We define prolongation of a juvenile state as a retarded tempo of growth, determined by the timing of peak height velocity in each subject and relate the retarded tempo of growth to metabolic syndrome, cardiovascular disease, and type 2 diabetes mellitus later in life by use of serial data of 237 study participants (119 men and 118 women) enrolled in the Fels Longitudinal study. RESULTS: Children who matured early tended to have greater body mass index, waist circumference, and percent of body fat and were more likely to have adverse cardiovascular risk profiles than children who matured late. The differences in these risk factors between early and late maturers were significant for percent body fat, fasting plasma triglycerides, and fasting plasma insulin. CONCLUSIONS: The analyses disclosed a clear separation between early and late maturers in the appearance of these risk factors in young adulthood.