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Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents - Academia.edu
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class="sap__header-grid-contents"><div class="sap__header-mobile-top-row"><div class="js-react-on-rails-component" style="display:none" data-component-name="DownloadButton" data-props="{"author":{"id":15193648,"first_name":"Bamgboye","middle_initials":null,"last_name":"Afolabi","page_name":"BamgboyeAfolabi","domain_name":"independent","created_at":"2014-08-13T19:07:57.447-07:00","display_name":"Bamgboye Afolabi","url":"https://independent.academia.edu/BamgboyeAfolabi","photo":"https://0.academia-photos.com/15193648/19647381/19523600/s200_bamgboye.afolabi.jpg"},"downloadUrl":"https://www.academia.edu/attachments/121198656/download_file?s=sap","reactionPrompt":null,"work":{"id":127471533,"title":"Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents","translatedTitle":"","metadata":{"doi":"10.20935/AcadMed7492","issn":"2994-435X","abstract":" Objective: This study aims to evaluate independent and combined association of body mass index (BMI)-for-age percentile (pctl) and waist circumference (WC) with components of metabolic syndrome (MetS) among Nigerian adolescents. Materials and methods: Cross-sectional data of biochemical and anthropometric indices were collected. Each subject was assessed for abnormal WC, elevated blood pressure (BP), diabetic fasting plasma glucose (FPG) level, and high levels of total cholesterol (T-Chol), triglyceride (TG), lowdensity lipoprotein-cholesterol (LDL-C), and low levels of high-density lipoprotein-cholesterol (HDL-C). Correlation and linear regression analyses were used to clarify the association between BMI-for-age pctl and WC in relation to the variables of MetS. Receiver operating characteristic curve was used to determine the diagnostic ability and optimal threshold of BMI-for-age pctl and WC for MetS and its components. The area under the curve (AUC) differences between BMI-for-age pctl and WC and components of MetS were compared. Results: Totally 624 adolescents were included in the analysis, of whom 52 (8.3%) met the criteria for MetS. Both BMIfor-age pctl and WC had equivalent ability to predict MetS with AUCs of 0.6847 (p-value \u0026lt; 0.0001) and 0.6479 (p-value \u0026lt; 0.0001) for BMI-for-age pctl and WC, respectively. Conclusions: Both BMI-for-age pctl and WC were effective screening tools to diagnose MetS. BMI-for-age pctl seemed a better predictor of MetS than WC in our study sample of predominantly Nigerian adolescents living in an urban area. Both BMI-for-age pctl and WC can be easily measured and are cost effective. Their application for predicting MetS among Nigerian adolescents has vital clinical utility. ","publisher":"Academia.edu","publicationDate":{"day":5,"month":2,"year":2025,"errors":{}},"publicationName":"Academia Medicine"},"translatedAbstract":" Objective: This study aims to evaluate independent and combined association of body mass index (BMI)-for-age percentile (pctl) and waist circumference (WC) with components of metabolic syndrome (MetS) among Nigerian adolescents. Materials and methods: Cross-sectional data of biochemical and anthropometric indices were collected. Each subject was assessed for abnormal WC, elevated blood pressure (BP), diabetic fasting plasma glucose (FPG) level, and high levels of total cholesterol (T-Chol), triglyceride (TG), lowdensity lipoprotein-cholesterol (LDL-C), and low levels of high-density lipoprotein-cholesterol (HDL-C). Correlation and linear regression analyses were used to clarify the association between BMI-for-age pctl and WC in relation to the variables of MetS. Receiver operating characteristic curve was used to determine the diagnostic ability and optimal threshold of BMI-for-age pctl and WC for MetS and its components. The area under the curve (AUC) differences between BMI-for-age pctl and WC and components of MetS were compared. Results: Totally 624 adolescents were included in the analysis, of whom 52 (8.3%) met the criteria for MetS. Both BMIfor-age pctl and WC had equivalent ability to predict MetS with AUCs of 0.6847 (p-value \u0026lt; 0.0001) and 0.6479 (p-value \u0026lt; 0.0001) for BMI-for-age pctl and WC, respectively. Conclusions: Both BMI-for-age pctl and WC were effective screening tools to diagnose MetS. BMI-for-age pctl seemed a better predictor of MetS than WC in our study sample of predominantly Nigerian adolescents living in an urban area. Both BMI-for-age pctl and WC can be easily measured and are cost effective. Their application for predicting MetS among Nigerian adolescents has vital clinical utility. ","internalUrl":"https://www.academia.edu/127471533/Linking_anthropometric_indices_with_components_of_metabolic_syndrome_among_Nigerian_adolescents","translatedInternalUrl":"","createdAt":"2025-02-05T00:11:13.798-08:00","previewUrl":null,"currentUserCanEdit":null,"currentUserIsOwner":null,"ownerId":15193648,"coauthorsCanEdit":true,"documentType":"paper","coAuthorTags":[],"downloadableAttachments":[{"id":121198656,"title":"","fileType":"pdf","scribdThumbnailUrl":"https://attachments.academia-assets.com/121198656/thumbnails/1.jpg","fileName":"273062_WEBPDF_1_.PDF","downloadUrl":"https://www.academia.edu/attachments/121198656/download_file","bulkDownloadFileName":"Linking_anthropometric_indices_with_comp.pdf","bulkDownloadUrl":"https://d1wqtxts1xzle7.cloudfront.net/121198656/273062_WEBPDF_1_-libre.PDF?1738744939=\u0026response-content-disposition=attachment%3B+filename%3DLinking_anthropometric_indices_with_comp.pdf\u0026Expires=1740149119\u0026Signature=F0EfYlxTFj1tF6YfPU7U14GMAx83atEK4cPwjAwzOVa8eHe4jT657J9xdzuABohMCgv1F3rl~wHEixtwgz6Ws9ouZp6vwJIJI8vKYeXpgxQAIkSG4NPTNETf4KzP0Gf4Y9Zlf4o26Y~SOGt63TIwIBK6toqyWcZYKwGIcXnFnuzPR1MBDH3K-OW8JfWtLEKge~OegoDQX1Cd1Wbyf84vLv3YNmgxxD~N9s9Cwq5OKuCVMLa2VOpsDl1-SM5-w7ZCG7vk9OfOkHp9ev-yx~40sCR3Lp6XIa--o7Mjj~LVyQXnkhmhq-ijVw7OsTp-IIJkdxXiQK1SPUo8STIRrK6rkw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Linking_anthropometric_indices_with_components_of_metabolic_syndrome_among_Nigerian_adolescents","translatedSlug":"","pageCount":21,"language":"en","contentType":"Work","summary":" Objective: This study aims to evaluate independent and combined association of body mass index (BMI)-for-age percentile (pctl) and waist circumference (WC) with components of metabolic syndrome (MetS) among Nigerian adolescents. Materials and methods: Cross-sectional data of biochemical and anthropometric indices were collected. Each subject was assessed for abnormal WC, elevated blood pressure (BP), diabetic fasting plasma glucose (FPG) level, and high levels of total cholesterol (T-Chol), triglyceride (TG), lowdensity lipoprotein-cholesterol (LDL-C), and low levels of high-density lipoprotein-cholesterol (HDL-C). Correlation and linear regression analyses were used to clarify the association between BMI-for-age pctl and WC in relation to the variables of MetS. Receiver operating characteristic curve was used to determine the diagnostic ability and optimal threshold of BMI-for-age pctl and WC for MetS and its components. The area under the curve (AUC) differences between BMI-for-age pctl and WC and components of MetS were compared. Results: Totally 624 adolescents were included in the analysis, of whom 52 (8.3%) met the criteria for MetS. Both BMIfor-age pctl and WC had equivalent ability to predict MetS with AUCs of 0.6847 (p-value \u0026lt; 0.0001) and 0.6479 (p-value \u0026lt; 0.0001) for BMI-for-age pctl and WC, respectively. Conclusions: Both BMI-for-age pctl and WC were effective screening tools to diagnose MetS. BMI-for-age pctl seemed a better predictor of MetS than WC in our study sample of predominantly Nigerian adolescents living in an urban area. Both BMI-for-age pctl and WC can be easily measured and are cost effective. Their application for predicting MetS among Nigerian adolescents has vital clinical utility. 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J., Afolabi, B., Onabanjo, O. O., Salau, I. O., \u0026 Lucas, O. T. (2025). Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents. Academia Medicine, 2(1). https://doi.org/10.20935/AcadMed7492"},{"name":"Chicago","citation":"Holdbrooke, Susan J, Bamgboye Afolabi, Oluseye O. Onabanjo, Islamiat O. Salau, and Olayinka T. Lucas. “Linking Anthropometric Indices with Components of Metabolic Syndrome among Nigerian Adolescents.” Academia Medicine 2, no. 1 (2025). doi:10.20935/AcadMed7492."},{"name":"Vancouver","citation":"Holdbrooke SJ, Afolabi B, Onabanjo OO, Salau IO, Lucas OT. Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents. Academia Medicine. 2025;2(1). doi:10.20935/AcadMed7492"},{"name":"Harvard","citation":"Holdbrooke, S. J. et al. (2025) “Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents,” Academia Medicine. Academia.edu Journals, 2(1). doi: 10.20935/AcadMed7492."}],"entity_id":7492,"source":"letters_citation_modal"}" data-trace="false" data-dom-id="CitationButton-react-component-306a8e25-3009-488e-aa8d-3fff3ac40e27"></div> <div id="CitationButton-react-component-306a8e25-3009-488e-aa8d-3fff3ac40e27"></div> <div style="width: calc(100% - 64px);"><a aria-label="AI podcast" class="ds2-5-button ds2-5-button--secondary" href="#podcast"><svg fill="none" height="24" viewBox="0 0 24 24" width="24" xmlns="http://www.w3.org/2000/svg"><path d="M14.1199 6.5C15.6095 5.80716 16.8072 4.60949 17.5 3.11995C18.1928 4.60949 19.3905 5.80716 20.8801 6.5C19.3905 7.19284 18.1928 8.39051 17.5 9.88005C16.8072 8.39051 15.6095 7.19284 14.1199 6.5Z" stroke="#141413" stroke-linejoin="round" stroke-width="1.5"></path><path d="M12 17V20H9H15" stroke="#141413" stroke-linecap="round" stroke-linejoin="round" stroke-width="1.5"></path><path d="M14.8293 12C14.4175 13.1652 13.3062 14 12 14C10.3431 14 9 12.6569 9 11V6C9 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data-props="{"workId":127471533,"source":"https://academia-edu-letters-public.s3.amazonaws.com/podcast-audio/127471533-audio-full.mp3?X-Amz-Algorithm=AWS4-HMAC-SHA256\u0026X-Amz-Credential=ASIATUSBJ6BAMXT4Q4VM%2F20250221%2Fus-east-1%2Fs3%2Faws4_request\u0026X-Amz-Date=20250221T134520Z\u0026X-Amz-Expires=21156\u0026X-Amz-Security-Token=IQoJb3JpZ2luX2VjEK7%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJGMEQCIG1j8FbFUshy8cPnjEHrFgVF7QEggVAaSTN5NkSJJuqUAiBi7y2XS83u9swOxKN7uNI%2FxLGX4FPw10Vtv6mOhguFlSqWBAjX%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAAaDDI1MDMxODgxMTIwMCIMb5FECGdgVjj0uGMPKuoDacr5QjZ0WMZULgs2bLOXMcqZJxZnDiFssd5O1kPPDWW5pdzEiTF3jHxdROPmSv1kqEyE0rUJD8FwN%2BJdUAUGw5Sls%2BitF%2B0INOKUy7OrwZEjMz5%2B5tPG5uKMwreKphOuWUuavP6KLsA9F%2BE3uCvlT5nZfqjs5kxZLG2TFoc%2FJcA1BNC5XYIPJEIOSPMFQXzPy%2FUSX9%2F98TShmxbnm2Fx2rIKiQB9ej%2FXz7WpomE0OZ4ihCfpBEe6a6SV4sWHvzrWmH7aOSqs%2FF2ig8YyE7rXQIrOJYqxklc8LdAqP2yKYNpjMbvpL2A1V6y%2FgZg63mvWj7OK9c2QMOBM6CktL5SrROdAGRrode%2F6FxgEAo71P2UYvRaFD5PW2VSBMpeyI2e5ChxUmfAQWyidOL6PwEuCt4hqKldEyxoPgZo1wIJolNFxGscMtT74eQOVKauEvalYihZT3LWeD0iOslng1P805QhhurYxvKE9yTwxrYEOEzFLrgNeMaNfEx%2BJJaEHgBSU104T0rR4PliMZgeUiBB0iPusBLWIXgB1yxqtaLw5qUrgJ%2Fx2nrYMZNhMOCeENQuEit%2FzVzA08DQa8r9UVLUW3KMnTdygucepEye59nrN4dkYh%2BZnPNABWOO%2BCsZXULStw3APGQxLWJHNeDC0g%2BK9BjqmAS4khFkKrSybyAU4caNSpkGuAAKvnZcui0Nc%2Bmh%2Brup0i6ZtQqwKTpYdSQ1Kbu2xPj%2B1d9tSB3hAY8re2RpP32sXuocrDYH1MWQKOrQkSoY9tytDql52p3iNVO6f7tRvuTzMmtUdS38GIFrYttYRW%2FT9KCSuQrxys3%2Fi2%2B0Ufl4sUdHaUpX8NbfQkqnvmsnA3F99V6Tn%2FhWbCRLU5gcsISNwx6Qt0bY%3D\u0026X-Amz-SignedHeaders=host\u0026X-Amz-Signature=51a17b6956a64275d282b34b86c776d15d3f98efc37841e577a6bf683c463de2"}" data-trace="false" data-dom-id="PodcastPlayer-react-component-e5326764-c20d-4c38-9c9c-eadf90c288f1"></div> <div id="PodcastPlayer-react-component-e5326764-c20d-4c38-9c9c-eadf90c288f1"></div> </div><div class="sap__section" id="article-about"><a id="about"></a><h2 class="sap__main-title">About this article</h2><div class="sap__sub-section"><h3 class="sap__section-title">Citation</h3><div class="sap__citation-grid"><div class="sap__citation-container"><div class="sap__title">MLA</div><div class="sap__content">Holdbrooke, Susan J., et al. “Linking Anthropometric Indices with Components of Metabolic Syndrome among Nigerian Adolescents.” Academia Medicine, vol. 2, no. 1, Academia.edu Journals, 2025, doi:10.20935/AcadMed7492.</div></div><div class="sap__citation-container"><div class="sap__title">APA</div><div class="sap__content">Holdbrooke, S. J., Afolabi, B., Onabanjo, O. O., Salau, I. O., & Lucas, O. T. (2025). Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents. Academia Medicine, 2(1). https://doi.org/10.20935/AcadMed7492</div></div><div class="sap__citation-container"><div class="sap__title">Chicago</div><div class="sap__content">Holdbrooke, Susan J, Bamgboye Afolabi, Oluseye O. Onabanjo, Islamiat O. Salau, and Olayinka T. Lucas. “Linking Anthropometric Indices with Components of Metabolic Syndrome among Nigerian Adolescents.” Academia Medicine 2, no. 1 (2025). doi:10.20935/AcadMed7492.</div></div><div class="sap__citation-container"><div class="sap__title">Vancouver</div><div class="sap__content">Holdbrooke SJ, Afolabi B, Onabanjo OO, Salau IO, Lucas OT. Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents. Academia Medicine. 2025;2(1). doi:10.20935/AcadMed7492</div></div><div class="sap__citation-container"><div class="sap__title">Harvard</div><div class="sap__content">Holdbrooke, S. J. et al. (2025) “Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents,” Academia Medicine. Academia.edu Journals, 2(1). doi: 10.20935/AcadMed7492.</div></div></div></div><div class="sap__sub-section"><h3 class="sap__section-title">Publication dates & DOI</h3><div class="sap__publication-section-row"><div class="sap__content-container"><div class="sap__title">Received</div><div class="sap__content">May 30, 2024</div></div><div class="sap__content-container"><div class="sap__title">Accepted</div><div class="sap__content">January 04, 2025</div></div><div class="sap__content-container"><div class="sap__title">Published</div><div class="sap__content">February 05, 2025</div></div></div></div><div class="sap__sub-section"><div class="sap__title">DOI</div><a class="sap__content" href="https://www.doi.org/10.20935/AcadMed7492">doi.org/10.20935/AcadMed7492</a></div></div><div id="article-download-container"><div class="js-react-on-rails-component" style="display:none" data-component-name="DownloadButton" data-props="{"author":{"id":15193648,"first_name":"Bamgboye","middle_initials":null,"last_name":"Afolabi","page_name":"BamgboyeAfolabi","domain_name":"independent","created_at":"2014-08-13T19:07:57.447-07:00","display_name":"Bamgboye Afolabi","url":"https://independent.academia.edu/BamgboyeAfolabi","photo":"https://0.academia-photos.com/15193648/19647381/19523600/s200_bamgboye.afolabi.jpg"},"downloadUrl":"https://www.academia.edu/attachments/121198656/download_file?s=sap","reactionPrompt":null,"work":{"id":127471533,"title":"Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents","translatedTitle":"","metadata":{"doi":"10.20935/AcadMed7492","issn":"2994-435X","abstract":" Objective: This study aims to evaluate independent and combined association of body mass index (BMI)-for-age percentile (pctl) and waist circumference (WC) with components of metabolic syndrome (MetS) among Nigerian adolescents. Materials and methods: Cross-sectional data of biochemical and anthropometric indices were collected. Each subject was assessed for abnormal WC, elevated blood pressure (BP), diabetic fasting plasma glucose (FPG) level, and high levels of total cholesterol (T-Chol), triglyceride (TG), lowdensity lipoprotein-cholesterol (LDL-C), and low levels of high-density lipoprotein-cholesterol (HDL-C). Correlation and linear regression analyses were used to clarify the association between BMI-for-age pctl and WC in relation to the variables of MetS. Receiver operating characteristic curve was used to determine the diagnostic ability and optimal threshold of BMI-for-age pctl and WC for MetS and its components. The area under the curve (AUC) differences between BMI-for-age pctl and WC and components of MetS were compared. Results: Totally 624 adolescents were included in the analysis, of whom 52 (8.3%) met the criteria for MetS. Both BMIfor-age pctl and WC had equivalent ability to predict MetS with AUCs of 0.6847 (p-value \u0026lt; 0.0001) and 0.6479 (p-value \u0026lt; 0.0001) for BMI-for-age pctl and WC, respectively. Conclusions: Both BMI-for-age pctl and WC were effective screening tools to diagnose MetS. BMI-for-age pctl seemed a better predictor of MetS than WC in our study sample of predominantly Nigerian adolescents living in an urban area. Both BMI-for-age pctl and WC can be easily measured and are cost effective. Their application for predicting MetS among Nigerian adolescents has vital clinical utility. ","publisher":"Academia.edu","publicationDate":{"day":5,"month":2,"year":2025,"errors":{}},"publicationName":"Academia Medicine"},"translatedAbstract":" Objective: This study aims to evaluate independent and combined association of body mass index (BMI)-for-age percentile (pctl) and waist circumference (WC) with components of metabolic syndrome (MetS) among Nigerian adolescents. Materials and methods: Cross-sectional data of biochemical and anthropometric indices were collected. Each subject was assessed for abnormal WC, elevated blood pressure (BP), diabetic fasting plasma glucose (FPG) level, and high levels of total cholesterol (T-Chol), triglyceride (TG), lowdensity lipoprotein-cholesterol (LDL-C), and low levels of high-density lipoprotein-cholesterol (HDL-C). Correlation and linear regression analyses were used to clarify the association between BMI-for-age pctl and WC in relation to the variables of MetS. Receiver operating characteristic curve was used to determine the diagnostic ability and optimal threshold of BMI-for-age pctl and WC for MetS and its components. The area under the curve (AUC) differences between BMI-for-age pctl and WC and components of MetS were compared. Results: Totally 624 adolescents were included in the analysis, of whom 52 (8.3%) met the criteria for MetS. Both BMIfor-age pctl and WC had equivalent ability to predict MetS with AUCs of 0.6847 (p-value \u0026lt; 0.0001) and 0.6479 (p-value \u0026lt; 0.0001) for BMI-for-age pctl and WC, respectively. Conclusions: Both BMI-for-age pctl and WC were effective screening tools to diagnose MetS. BMI-for-age pctl seemed a better predictor of MetS than WC in our study sample of predominantly Nigerian adolescents living in an urban area. Both BMI-for-age pctl and WC can be easily measured and are cost effective. Their application for predicting MetS among Nigerian adolescents has vital clinical utility. 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a:hover{text-decoration:underline}.ds2-5-article-card__stat-group{display:flex;flex-direction:row;width:100%}.ds2-5-article-card__stat-group__stat{width:50%}@media(min-width: 568px)and (max-width: 1279px){.ds2-5-article-card__stat-group__stat{width:33%}}@media(min-width: 1280px){.ds2-5-article-card__stat-group__stat{width:33%}}</style><div class="ds2-5-article-card"><div class="ds2-5-article-card__metadata"><div class="ds2-5-article-card__metadata__article-type"><span class="color-indicator review_article"></span><span>Review article</span></div><div class="ds2-5-article-card__metadata__publication_date">February 21, 2025</div></div><div class="ds2-5-article-card__figure-highlight"><div class="ds2-5-article-card__figure-highlight__article-info"><div class="ds2-5-article-card__figure-highlight__title-with-image"><a class="ds2-5-article-card__figure-highlight__title-link" href="/articles/10.20935/AcadMed7509?source=academia-medicine-sap-page">Applications of artificial intelligence in thoracic imaging: a review</a><a class="ds2-5-article-card__figure-highlight__small-image-link" href="/articles/10.20935/AcadMed7509?source=academia-medicine-sap-page-highlight"><img src="https://journals.academia-photos.com/4/7509/image3.jpg" /></a></div><div class="ds2-5-article-card__article-info"><div class="ds2-5-article-card__article-info__authors">Arjun Kalyanpur, Neetika Mathur</div><div class="ds2-5-article-card__article-info__details">Special Issue: <a href="/journals/academia-medicine/special-issues/48/Artificial-Intelligence-in-Modern-Clinical-Practice?source=article-card">Artificial Intelligence in Modern Clinical Practice</a></div></div><div class="ds2-5-article-card__stat-group"><div class="ds2-5-article-card__stat-group__stat"><div class="ds2-5-stat--basic-small"><div class="ds2-5-stat--basic-small__label">downloads</div><div class="ds2-5-stat--basic-small__value">0</div></div></div><div class="ds2-5-article-card__stat-group__stat"><div 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a{color:inherit;text-decoration:none}.ds2-5-article-card__article-info__details a:hover{text-decoration:underline}.ds2-5-article-card__stat-group{display:flex;flex-direction:row;width:100%}.ds2-5-article-card__stat-group__stat{width:50%}@media(min-width: 568px)and (max-width: 1279px){.ds2-5-article-card__stat-group__stat{width:33%}}@media(min-width: 1280px){.ds2-5-article-card__stat-group__stat{width:33%}}</style><div class="ds2-5-article-card"><div class="ds2-5-article-card__metadata"><div class="ds2-5-article-card__metadata__article-type"><span class="color-indicator brief_research_report"></span><span>Brief research report</span></div><div class="ds2-5-article-card__metadata__publication_date">February 20, 2025</div></div><div class="ds2-5-article-card__figure-highlight"><div class="ds2-5-article-card__figure-highlight__article-info"><div class="ds2-5-article-card__figure-highlight__title-with-image"><a class="ds2-5-article-card__figure-highlight__title-link" href="/articles/10.20935/AcadMed7535?source=academia-medicine-sap-page">Effects of chronic treadmill exercise on testosterone levels in males and females</a><a class="ds2-5-article-card__figure-highlight__small-image-link" href="/articles/10.20935/AcadMed7535?source=academia-medicine-sap-page-highlight"><img src="https://journals.academia-photos.com/4/7535/image3.jpg" /></a></div><div class="ds2-5-article-card__article-info"><div class="ds2-5-article-card__article-info__authors">Brendan Perreault, Samantha Penman, Nikki Hammond, Kenneth Blum, Kai Uwe Lewandrowski, Rajendra D. Badgaiyan, Mark S. Gold, David Baron, Panayotis K. Thanos</div><div class="ds2-5-article-card__article-info__details"></div></div><div class="ds2-5-article-card__stat-group"><div class="ds2-5-article-card__stat-group__stat"><div class="ds2-5-stat--basic-small"><div class="ds2-5-stat--basic-small__label">downloads</div><div class="ds2-5-stat--basic-small__value">8</div></div></div><div class="ds2-5-article-card__stat-group__stat"><div class="ds2-5-stat--basic-small"><div class="ds2-5-stat--basic-small__label">views</div><div class="ds2-5-stat--basic-small__value">19</div></div></div></div></div><a class="ds2-5-article-card__figure-highlight__big-image-link" href="/articles/10.20935/AcadMed7535?source=academia-medicine-sap-page-highlight"><img src="https://journals.academia-photos.com/4/7535/image3.jpg" /></a></div></div><style type="text/css">html{font-size:16px !important}.ds2-5-article-card{font-size:16px;color:var(--text-primary, #070a15);display:flex;flex-direction:column;border-top:1px solid var(--stroke-dark, 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class="ds2-5-stat--basic-small__value">3,679</div></div></div></div></div></div></div><div><!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=UTF-8"> <title>Holdbrooke, Afolabi, Onabanjo, Salau, Lucas, and Sakakushev: Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents</title> </head> <body><div id="article-root"> <div id="article-front-container" class="sap__front-container"> <div id="article-front-column" class="sap__front"> <div id="article-front" class="sap__front"> <div class="sap__metadata sap__centered"><h1 class="sap__document-title">Linking anthropometric indices with components of metabolic syndrome among Nigerian adolescents</h1></div> <div class="sap__metadata sap__author-list"> <div class="sap__metadata sap__author"> <div class="sap__author-names"><div class="sap__metadata-group"><p class="sap__metadata-entry"><a id="id1"><!-- named anchor --></a>Susan J. Holdbrooke<a href="#anote-2">#</a><span class="sap__generated"> [</span><a href="#aff1">1</a><span class="sap__generated">]</span></p></div></div> <div class="sap__author-info"><div class="sap__metadata-group"></div></div> <span>,</span> </div> <div class="sap__metadata sap__author"> <div class="sap__author-names"><div class="sap__metadata-group"><p class="sap__metadata-entry"><a id="id2"><!-- named anchor --></a>Bamgboye M. Afolabi<a href="#anote-2">#</a><a href="#anote-1">*</a><span class="sap__generated"> [</span><a href="#aff1">1</a>,<a href="#aff2">2</a><span class="sap__generated">]</span></p></div></div> <div class="sap__author-info"><div class="sap__metadata-group"></div></div> <span>,</span> </div> <div class="sap__metadata sap__author"> <div class="sap__author-names"><div class="sap__metadata-group"><p class="sap__metadata-entry"><a id="id3"><!-- named anchor --></a>Oluseye O. Onabanjo<span class="sap__generated"> [</span><a href="#aff3">3</a><span class="sap__generated">]</span></p></div></div> <div class="sap__author-info"><div class="sap__metadata-group"></div></div> <span>,</span> </div> <div class="sap__metadata sap__author"> <div class="sap__author-names"><div class="sap__metadata-group"><p class="sap__metadata-entry"><a id="id4"><!-- named anchor --></a>Islamiat O. Salau<span class="sap__generated"> [</span><a href="#aff1">1</a><span class="sap__generated">]</span></p></div></div> <div class="sap__author-info"><div class="sap__metadata-group"></div></div> <span>,</span> </div> <div class="sap__metadata sap__author"> <div class="sap__author-names"><div class="sap__metadata-group"><p class="sap__metadata-entry"><a id="id5"><!-- named anchor --></a>Olayinka T. Lucas<span class="sap__generated"> [</span><a href="#aff1">1</a><span class="sap__generated">]</span></p></div></div> <div class="sap__author-info"><div class="sap__metadata-group"></div></div> </div> </div> <div class="affiliation-list-link-area"><a id="affiliation-list-link" data-target="#affiliation-list" data-toggle="collapse" href="javascript:void(0)"><span>Author Affiliations</span><svg xmlns="http://www.w3.org/2000/svg" id="chevron" class="" width="16px" height="16px" viewbox="0 0 24 24" style="vertical-align: middle;"><path d="m12 15.375-6-6 1.4-1.4 4.6 4.6 4.6-4.6 1.4 1.4Z" class="expand-more" fill="#222233"></path></svg></a></div> <div id="affiliation-list" class="sap__metadata sap__two-column sap__table collapse"><div class="affiliation-list-items"><div class="sap__row"> <div class="sap__cell sap__empty"></div> <div class="sap__cell"><div class="sap__metadata-group"> <p class="sap__metadata-entry"><a id="aff1"><!-- named anchor --></a><sup>1</sup>Department of Biochemistry and Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, 101212 Nigeria.</p> <p class="sap__metadata-entry"><a id="aff2"><!-- named anchor --></a><sup>2</sup>Health, Environment and Development Foundation, Surulere, Lagos, 102215 Nigeria.</p> <p class="sap__metadata-entry"><a id="aff3"><!-- named anchor --></a><sup>3</sup>Department of Nutrition and Dietetics, Federal University of Agriculture, Abeokuta, Ogun State, 110111 Nigeria.</p> <a id="anote-1"><!-- named anchor --></a><p class="sap__metadata-entry">*Correspondence to bmafolabi@nimr.gov.ng<span class="sap__generated">, </span>bmafolabi@gmail.com</p> <a id="anote-2"><!-- named anchor --></a><p class="sap__metadata-entry">#Joint first authors.</p> </div></div> </div></div></div> <div class="sap__dates-and-open-access"><div class="sap__metadata-area"> <p class="sap__metadata-entry"><span class="sap__generated"><a id="open-access-link" data-target="#sap__Open-Access" data-toggle="collapse" href="javascript:void(0)"><span>Open Access</span><svg xmlns="http://www.w3.org/2000/svg" id="chevron-open-access" class="" width="16px" height="16px" viewbox="0 0 24 24" style="vertical-align: middle;"><path d="m12 15.375-6-6 1.4-1.4 4.6 4.6 4.6-4.6 1.4 1.4Z" class="expand-more" fill="#222233"></path></svg></a></span></p> <div class="sap__metadata-chunk"><div id="sap__Open-Access" class="collapse"><div class="sap__metadata-chunk-content"><p>© 2025 copyright by the authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). <a target="xrefwindow" href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</a></p></div></div></div> </div></div> </div> <div class="sap__section"> <a id="id6"><!-- named anchor --></a><h2 class="sap__main-title"><span class="sap__generated">Abstract</span></h2> <p class="first" id="id7"><b>Objective</b>: This study aims to evaluate independent and combined association of body mass index (BMI)-for-age percentile (pctl) and waist circumference (WC) with components of metabolic syndrome (MetS) among Nigerian adolescents. <b>Materials and methods</b>: Cross-sectional data of biochemical and anthropometric indices were collected. Each subject was assessed for abnormal WC, elevated blood pressure (BP), diabetic fasting plasma glucose (FPG) level, and high levels of total cholesterol (T-Chol), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), and low levels of high-density lipoprotein-cholesterol (HDL-C). Correlation and linear regression analyses were used to clarify the association between BMI-for-age pctl and WC in relation to the variables of MetS. Receiver operating characteristic curve was used to determine the diagnostic ability and optimal threshold of BMI-for-age pctl and WC for MetS and its components. The area under the curve (AUC) differences between BMI-for-age pctl and WC and components of MetS were compared. <b>Results:</b> Totally 624 adolescents were included in the analysis, of whom 52 (8.3%) met the criteria for MetS. Both BMI-for-age pctl and WC had equivalent ability to predict MetS with AUCs of 0.6847 (<i>p</i>-value < 0.0001) and 0.6479 (<i>p</i>-value < 0.0001) for BMI-for-age pctl and WC, respectively. <b>Conclusions:</b> Both BMI-for-age pctl and WC were effective screening tools to diagnose MetS. BMI-for-age pctl seemed a better predictor of MetS than WC in our study sample of predominantly Nigerian adolescents living in an urban area. Both BMI-for-age pctl and WC can be easily measured and are cost effective. Their application for predicting MetS among Nigerian adolescents has vital clinical utility.</p> </div> </div> <div class="sap__spacer"></div> </div> <div id="article-container"> <div id="article-text"> <div id="article-body" class="sap__body"> <div class="sap__section"> <a id="sec1"><!-- named anchor --></a><h2 class="sap__main-title">1. Introduction</h2> <p id="id8">Metabolic syndrome (MetS) has been defined by an array of biochemical, physiological, clinical, and metabolic factors that precisely foster the risk of atherosclerosis, type 2 diabetes mellitus (T2DM), cardiovascular diseases, and all-cause mortality [<a href="#ref1">1</a>]. It was earlier thought that MetS, a collection of several cardiovascular risk factors, was rare among the generality of sub-Saharan Black Africans. However, contrary to this assumption, the prevalence of this disorder is relatively high [<a href="#ref2">2</a>–<a href="#ref7">7</a>] and tends to increase with age [<a href="#ref8">8</a>–<a href="#ref10">10</a>]. It has been suggested that the transition from traditional African diet and lifestyle to western diet and lifestyle has contributed to the perceived increase in metabolic disorders [<a href="#ref7">7</a>]. Dyslipidemia, a combined metabolic disorder linked with high total cholesterol (T-Chol) and/or triglyceride (TG) levels, high low-density lipoprotein-cholesterol (LDL-C), and low high-density lipoprotein-cholesterol (HDL-C), is a precursor of MetS, and it contributes to the risk factors for cardiovascular diseases, diabetes mellitus (DM), and atherosclerosis [<a href="#ref11">11</a>]. Certain diseases have risk factors for MetS. A study in Iran reported that among patients with DM, early adulthood T2DM can be predicted by adolescent MetS and some combinations of MetS component such as high TG, high WC, and high BP [<a href="#ref12">12</a>]. Elsewhere, earlier studies reported much higher prevalence rates of the syndrome in adolescents who were overweight or obese [<a href="#ref13">13</a>, <a href="#ref14">14</a>]. Visceral obesity is regarded as the major risk factor for MetS, and it is speculated that by 2030, approximately 50% of adults will be categorized as obese, making MetS a significant health burden and an economic drain [<a href="#ref15">15</a>]. Visceral obesity is also a major risk factor for systemic inflammation, hyperlipidemia, insulin resistance, and cardiovascular disease [<a href="#ref16">16</a>]. It is linked with the growth of adipose cells that are enlarged and dysfunctional [<a href="#ref17">17</a>]. Waist circumference (WC) is one of the abdominal indices proposed as an alternative to body mass index (BMI) because these other indices, including waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), modify and control for the restrictions of BMI [<a href="#ref18">18</a>–<a href="#ref21">21</a>].</p> <p id="id9">It is generally agreed that unlike in adults, defining MetS in adolescence is problematic because of the physiological transformations that happen during this specific period of life [<a href="#ref22">22</a>]. Jeffery et al. [<a href="#ref23">23</a>] argued that insulin resistance increases in early puberty but stabilizes in mid-adolescence and may vary also between genders. Insulin resistance indeed exhibits intriguing patterns during the transition from childhood to adolescence; however, >60% of the variation in insulin resistance prior to puberty remains unexplained. Lipid profiles have also been noted to vary across ages. During adolescence, levels of TC, LDL-cholesterol, and non-HDL-cholesterol decrease, TG in males increases and both HDL-cholesterol and TG in females show no changes [<a href="#ref24">24</a>]. Thus, specific consensus guidelines recommending diagnostic criteria for adolescent MetS may not be currently available [<a href="#ref25">25</a>], although adult standards of the National Cholesterol Education Program Adult Treatment Panel III (ATPIII) criteria, or other definitions, have long been adopted [<a href="#ref13">13</a>, <a href="#ref14">14</a>, <a href="#ref26">26</a>]. Such adopted criteria for MetS in adolescents are high TG level ≥110 mg/dL, low HDL-C level ≤40 mg/dL, abdominal obesity, WC cm ≥90th percentile—94 cm in males and 80 cm in females—high fasting plasma glucose (FPG) level ≥110 mg/dL, and high BP ≥90th percentile [<a href="#ref27">27</a>]. A study reports that MetS among children and adolescents is an emerging public health challenge in low- and middle-income countries (LMICs) including Nigeria, where the prevalence of obesity is on the rise [<a href="#ref28">28</a>]. The exact clinical and biophysical profile of adolescents with MetS among Black Africans is rare. One study in Ghana postulated that obesity is an independent major contributor to the development of MetS in adolescents [<a href="#ref29">29</a>]. A study in East Java predicted that high WTH ratio (>0.89) in adolescents is associated with a higher risk to develop MetS and can be proposed as a predictor for the disease in obese adolescents [<a href="#ref30">30</a>]. Another study in China reported that lipid profiles are more closely associated with MetS [<a href="#ref31">31</a>]. Many studies have postulated that hyperglycemia, hyperlipidemia, and hypertension are central features of MetS [<a href="#ref32">32</a>–<a href="#ref34">34</a>]. In most of these studies, however, the relationship between the anthropometric and clinical components of MetS was not adequately established. Obesity in adolescence is generally assessed using BMI-for-age of 95th percentile and above [<a href="#ref35">35</a>], while WC is a direct measurement of the waist of the individual. These two anthropometric indices seem to be central in deciding whether a person develops MetS or not. However, relationship between these two indices and clinical components of MetS is rare or lacking, especially among Black African adolescents, including Nigerians. Furthermore, most of the studies were conducted among adolescents in high-income developed countries [<a href="#ref36">36</a>–<a href="#ref38">38</a>]. The purpose of the current study, therefore, was to evaluate the relationship between BMI-for-age pctl, WC, and clinical components of MetS and to determine whether these two anthropometric indices are useful in practical methods used to identify MetS and its components among Nigerian adolescents. Results from this study will be useful in designing preventive strategies such as school-based interventions that include the promotion of physical activities and healthy eating behaviors and in screening for early identification of risk factors to avert MetS among adolescents in the country.</p> </div> <div class="sap__section"> <a id="sec2"><!-- named anchor --></a><h2 class="sap__main-title">2. Materials and methods</h2> <p id="id10">This is a descriptive and cross-sectional study carried out by the Department of Biochemistry and Nutrition of the Nigerian Institute of Medical Research. Primary data were collected from adolescents aged 10–19 years who were attending secondary school in Lagos State, Nigeria. The study, including 624 participants (241 boys and 383 girls), was started in October 2019 and was concluded in March 2020. Written informed consents were obtained from parents, and each participating student gave verbal assent. The Institutional Review Board of the Nigerian Institute of Medical Research (NIMR IRB (IRB/18/062)) approved the study protocol, and the study was conducted in accordance with the Declaration of Helsinki (2000).</p> <p id="id11"><b>Study site:</b> This study took place in Lagos State, southwest Nigeria. Lagos is the most economically important, as well as the most populous, city in the country. The city has 616 registered public (372, 60.4%) and private (244, 39.6%) secondary schools in the local government areas (LGAs) selected for the study [<a href="#ref39">39</a>].</p> <p id="id12"><b>Study population:</b> The target population was students in selected government-approved secondary schools in Lagos State. The World Health Organization (WHO) defined the age range for adolescents to be between 10 and 19 years [<a href="#ref40">40</a>].</p> <p id="id13"><b>Sample size:</b> The sample size was calculated for a single population with 95% confidence interval, 54% proportion, a margin of error 5%, and allowing 12% non-response. To ensure that results of the study are representative of all Nigerian ethnic groups resident in Lagos State, the sample size would then be 650 students to cater for attrition and missing data.</p> <p id="id14"><b>Sampling technique and procedure:</b> Lagos State is comprised of three senatorial districts (SDs): Lagos East with five LGAs, Lagos Central with five LGAs, and Lagos West with ten LGAs. Using simple random sampling technique (SRST), one LGA was selected from Lagos East SD (Ikorodu LGA with 222 secondary schools), one LGA from Lagos Central SD (Mainland LGA with 100 secondary schools), and two LGAs from Lagos West SD (Ojo with 247 and Mushin with 47 secondary schools). Using probability proportional to size (PPS), different arms of classes—Years 1–3 of junior secondary school (JSS; mainly aged 10–15 years) and Years 1–3 of senior secondary school (SSS; mainly aged 16–19 years)—were chosen since there were many arms in both JSS and SSS. Finally, systematic sampling technique was used to select students in selected arms of each class. Thus, selection was stratified by junior and senior school years proportional to school size (<b><a href="#fig001">Figure 1</a></b>).</p> <div class="sap__fig sap__figure_panel"> <a id="fig001"><!-- named anchor --></a><h5 class="sap__label">Figure 1</h5> <div class="sap__caption"><h4 class="sap__subsection-title">Flowchart of the recruitment of study participants.</h4></div> <img alt="media/image3.jpg" src="https://journals.academia-photos.com/4/7492/image3.jpg"> </div> <div class="sap__sub-section"> <a id="sec2_1"><!-- named anchor --></a><h3 class="sap__section-title">2.1. Eligibility criteria</h3> <p id="id15"><b>Inclusion criteria:</b> Ten- to 19-year-old Black and Indigenous Nigerian secondary school students were recruited for this study. The students must be residents in the community for a minimum of two years in the respective LGAs of the study. They must also be regular students at the secondary schools identified for the study. The approvals from the State Government Ministry of Education and the parents were decisive inclusion criteria.</p> <p id="id16"><b>Exclusion criteria:</b> Those on therapeutic diet or drugs and those on admissions to a health facility in previous six month were excluded from the study. Thus, students with diabetes, those taking lipid-lowering medications, or with a history of vascular/liver/renal or other continuing illness were excluded. Pregnancy, suspected pregnancy, breastfeeding, and use of oral contraceptives were also included in the exclusion criteria.</p> </div> <div class="sap__sub-section"> <a id="sec2_2"><!-- named anchor --></a><h3 class="sap__section-title">2.2. Data collection</h3> <p id="id17">Data on sociodemographic and economic characteristics were gathered from both parents and students. Body weight, height, waist, and hip circumferences were measured by trained field workers. Weight was measured with minimal clothing (no shoes) to the nearest 0.1 kg using an electronic scale (FPG machine Model HBF-514C and DP scale HN-283), and height was measured (without participants wearing shoes) to the nearest millimeter using a portable stature meter (SURGILAC, Germany). Waist and hip circumferences were also measured to the nearest millimeter over light clothing, waist midway between the lowest rib and the iliac crest, and hip at the widest part of the buttocks. The WHO AnthroPlus V1.0.4 (Geneva, Switzerland) was used to calculate BMI-for-age and height-for-age percentiles for boys and girls separately [<a href="#ref41">41</a>]. Sex-specific categorization was used for BMI. Cutoffs available for Nigerian or African for WC were 0.94 m for boys and 0.80 m for girls, no Nigeria- or Africa-specific limits being available for this age group. Blood pressure (BP) (upper arm) and pulse rate were measured after 30-min sitting (aneroid sphygmomanometer for a very thin hand (SURGILAC CE 123-HS-20C [Germany]), automatic BP monitor for moderate hand (Medical Instrument WUXI, Ltd, EN-BL-8030 [China]), or a mercury sphygmomanometer (long cuff Medical Instrument WUXI, Ltd, EN-BL-8030 [Wuxi, China]) machine for a very big hand). The average of the three measurements was used. Participants were asked to fast overnight, after which 5 ml of venous blood was taken. Fasting blood for glucose was collected into fluoride oxalate tubes, while the fasting blood for lipids was collected in lithium heparin tubes. These tubes were centrifuged for the production of plasma samples, which were stored at –20ºC before analysis. Randox Glucose-PAP (Randox Laboratories, Crumlin, UK) reagent was used for analyzing FPG, and lipid profile (TC, HDL-cholesterol, LDL-cholesterol, and TG) was measured using a photo spectrometric analyzer (BioSystems EN ISO 13485 and EN ISO 9001 standards [Barcelona, Spain]).</p> <p id="id18"><b>Definitions:</b> Dyslipidemia has been defined as a combination of TC ≥ 200 mg/dL, LDL-C ≥ 130 mg/dL, TG ≥ 130 mg/dL, or HDL-C < 40 mg/dL [<a href="#ref42">42</a>]. The National Heart, Lung and Blood Institute (NHLBI) criteria specifically for children and adolescents were used to identify MetS among participants aged 10–19 years [<a href="#ref43">43</a>]. This requires three or more of the following indicators: (i) BMI-for-age of ≥95th percentile; fasting plasma levels of (ii) TG ≥ 130 mg/dL; (iii) HDL-cholesterol < 40 mg/dL; (iv) LDL-cholesterol ≥ 130 mg/dL; (v) TC ≥ 200 mg/dL; (vi) glucose ≥ 100mg/dL; and (vi) pre-hypertension as systolic/diastolic BP (SBP/DBP) 120–129/ <80 mmHg, stage 1 hypertension, BP 130–139/80–89, and stage 2 ≥140/90 mmHg [<a href="#ref44">44</a>]. Normal, borderline, and high cutoff points of various components of MetS are illustrated in <b><a href="#table001">Table 1</a></b>. In each component of MetS, the value less than the lower limit of normal was regarded as low.</p> <div class="sap__table-wrap sap__figure_panel"> <a id="table001"><!-- named anchor --></a><h5 class="sap__label">Table 1</h5> <div class="sap__caption"><h3 class="sap__title">Classification of components of metabolic syndrome among adolescents in the study</h3></div> <table frame="box" rules="all" cellpadding="11"> <a id="id19"><!-- named anchor --></a><thead> <a id="id20"><!-- named anchor --></a><tr> <a id="id21"><!-- named anchor --></a><th align="left" valign="top" rowspan="3" colspan="2"> <a id="id22"><!-- named anchor --></a>Components of MetS</th> <th align="left" valign="top" rowspan="3"> <a id="id23"><!-- named anchor --></a>Unit</th> <th align="left" valign="top" rowspan="3"> <a id="id24"><!-- named anchor --></a>Low</th> <th align="left" valign="top" rowspan="3"> <a id="id25"><!-- named anchor --></a>Normal</th> <th align="left" valign="top" rowspan="3"> <a id="id26"><!-- named anchor --></a>Borderline</th> <th align="left" valign="top" colspan="5"> <a id="id27"><!-- named anchor --></a>High</th> </tr> <tr> <a id="id28"><!-- named anchor --></a><th align="left" valign="top" colspan="2"> <a id="id29"><!-- named anchor --></a>Hypertension</th> <th align="left" valign="top" colspan="2"> <a id="id30"><!-- named anchor --></a>FPG</th> <th align="left" valign="top" rowspan="2"> <a id="id31"><!-- named anchor --></a>High</th> </tr> <tr> <a id="id32"><!-- named anchor --></a><th align="left" valign="top"> <a id="id33"><!-- named anchor --></a>Stage 1</th> <th align="left" valign="top"> <a id="id34"><!-- named anchor --></a>Stage 2</th> <th align="left" valign="top"> <a id="id35"><!-- named anchor --></a>Impaired</th> <th align="left" valign="top"> <a id="id36"><!-- named anchor --></a>Diabetic</th> </tr> </thead> <tbody> <a id="id37"><!-- named anchor --></a><tr> <a id="id38"><!-- named anchor --></a><td align="left" valign="top" colspan="2"> <a id="id39"><!-- named anchor --></a>Systolic BP</td> <td align="left" valign="top" rowspan="2"> <a id="id40"><!-- named anchor --></a>mmHg</td> <td align="left" valign="top"> <a id="id41"><!-- named anchor --></a>≤89</td> <td align="left" valign="top"> <a id="id42"><!-- named anchor --></a>90–119</td> <td align="left" valign="top"> <a id="id43"><!-- named anchor --></a>120–129</td> <td align="left" valign="top"> <a id="id44"><!-- named anchor --></a>130–139</td> <td align="left" valign="top"> <a id="id45"><!-- named anchor --></a>≥140</td> <td align="left" valign="top"> <a id="id46"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id47"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id48"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id49"><!-- named anchor --></a><td align="left" valign="top" colspan="2"> <a id="id50"><!-- named anchor --></a>Diastolic BP(not a component)</td> <td align="left" valign="top"> <a id="id51"><!-- named anchor --></a>≤66</td> <td align="left" valign="top"> <a id="id52"><!-- named anchor --></a>67–80</td> <td align="left" valign="top"> <a id="id53"><!-- named anchor --></a>80–89</td> <td align="left" valign="top"> <a id="id54"><!-- named anchor --></a>90–100</td> <td align="left" valign="top"> <a id="id55"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id56"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id57"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id58"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id59"><!-- named anchor --></a><td align="left" valign="top" colspan="2"> <a id="id60"><!-- named anchor --></a>Fasting blood sugar</td> <td align="left" valign="top" rowspan="5"> <a id="id61"><!-- named anchor --></a>mg/dL</td> <td align="left" valign="top"> <a id="id62"><!-- named anchor --></a><50</td> <td align="left" valign="top"> <a id="id63"><!-- named anchor --></a>50–99</td> <td align="left" valign="top"> <a id="id64"><!-- named anchor --></a>≥100–125</td> <td align="left" valign="top"> <a id="id65"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id66"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id67"><!-- named anchor --></a>≥100–125</td> <td align="left" valign="top"> <a id="id68"><!-- named anchor --></a>>125.0</td> <td align="left" valign="top"> <a id="id69"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id70"><!-- named anchor --></a><td align="left" valign="top" colspan="2"> <a id="id71"><!-- named anchor --></a>Triglyceride</td> <td align="left" valign="top"> <a id="id72"><!-- named anchor --></a> <50</td> <td align="left" valign="top"> <a id="id73"><!-- named anchor --></a>50–90</td> <td align="left" valign="top"> <a id="id74"><!-- named anchor --></a>90–129</td> <td align="left" valign="top"> <a id="id75"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id76"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id77"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id78"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id79"><!-- named anchor --></a>≥130</td> </tr> <tr> <a id="id80"><!-- named anchor --></a><td align="left" valign="top" colspan="2"> <a id="id81"><!-- named anchor --></a>Total cholesterol</td> <td align="left" valign="top"> <a id="id82"><!-- named anchor --></a> <60</td> <td align="left" valign="top"> <a id="id83"><!-- named anchor --></a>60–170</td> <td align="left" valign="top"> <a id="id84"><!-- named anchor --></a>170–199</td> <td align="left" valign="top"> <a id="id85"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id86"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id87"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id88"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id89"><!-- named anchor --></a>≥200</td> </tr> <tr> <a id="id90"><!-- named anchor --></a><td align="left" valign="top" colspan="2"> <a id="id91"><!-- named anchor --></a>Low-density lipoprotein-cholesterol</td> <td align="left" valign="top"> <a id="id92"><!-- named anchor --></a><40</td> <td align="left" valign="top"> <a id="id93"><!-- named anchor --></a>40–110</td> <td align="left" valign="top"> <a id="id94"><!-- named anchor --></a>110–129</td> <td align="left" valign="top"> <a id="id95"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id96"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id97"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id98"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id99"><!-- named anchor --></a>≥130</td> </tr> <tr> <a id="id100"><!-- named anchor --></a><td align="left" valign="top" colspan="2"> <a id="id101"><!-- named anchor --></a>High-density lipoprotein-cholesterol</td> <td align="left" valign="top"> <a id="id102"><!-- named anchor --></a> <40</td> <td align="left" valign="top"> <a id="id103"><!-- named anchor --></a>>45</td> <td align="left" valign="top"> <a id="id104"><!-- named anchor --></a>40–45</td> <td align="left" valign="top"> <a id="id105"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id106"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id107"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id108"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id109"><!-- named anchor --></a>>45</td> </tr> <tr> <a id="id110"><!-- named anchor --></a><td align="left" valign="top" rowspan="2"> <a id="id111"><!-- named anchor --></a>Waist circumference</td> <td align="left" valign="top"> <a id="id112"><!-- named anchor --></a>Boys</td> <td align="left" valign="top" rowspan="2"> <a id="id113"><!-- named anchor --></a>Cm</td> <td align="left" valign="top"> <a id="id114"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id115"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id116"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id117"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id118"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id119"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id120"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id121"><!-- named anchor --></a>≥94</td> </tr> <tr> <a id="id122"><!-- named anchor --></a><td align="left" valign="top"> <a id="id123"><!-- named anchor --></a>Girls</td> <td align="left" valign="top"> <a id="id124"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id125"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id126"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id127"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id128"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id129"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id130"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id131"><!-- named anchor --></a>≥80</td> </tr> </tbody> </table> <div class="sap__table-wrap-foot"><p class="sap__attrib">BP, blood pressure; FPG, fasting plasma glucose; MetS, metabolic syndrome.</p></div> </div> <p id="id132"><b>Statistical analysis:</b> Data of each patient were coded for anonymity, ease of reference, and avoidance of bias; fed into a laptop computer; and cleaned and crosschecked for errors. NCSS version 2022 statistical software (Kaysville, UT) was used for data analysis and calculating the receiver operating characteristic (ROC) curves for the comparison of the ability of each anthropometric index to predict MetS and to determine the diagnostic thresholds of the components of MetS.<i> Area under the curve (AUC</i>): The optimal cutoff point for each anthropometric index in detecting MetS was chosen as the point on the curve with the highest Youden index: sensitivity + specificity – 1. The data were analyzed descriptively for obtaining frequencies and percentages. The student’s <i>t</i>-test was used to compare the means of two continuous variables, and analysis of variance was used to compare the means of more than two variables. Correlation analysis (Pearson’s) was performed between each of the anthropometric indices and components of MetS, and correlation coefficient,<i> r</i>, was regarded as very strong, strong, moderate, weak, or negligible if the degree of correlation was ±0.90 to ±1.0, ±0.70 to ±0.90, ±0.50 to ±0.70, ±0.30 to ±0.50, and ±0.00 to ±0.30, respectively [<a href="#ref45">45</a>]. The Shapiro–Wilk <i>W</i> test was used to determine the normality of data distribution. When <i>p</i>-value (asymp. sig.) was <0.05, the normality of data distribution was rejected and Mann–Whitney <i>U</i> test was used to compare the median values of components of MetS-positive and MetS-negative subjects. Multivariate logistic regression analyses were also performed to define correlation between independent variables (systolic hypertension, diabetic FPG, dyslipidemias) and dependent variables (BMI-for-age pctl and WC). A<i> p</i>-value < 0.05 was considered as statistically significant. Confidence interval (CI) in this study refers to a range of values for specific variables constructed so that this range has a specified probability of including the true value of that variable. The results of analyses were presented as tables, graphs, charts, and figures.</p> </div> </div> <div class="sap__section"> <a id="sec3"><!-- named anchor --></a><h2 class="sap__main-title">3. Results</h2> <p id="id133">A total of 650 students were recruited for this study, but complete data were available for 624 (boys: 241, 38.6%; girls: 383, 61.4%) with a negligible 26 (4.0%) discarded due to incomplete entry. A description of the demographic profile of the study participants and the 8.3% prevalence of MetS has been reported in an earlier publication [<a href="#ref46">46</a>]. In all subjects, the median values of anthropometric indicators for MetS—BMI-for-age pctl and WC—were significantly higher (<i>p</i>-value < 0.001) among MetS-positive (61.4 and 68.5 cm) compared to MetS-negative (30.2 and 64.0 cm) study participants. These two indicators tended to increase with increasing SBP and DBP, tended to decrease with increasing FPG, but showed inconsistency with TG TC, HDL-C, and LDL-C (<b><a href="#table002">Table 2</a></b>). Except for LDL-C, all other risk factors for MetS were significantly higher among MetS-positive than among MetS-negative study participants (<b><a href="#table003">Table 3</a></b>). There were significant but weak correlations between WC, SBP (<i>r</i> = +40, <i>p</i>-value ≤ 0.00001) and DBP (<i>r</i> = +0.32, <i>p</i>-value ≤ 0.00001) but not with other risk factors for MetS. There were also significant but weaker correlations between BMI-for-age pctl, SBP (<i>r</i> = +30,<i> p</i>-value ≤ 0.00001), and DBP (<i>r =</i> +0.25, <i>p</i>-value ≤ 0.00001) (<b><a href="#fig002">Figures 2a</a></b>–<b><a href="#fig005">5b</a></b>). Binary logistic regression analysis between anthropometric indices—BMI-for-age pctl and WC—and the cardiometabolic risk factors under study was conducted. Both anthropometric indices independently and significantly correlated with high SBP (OR = 1.006, <i>p</i>-value < 0.0001; OR = 1.082,<i> p</i>-value < 0.0001), while only WC was significantly correlated with hypertriglyceridemia (OR = 1.041, <i>p</i>-value = 0.021). Overall, WC had slightly higher OR for MetS, systolic hypertension, hypertriglyceridemia, high T-Chol, and high LDL-C, while BMI-for-age pctl had slightly higher OR for diastolic hypertension, dysglycemia, and low HDL-C (<b><a href="#table004">Table 4</a></b>). Scatterplot diagram and Pearson’s correlation coefficient analysis show that in all participants, WC (cm) had weak but significant correlations with SBP (<i>r</i> = +0.40, <i>p</i>-value <0.00001) and DBP (<i>r</i> = +0.32,<i> p</i>-value < 0.00001), but not with other risk factors for MetS. BMI-for-age pctl had relatively weaker but notable correlations with SBP (<i>r</i> = +0.30,<i> p</i>-value < 0.00001) and DBP (<i>r</i> = +0.25, <i>p</i>-value < 0.00001), and negligible insignificant correlation with other MetS risk factors (<b><a href="#fig002">Figures 2a</a></b>–<b><a href="#fig004">4b</a></b>). The diagnostic ability of BMI-for-age pctl and WC to predict MetS and its components was then evaluated. Both BMI-for-age pctl (distance to corner = 0.836, AUC = 0.6847) and WC (distance to corner = 0.535, AUC = 0.6479) had equivalent ability to identify MetS and very poor ability in predicting all other components of MetS. The optimal cutoff values for the identification of MetS were ≥77.50 for BMI-for-age pctl and ≥69.00 cm for WC. However, WC showed higher sensitivity (0.519) but lower specificity (0.766) to recognize MetS, while BMI-for-age pctl showed a lower sensitivity (0.404) but higher specificity (0.879) in identifying MetS (<b><a href="#fig006">Figure 6a</a></b>–<b><a href="#fig006">b</a></b>). Finally, a multivariate regression analysis between each component of MetS as dependent variable and both BMI-for-age pctl and WC as predictor variables was computed. The predictor variables, BMI-for-age pctl and WC, together explained a significant 16.4% variability in the SBP (<i>R</i><sup>2</sup> = 0.164, <i>p</i>-value < 0.0001). WC was more significantly predicted and had a stronger influence (coef. = 0.634, <i>p</i>-value < 0.0001) on elevated SBP than BMI-for-age pctl (coef. = 0.039<i>, p</i>-value = 0.035). Moreover, both BMI-for-age pctl and WC are responsible for a substantial 11.2% variation in DBP (<i>R</i><sup>2</sup> = 0.112,<i> p</i>-value < 0.0001), and again WC had a stronger influence (coef. = 0.393, <i>p</i>-value < 0.0001) in predicting higher DBP than BMI-for-age pctl (coef. = 0.028, <i>p-</i>value = 0.054). Neither of the two anthropometric indices had any significant influence on other cardiometabolic risk factors except a significant 1.1% influence on TG (<i>R</i><sup>2</sup> = 0.011, <i>p</i>-value = 0.030), in which WC exerted a stronger influence (coef. = 2.199, <i>p</i>-value = 0.009) than BMI-for-age pctl which decreased as TG increased (coef. = −0.237,<i> p</i>-value = 0.196).</p> <div class="sap__fig sap__figure_panel"> <a id="fig002"><!-- named anchor --></a><h5 class="sap__label">Figure 2</h5> <div class="sap__caption"><h4 class="sap__subsection-title">Scatterplot and Pearson’s correlation coefficient (r) of (a) systolic blood pressure (mmHg) and (b) diastolic blood pressure (mmHg) with BMI-for-age percentile and waist circumference (cm).</h4></div> <img alt="media/image4a.jpg" src="https://journals.academia-photos.com/4/7492/image4a.jpg"><img alt="media/image4b.jpg" src="https://journals.academia-photos.com/4/7492/image4b.jpg"> </div> <div class="sap__fig sap__figure_panel"> <a id="fig003"><!-- named anchor --></a><h5 class="sap__label">Figure 3</h5> <div class="sap__caption"><h4 class="sap__subsection-title">Scatterplot and Pearson’s correlation coefficient of fasting plasma glucose (mg/dL) with BMI-for-age percentile and waist circumference (cm).</h4></div> <img alt="media/image5.jpg" src="https://journals.academia-photos.com/4/7492/image5.jpg"> </div> <div class="sap__fig sap__figure_panel"> <a id="fig004"><!-- named anchor --></a><h5 class="sap__label">Figure 4</h5> <div class="sap__caption"><h4 class="sap__subsection-title">Scatterplot and Pearson’s correlation coefficient of (a) TG and (b) T-Chol (mg/dL) with BMI-for-age percentile and waist circumference (cm).</h4></div> <img alt="media/image6a.jpg" src="https://journals.academia-photos.com/4/7492/image6a.jpg"><img alt="media/image6b.jpg" src="https://journals.academia-photos.com/4/7492/image6b.jpg"> </div> <div class="sap__fig sap__figure_panel"> <a id="fig005"><!-- named anchor --></a><h5 class="sap__label">Figure 5</h5> <div class="sap__caption"><h4 class="sap__subsection-title">Scatterplot and Pearson’s correlation coefficient of (a) LDL and (b) HDL (mg/dL) with BMI-for-age percentile and waist circumference (cm).</h4></div> <img alt="media/image7a.jpg" src="https://journals.academia-photos.com/4/7492/image7a.jpg"><img alt="media/image7b.jpg" src="https://journals.academia-photos.com/4/7492/image7b.jpg"> </div> <div class="sap__fig sap__figure_panel"> <a id="fig006"><!-- named anchor --></a><h5 class="sap__label">Figure 6</h5> <div class="sap__caption"><h4 class="sap__subsection-title">(a, b) ROC analysis of anthropometric indices for MetS and its risk factors.</h4></div> <img alt="media/image8a.jpg" src="https://journals.academia-photos.com/4/7492/image8a.jpg"><img alt="media/image8b.jpg" src="https://journals.academia-photos.com/4/7492/image8b.jpg"> </div> <div class="sap__table-wrap sap__figure_panel"> <a id="table002"><!-- named anchor --></a><h5 class="sap__label">Table 2</h5> <div class="sap__caption"><h4 class="sap__subsection-title">Descriptive statistics of BMI-for-age percentile and waist circumference of study subjects relative to categorical components of metabolic syndrome</h4></div> <table frame="box" rules="all" cellpadding="16"> <a id="id134"><!-- named anchor --></a><thead> <a id="id135"><!-- named anchor --></a><tr> <a id="id136"><!-- named anchor --></a><th align="left" valign="top" rowspan="3"> <a id="id137"><!-- named anchor --></a>Components of MetS</th> <th align="left" valign="top" rowspan="3"> <a id="id138"><!-- named anchor --></a>Category</th> <th align="left" valign="top" colspan="4"> <a id="id139"><!-- named anchor --></a>All subjects</th> <th align="left" valign="top" colspan="4"> <a id="id140"><!-- named anchor --></a>MetS < 90th percentile</th> <th align="left" valign="top" colspan="4"> <a id="id141"><!-- named anchor --></a>MetS ≥ 90th percentile</th> <th align="left" valign="top" colspan="2"> <a id="id142"><!-- named anchor --></a>MetS < 90th vs MetS ≥ 90th percentile</th> </tr> <tr> <a id="id143"><!-- named anchor --></a><th align="left" valign="top" rowspan="2"> <a id="id144"><!-- named anchor --></a>Freq.</th> <th align="left" valign="top" rowspan="2"> <a id="id145"><!-- named anchor --></a>%</th> <th align="left" valign="top"> <a id="id146"><!-- named anchor --></a>BMI-for-age percentile</th> <th align="left" valign="top"> <a id="id147"><!-- named anchor --></a>Waist circumference (cm)</th> <th align="left" valign="top" rowspan="2"> <a id="id148"><!-- named anchor --></a>Freq.</th> <th align="left" valign="top" rowspan="2"> <a id="id149"><!-- named anchor --></a>%</th> <th align="left" valign="top"> <a id="id150"><!-- named anchor --></a>BMI-for-age percentile</th> <th align="left" valign="top"> <a id="id151"><!-- named anchor --></a>Waist circumference (cm)</th> <th align="left" valign="top" rowspan="2"> <a id="id152"><!-- named anchor --></a>Freq.</th> <th align="left" valign="top" rowspan="2"> <a id="id153"><!-- named anchor --></a>%</th> <th align="left" valign="top"> <a id="id154"><!-- named anchor --></a>BMI-for-age percentile</th> <th align="left" valign="top"> <a id="id155"><!-- named anchor --></a>Waist circumference (cm)</th> <th align="left" valign="top"> <a id="id156"><!-- named anchor --></a>BMI-for-age percentile</th> <th align="left" valign="top"> <a id="id157"><!-- named anchor --></a>Waist circumference (cm)</th> </tr> <tr> <a id="id158"><!-- named anchor --></a><th align="left" valign="top"> <a id="id159"><!-- named anchor --></a>Median</th> <th align="left" valign="top"> <a id="id160"><!-- named anchor --></a>Median</th> <th align="left" valign="top"> <a id="id161"><!-- named anchor --></a>Median</th> <th align="left" valign="top"> <a id="id162"><!-- named anchor --></a>Median</th> <th align="left" valign="top"> <a id="id163"><!-- named anchor --></a>Median</th> <th align="left" valign="top"> <a id="id164"><!-- named anchor --></a>Median</th> <th align="left" valign="top" colspan="2"> <a id="id165"><!-- named anchor --></a>Mann–Whitney <i>U</i> test (<i>p</i>-value)</th> </tr> </thead> <tbody> <a id="id166"><!-- named anchor --></a><tr> <a id="id167"><!-- named anchor --></a><td align="left" valign="top" colspan="2"> <a id="id168"><!-- named anchor --></a>All</td> <td align="left" valign="top"> <a id="id169"><!-- named anchor --></a>624</td> <td align="left" valign="top"> <a id="id170"><!-- named anchor --></a>100.0</td> <td align="left" valign="top"> <a id="id171"><!-- named anchor --></a>31.6</td> <td align="left" valign="top"> <a id="id172"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id173"><!-- named anchor --></a>572</td> <td align="left" valign="top"> <a id="id174"><!-- named anchor --></a>91.7</td> <td align="left" valign="top"> <a id="id175"><!-- named anchor --></a>30.2</td> <td align="left" valign="top"> <a id="id176"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id177"><!-- named anchor --></a>52</td> <td align="left" valign="top"> <a id="id178"><!-- named anchor --></a>8.3</td> <td align="left" valign="top"> <a id="id179"><!-- named anchor --></a>61.4</td> <td align="left" valign="top"> <a id="id180"><!-- named anchor --></a>68.5</td> <td align="left" valign="top"> <a id="id181"><!-- named anchor --></a>4.41 (0.00001)</td> <td align="left" valign="top"> <a id="id182"><!-- named anchor --></a>3.33 (0.0009)</td> </tr> <tr> <a id="id183"><!-- named anchor --></a><td align="left" valign="top" rowspan="5"> <a id="id184"><!-- named anchor --></a>SBP</td> <td align="left" valign="top"> <a id="id185"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id186"><!-- named anchor --></a>41</td> <td align="left" valign="top"> <a id="id187"><!-- named anchor --></a>6.6</td> <td align="left" valign="top"> <a id="id188"><!-- named anchor --></a> 6.9</td> <td align="left" valign="top"> <a id="id189"><!-- named anchor --></a>58.0</td> <td align="left" valign="top"> <a id="id190"><!-- named anchor --></a>40</td> <td align="left" valign="top"> <a id="id191"><!-- named anchor --></a>7.0</td> <td align="left" valign="top"> <a id="id192"><!-- named anchor --></a>6.0</td> <td align="left" valign="top"> <a id="id193"><!-- named anchor --></a>58.0</td> <td align="left" valign="top"> <a id="id194"><!-- named anchor --></a>1</td> <td align="left" valign="top"> <a id="id195"><!-- named anchor --></a>1.9</td> <td align="left" valign="top"> <a id="id196"><!-- named anchor --></a>95.5</td> <td align="left" valign="top"> <a id="id197"><!-- named anchor --></a>62.0</td> <td align="left" valign="top"> <a id="id198"><!-- named anchor --></a>1.69 (0.09)</td> <td align="left" valign="top"> <a id="id199"><!-- named anchor --></a>1.06 (0.29)</td> </tr> <tr> <a id="id200"><!-- named anchor --></a><td align="left" valign="top"> <a id="id201"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id202"><!-- named anchor --></a>472</td> <td align="left" valign="top"> <a id="id203"><!-- named anchor --></a>75.6</td> <td align="left" valign="top"> <a id="id204"><!-- named anchor --></a>30.5</td> <td align="left" valign="top"> <a id="id205"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id206"><!-- named anchor --></a>435</td> <td align="left" valign="top"> <a id="id207"><!-- named anchor --></a>76.0</td> <td align="left" valign="top"> <a id="id208"><!-- named anchor --></a>29.6</td> <td align="left" valign="top"> <a id="id209"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id210"><!-- named anchor --></a>37</td> <td align="left" valign="top"> <a id="id211"><!-- named anchor --></a>71.1</td> <td align="left" valign="top"> <a id="id212"><!-- named anchor --></a>45.8</td> <td align="left" valign="top"> <a id="id213"><!-- named anchor --></a>67.0</td> <td align="left" valign="top"> <a id="id214"><!-- named anchor --></a>3.22 (0.0001)</td> <td align="left" valign="top"> <a id="id215"><!-- named anchor --></a>2.21 (0.03)</td> </tr> <tr> <a id="id216"><!-- named anchor --></a><td align="left" valign="top"> <a id="id217"><!-- named anchor --></a>Elevated</td> <td align="left" valign="top"> <a id="id218"><!-- named anchor --></a>84</td> <td align="left" valign="top"> <a id="id219"><!-- named anchor --></a>13.5</td> <td align="left" valign="top"> <a id="id220"><!-- named anchor --></a>44.9</td> <td align="left" valign="top"> <a id="id221"><!-- named anchor --></a>69.0</td> <td align="left" valign="top"> <a id="id222"><!-- named anchor --></a>77</td> <td align="left" valign="top"> <a id="id223"><!-- named anchor --></a>13.5</td> <td align="left" valign="top"> <a id="id224"><!-- named anchor --></a>42.9</td> <td align="left" valign="top"> <a id="id225"><!-- named anchor --></a>69.0</td> <td align="left" valign="top"> <a id="id226"><!-- named anchor --></a>7</td> <td align="left" valign="top"> <a id="id227"><!-- named anchor --></a>13.5</td> <td align="left" valign="top"> <a id="id228"><!-- named anchor --></a>67.8</td> <td align="left" valign="top"> <a id="id229"><!-- named anchor --></a>72.0</td> <td align="left" valign="top"> <a id="id230"><!-- named anchor --></a>1.14 (0.25)</td> <td align="left" valign="top"> <a id="id231"><!-- named anchor --></a>0.60 (0.55)</td> </tr> <tr> <a id="id232"><!-- named anchor --></a><td align="left" valign="top"> <a id="id233"><!-- named anchor --></a>Stage 1</td> <td align="left" valign="top"> <a id="id234"><!-- named anchor --></a>24</td> <td align="left" valign="top"> <a id="id235"><!-- named anchor --></a>3.8</td> <td align="left" valign="top"> <a id="id236"><!-- named anchor --></a>64.3</td> <td align="left" valign="top"> <a id="id237"><!-- named anchor --></a>71.5</td> <td align="left" valign="top"> <a id="id238"><!-- named anchor --></a>17</td> <td align="left" valign="top"> <a id="id239"><!-- named anchor --></a>3.0</td> <td align="left" valign="top"> <a id="id240"><!-- named anchor --></a>57.1</td> <td align="left" valign="top"> <a id="id241"><!-- named anchor --></a>70.9</td> <td align="left" valign="top"> <a id="id242"><!-- named anchor --></a>7</td> <td align="left" valign="top"> <a id="id243"><!-- named anchor --></a>13.5</td> <td align="left" valign="top"> <a id="id244"><!-- named anchor --></a>85.9</td> <td align="left" valign="top"> <a id="id245"><!-- named anchor --></a>72.0</td> <td align="left" valign="top"> <a id="id246"><!-- named anchor --></a>1.05 (0.29)</td> <td align="left" valign="top"> <a id="id247"><!-- named anchor --></a>0.54 (0.59)</td> </tr> <tr> <a id="id248"><!-- named anchor --></a><td align="left" valign="top"> <a id="id249"><!-- named anchor --></a>Stage 2</td> <td align="left" valign="top"> <a id="id250"><!-- named anchor --></a>3</td> <td align="left" valign="top"> <a id="id251"><!-- named anchor --></a>0.5</td> <td align="left" valign="top"> <a id="id252"><!-- named anchor --></a>31.1</td> <td align="left" valign="top"> <a id="id253"><!-- named anchor --></a>60.0</td> <td align="left" valign="top"> <a id="id254"><!-- named anchor --></a>3</td> <td align="left" valign="top"> <a id="id255"><!-- named anchor --></a>0.5</td> <td align="left" valign="top"> <a id="id256"><!-- named anchor --></a>31.1</td> <td align="left" valign="top"> <a id="id257"><!-- named anchor --></a>60.0</td> <td align="left" valign="top"> <a id="id258"><!-- named anchor --></a>0</td> <td align="left" valign="top"> <a id="id259"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id260"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id261"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id262"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id263"><!-- named anchor --></a>0.0</td> </tr> <tr> <a id="id264"><!-- named anchor --></a><td align="left" valign="top" rowspan="4"> <a id="id265"><!-- named anchor --></a>DBP</td> <td align="left" valign="top"> <a id="id266"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id267"><!-- named anchor --></a>299</td> <td align="left" valign="top"> <a id="id268"><!-- named anchor --></a>47.9</td> <td align="left" valign="top"> <a id="id269"><!-- named anchor --></a>24.2</td> <td align="left" valign="top"> <a id="id270"><!-- named anchor --></a>63.0</td> <td align="left" valign="top"> <a id="id271"><!-- named anchor --></a>279</td> <td align="left" valign="top"> <a id="id272"><!-- named anchor --></a>48.8</td> <td align="left" valign="top"> <a id="id273"><!-- named anchor --></a>22.8</td> <td align="left" valign="top"> <a id="id274"><!-- named anchor --></a>63.0</td> <td align="left" valign="top"> <a id="id275"><!-- named anchor --></a>20</td> <td align="left" valign="top"> <a id="id276"><!-- named anchor --></a>38.5</td> <td align="left" valign="top"> <a id="id277"><!-- named anchor --></a>47.1</td> <td align="left" valign="top"> <a id="id278"><!-- named anchor --></a>66.5</td> <td align="left" valign="top"> <a id="id279"><!-- named anchor --></a>2.66 (0.008)</td> <td align="left" valign="top"> <a id="id280"><!-- named anchor --></a>2.53 (0.01)</td> </tr> <tr> <a id="id281"><!-- named anchor --></a><td align="left" valign="top"> <a id="id282"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id283"><!-- named anchor --></a>278</td> <td align="left" valign="top"> <a id="id284"><!-- named anchor --></a>44.5</td> <td align="left" valign="top"> <a id="id285"><!-- named anchor --></a>38.5</td> <td align="left" valign="top"> <a id="id286"><!-- named anchor --></a>66.0</td> <td align="left" valign="top"> <a id="id287"><!-- named anchor --></a>253</td> <td align="left" valign="top"> <a id="id288"><!-- named anchor --></a>44.2</td> <td align="left" valign="top"> <a id="id289"><!-- named anchor --></a>37.8</td> <td align="left" valign="top"> <a id="id290"><!-- named anchor --></a>66.0</td> <td align="left" valign="top"> <a id="id291"><!-- named anchor --></a>25</td> <td align="left" valign="top"> <a id="id292"><!-- named anchor --></a>48.1</td> <td align="left" valign="top"> <a id="id293"><!-- named anchor --></a>63.7</td> <td align="left" valign="top"> <a id="id294"><!-- named anchor --></a>69.0</td> <td align="left" valign="top"> <a id="id295"><!-- named anchor --></a>2.31 (0.02)</td> <td align="left" valign="top"> <a id="id296"><!-- named anchor --></a>1.39 (0.16)</td> </tr> <tr> <a id="id297"><!-- named anchor --></a><td align="left" valign="top"> <a id="id298"><!-- named anchor --></a>Elevated</td> <td align="left" valign="top"> <a id="id299"><!-- named anchor --></a>39</td> <td align="left" valign="top"> <a id="id300"><!-- named anchor --></a>6.3</td> <td align="left" valign="top"> <a id="id301"><!-- named anchor --></a>57.9</td> <td align="left" valign="top"> <a id="id302"><!-- named anchor --></a>69.0</td> <td align="left" valign="top"> <a id="id303"><!-- named anchor --></a>34</td> <td align="left" valign="top"> <a id="id304"><!-- named anchor --></a>5.9</td> <td align="left" valign="top"> <a id="id305"><!-- named anchor --></a>56.8</td> <td align="left" valign="top"> <a id="id306"><!-- named anchor --></a>68.0</td> <td align="left" valign="top"> <a id="id307"><!-- named anchor --></a>5</td> <td align="left" valign="top"> <a id="id308"><!-- named anchor --></a>9.6</td> <td align="left" valign="top"> <a id="id309"><!-- named anchor --></a>92.6</td> <td align="left" valign="top"> <a id="id310"><!-- named anchor --></a>73.0</td> <td align="left" valign="top"> <a id="id311"><!-- named anchor --></a>2.05 (0.04)</td> <td align="left" valign="top"> <a id="id312"><!-- named anchor --></a>1.49 (0.14)</td> </tr> <tr> <a id="id313"><!-- named anchor --></a><td align="left" valign="top"> <a id="id314"><!-- named anchor --></a>Stage 1</td> <td align="left" valign="top"> <a id="id315"><!-- named anchor --></a>8</td> <td align="left" valign="top"> <a id="id316"><!-- named anchor --></a>1.3</td> <td align="left" valign="top"> <a id="id317"><!-- named anchor --></a>34.9</td> <td align="left" valign="top"> <a id="id318"><!-- named anchor --></a>66.5</td> <td align="left" valign="top"> <a id="id319"><!-- named anchor --></a>6</td> <td align="left" valign="top"> <a id="id320"><!-- named anchor --></a>1.1</td> <td align="left" valign="top"> <a id="id321"><!-- named anchor --></a>24.0</td> <td align="left" valign="top"> <a id="id322"><!-- named anchor --></a>65.5</td> <td align="left" valign="top"> <a id="id323"><!-- named anchor --></a>2</td> <td align="left" valign="top"> <a id="id324"><!-- named anchor --></a>3.8</td> <td align="left" valign="top"> <a id="id325"><!-- named anchor --></a>89.6</td> <td align="left" valign="top"> <a id="id326"><!-- named anchor --></a>69.5</td> <td align="left" valign="top"> <a id="id327"><!-- named anchor --></a>2.00 (0.045)</td> <td align="left" valign="top"> <a id="id328"><!-- named anchor --></a>0.67 (0.51)</td> </tr> <tr> <a id="id329"><!-- named anchor --></a><td align="left" valign="top" rowspan="4"> <a id="id330"><!-- named anchor --></a>FPG</td> <td align="left" valign="top"> <a id="id331"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id332"><!-- named anchor --></a>88</td> <td align="left" valign="top"> <a id="id333"><!-- named anchor --></a>14.1</td> <td align="left" valign="top"> <a id="id334"><!-- named anchor --></a>34.3</td> <td align="left" valign="top"> <a id="id335"><!-- named anchor --></a>65.5</td> <td align="left" valign="top"> <a id="id336"><!-- named anchor --></a>87</td> <td align="left" valign="top"> <a id="id337"><!-- named anchor --></a>15.2</td> <td align="left" valign="top"> <a id="id338"><!-- named anchor --></a>34.0</td> <td align="left" valign="top"> <a id="id339"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id340"><!-- named anchor --></a>1</td> <td align="left" valign="top"> <a id="id341"><!-- named anchor --></a>1.9</td> <td align="left" valign="top"> <a id="id342"><!-- named anchor --></a>67.3</td> <td align="left" valign="top"> <a id="id343"><!-- named anchor --></a>71.0</td> <td align="left" valign="top"> <a id="id344"><!-- named anchor --></a>1.04 (0.30)</td> <td align="left" valign="top"> <a id="id345"><!-- named anchor --></a>1.24 (0.21)</td> </tr> <tr> <a id="id346"><!-- named anchor --></a><td align="left" valign="top"> <a id="id347"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id348"><!-- named anchor --></a>344</td> <td align="left" valign="top"> <a id="id349"><!-- named anchor --></a>55.1</td> <td align="left" valign="top"> <a id="id350"><!-- named anchor --></a>31.9</td> <td align="left" valign="top"> <a id="id351"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id352"><!-- named anchor --></a>332</td> <td align="left" valign="top"> <a id="id353"><!-- named anchor --></a>58.0</td> <td align="left" valign="top"> <a id="id354"><!-- named anchor --></a>31.2</td> <td align="left" valign="top"> <a id="id355"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id356"><!-- named anchor --></a>12</td> <td align="left" valign="top"> <a id="id357"><!-- named anchor --></a>23.1</td> <td align="left" valign="top"> <a id="id358"><!-- named anchor --></a>83.6</td> <td align="left" valign="top"> <a id="id359"><!-- named anchor --></a>71.5</td> <td align="left" valign="top"> <a id="id360"><!-- named anchor --></a>3.64 (0.0003)</td> <td align="left" valign="top"> <a id="id361"><!-- named anchor --></a>2.77 (0.006)</td> </tr> <tr> <a id="id362"><!-- named anchor --></a><td align="left" valign="top"> <a id="id363"><!-- named anchor --></a>Impaired</td> <td align="left" valign="top"> <a id="id364"><!-- named anchor --></a>120</td> <td align="left" valign="top"> <a id="id365"><!-- named anchor --></a>19.2</td> <td align="left" valign="top"> <a id="id366"><!-- named anchor --></a>30.8</td> <td align="left" valign="top"> <a id="id367"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id368"><!-- named anchor --></a>101</td> <td align="left" valign="top"> <a id="id369"><!-- named anchor --></a>17.7</td> <td align="left" valign="top"> <a id="id370"><!-- named anchor --></a>26.2</td> <td align="left" valign="top"> <a id="id371"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id372"><!-- named anchor --></a>19</td> <td align="left" valign="top"> <a id="id373"><!-- named anchor --></a>36.5</td> <td align="left" valign="top"> <a id="id374"><!-- named anchor --></a>70.9</td> <td align="left" valign="top"> <a id="id375"><!-- named anchor --></a>72.0</td> <td align="left" valign="top"> <a id="id376"><!-- named anchor --></a>3.45 (0.006)</td> <td align="left" valign="top"> <a id="id377"><!-- named anchor --></a>3.61 (0.0003)</td> </tr> <tr> <a id="id378"><!-- named anchor --></a><td align="left" valign="top"> <a id="id379"><!-- named anchor --></a>Diabetic</td> <td align="left" valign="top"> <a id="id380"><!-- named anchor --></a>72</td> <td align="left" valign="top"> <a id="id381"><!-- named anchor --></a>11.6</td> <td align="left" valign="top"> <a id="id382"><!-- named anchor --></a>30.7</td> <td align="left" valign="top"> <a id="id383"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id384"><!-- named anchor --></a>52</td> <td align="left" valign="top"> <a id="id385"><!-- named anchor --></a>9.1</td> <td align="left" valign="top"> <a id="id386"><!-- named anchor --></a>28.1</td> <td align="left" valign="top"> <a id="id387"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id388"><!-- named anchor --></a>20</td> <td align="left" valign="top"> <a id="id389"><!-- named anchor --></a>38.5</td> <td align="left" valign="top"> <a id="id390"><!-- named anchor --></a>42.1</td> <td align="left" valign="top"> <a id="id391"><!-- named anchor --></a>64.5</td> <td align="left" valign="top"> <a id="id392"><!-- named anchor --></a>0.84 (0.40)</td> <td align="left" valign="top"> <a id="id393"><!-- named anchor --></a>0.25 (0.81)</td> </tr> <tr> <a id="id394"><!-- named anchor --></a><td align="left" valign="top" rowspan="3"> <a id="id395"><!-- named anchor --></a>TG</td> <td align="left" valign="top"> <a id="id396"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id397"><!-- named anchor --></a>174</td> <td align="left" valign="top"> <a id="id398"><!-- named anchor --></a>27.9</td> <td align="left" valign="top"> <a id="id399"><!-- named anchor --></a>31.9</td> <td align="left" valign="top"> <a id="id400"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id401"><!-- named anchor --></a>14</td> <td align="left" valign="top"> <a id="id402"><!-- named anchor --></a>2.5</td> <td align="left" valign="top"> <a id="id403"><!-- named anchor --></a>31.8</td> <td align="left" valign="top"> <a id="id404"><!-- named anchor --></a>61.5</td> <td align="left" valign="top"> <a id="id405"><!-- named anchor --></a>1</td> <td align="left" valign="top"> <a id="id406"><!-- named anchor --></a>1.9</td> <td align="left" valign="top"> <a id="id407"><!-- named anchor --></a>63.7</td> <td align="left" valign="top"> <a id="id408"><!-- named anchor --></a>63.0</td> <td align="left" valign="top"> <a id="id409"><!-- named anchor --></a>0.69 (0.49)</td> <td align="left" valign="top"> <a id="id410"><!-- named anchor --></a>1.06 (0.29)</td> </tr> <tr> <a id="id411"><!-- named anchor --></a><td align="left" valign="top"> <a id="id412"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id413"><!-- named anchor --></a>72</td> <td align="left" valign="top"> <a id="id414"><!-- named anchor --></a>11.5</td> <td align="left" valign="top"> <a id="id415"><!-- named anchor --></a>30.1</td> <td align="left" valign="top"> <a id="id416"><!-- named anchor --></a>64.8</td> <td align="left" valign="top"> <a id="id417"><!-- named anchor --></a>185</td> <td align="left" valign="top"> <a id="id418"><!-- named anchor --></a>32.3</td> <td align="left" valign="top"> <a id="id419"><!-- named anchor --></a>30.2</td> <td align="left" valign="top"> <a id="id420"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id421"><!-- named anchor --></a>8</td> <td align="left" valign="top"> <a id="id422"><!-- named anchor --></a>15.4</td> <td align="left" valign="top"> <a id="id423"><!-- named anchor --></a>36.4</td> <td align="left" valign="top"> <a id="id424"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id425"><!-- named anchor --></a>0.57 (0.57)</td> <td align="left" valign="top"> <a id="id426"><!-- named anchor --></a>0.003 (1.00)</td> </tr> <tr> <a id="id427"><!-- named anchor --></a><td align="left" valign="top"> <a id="id428"><!-- named anchor --></a>High</td> <td align="left" valign="top"> <a id="id429"><!-- named anchor --></a>378</td> <td align="left" valign="top"> <a id="id430"><!-- named anchor --></a>60.6</td> <td align="left" valign="top"> <a id="id431"><!-- named anchor --></a>31.7</td> <td align="left" valign="top"> <a id="id432"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id433"><!-- named anchor --></a>373</td> <td align="left" valign="top"> <a id="id434"><!-- named anchor --></a>65.2</td> <td align="left" valign="top"> <a id="id435"><!-- named anchor --></a>30.3</td> <td align="left" valign="top"> <a id="id436"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id437"><!-- named anchor --></a>43</td> <td align="left" valign="top"> <a id="id438"><!-- named anchor --></a>82.7</td> <td align="left" valign="top"> <a id="id439"><!-- named anchor --></a>61.6</td> <td align="left" valign="top"> <a id="id440"><!-- named anchor --></a>69.0</td> <td align="left" valign="top"> <a id="id441"><!-- named anchor --></a>4.42 (0.00001)</td> <td align="left" valign="top"> <a id="id442"><!-- named anchor --></a>3.60 (0.0003)</td> </tr> <tr> <a id="id443"><!-- named anchor --></a><td align="left" valign="top" rowspan="3"> <a id="id444"><!-- named anchor --></a>T-Chol</td> <td align="left" valign="top"> <a id="id445"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id446"><!-- named anchor --></a>15</td> <td align="left" valign="top"> <a id="id447"><!-- named anchor --></a>2.4</td> <td align="left" valign="top"> <a id="id448"><!-- named anchor --></a>37.3</td> <td align="left" valign="top"> <a id="id449"><!-- named anchor --></a>62.0</td> <td align="left" valign="top"> <a id="id450"><!-- named anchor --></a>155</td> <td align="left" valign="top"> <a id="id451"><!-- named anchor --></a>27.1</td> <td align="left" valign="top"> <a id="id452"><!-- named anchor --></a>28.8</td> <td align="left" valign="top"> <a id="id453"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id454"><!-- named anchor --></a>19</td> <td align="left" valign="top"> <a id="id455"><!-- named anchor --></a>36.5</td> <td align="left" valign="top"> <a id="id456"><!-- named anchor --></a>67.3</td> <td align="left" valign="top"> <a id="id457"><!-- named anchor --></a>71.0</td> <td align="left" valign="top"> <a id="id458"><!-- named anchor --></a>3.83 (0.0001)</td> <td align="left" valign="top"> <a id="id459"><!-- named anchor --></a>2.25 (0.02)</td> </tr> <tr> <a id="id460"><!-- named anchor --></a><td align="left" valign="top"> <a id="id461"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id462"><!-- named anchor --></a>193</td> <td align="left" valign="top"> <a id="id463"><!-- named anchor --></a>30.9</td> <td align="left" valign="top"> <a id="id464"><!-- named anchor --></a>30.2</td> <td align="left" valign="top"> <a id="id465"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id466"><!-- named anchor --></a>59</td> <td align="left" valign="top"> <a id="id467"><!-- named anchor --></a>10.3</td> <td align="left" valign="top"> <a id="id468"><!-- named anchor --></a>25.0</td> <td align="left" valign="top"> <a id="id469"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id470"><!-- named anchor --></a>13</td> <td align="left" valign="top"> <a id="id471"><!-- named anchor --></a>25.0</td> <td align="left" valign="top"> <a id="id472"><!-- named anchor --></a>42.6</td> <td align="left" valign="top"> <a id="id473"><!-- named anchor --></a>66.0</td> <td align="left" valign="top"> <a id="id474"><!-- named anchor --></a>1.56 (0.19)</td> <td align="left" valign="top"> <a id="id475"><!-- named anchor --></a>1.68 (0.09)</td> </tr> <tr> <a id="id476"><!-- named anchor --></a><td align="left" valign="top"> <a id="id477"><!-- named anchor --></a>High</td> <td align="left" valign="top"> <a id="id478"><!-- named anchor --></a>416</td> <td align="left" valign="top"> <a id="id479"><!-- named anchor --></a>66.7</td> <td align="left" valign="top"> <a id="id480"><!-- named anchor --></a>33.1</td> <td align="left" valign="top"> <a id="id481"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id482"><!-- named anchor --></a>358</td> <td align="left" valign="top"> <a id="id483"><!-- named anchor --></a>62.6</td> <td align="left" valign="top"> <a id="id484"><!-- named anchor --></a>31.3</td> <td align="left" valign="top"> <a id="id485"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id486"><!-- named anchor --></a>20</td> <td align="left" valign="top"> <a id="id487"><!-- named anchor --></a>38.5</td> <td align="left" valign="top"> <a id="id488"><!-- named anchor --></a>69.2</td> <td align="left" valign="top"> <a id="id489"><!-- named anchor --></a>69.0</td> <td align="left" valign="top"> <a id="id490"><!-- named anchor --></a>2.39 (0.02)</td> <td align="left" valign="top"> <a id="id491"><!-- named anchor --></a>2.04 (0.04)</td> </tr> <tr> <a id="id492"><!-- named anchor --></a><td align="left" valign="top" rowspan="3"> <a id="id493"><!-- named anchor --></a>LDL</td> <td align="left" valign="top"> <a id="id494"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id495"><!-- named anchor --></a>46</td> <td align="left" valign="top"> <a id="id496"><!-- named anchor --></a>7.4</td> <td align="left" valign="top"> <a id="id497"><!-- named anchor --></a>29.3</td> <td align="left" valign="top"> <a id="id498"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id499"><!-- named anchor --></a>42</td> <td align="left" valign="top"> <a id="id500"><!-- named anchor --></a>7.3</td> <td align="left" valign="top"> <a id="id501"><!-- named anchor --></a>26.7</td> <td align="left" valign="top"> <a id="id502"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id503"><!-- named anchor --></a>4</td> <td align="left" valign="top"> <a id="id504"><!-- named anchor --></a>7.7</td> <td align="left" valign="top"> <a id="id505"><!-- named anchor --></a>67.0</td> <td align="left" valign="top"> <a id="id506"><!-- named anchor --></a>66.5</td> <td align="left" valign="top"> <a id="id507"><!-- named anchor --></a>1.83 (0.07)</td> <td align="left" valign="top"> <a id="id508"><!-- named anchor --></a>0.41 (0.68)</td> </tr> <tr> <a id="id509"><!-- named anchor --></a><td align="left" valign="top"> <a id="id510"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id511"><!-- named anchor --></a>1</td> <td align="left" valign="top"> <a id="id512"><!-- named anchor --></a>0.2</td> <td align="left" valign="top"> <a id="id513"><!-- named anchor --></a>1.4</td> <td align="left" valign="top"> <a id="id514"><!-- named anchor --></a>58.0</td> <td align="left" valign="top"> <a id="id515"><!-- named anchor --></a>1</td> <td align="left" valign="top"> <a id="id516"><!-- named anchor --></a>0.2</td> <td align="left" valign="top"> <a id="id517"><!-- named anchor --></a>1.4</td> <td align="left" valign="top"> <a id="id518"><!-- named anchor --></a>58.0</td> <td align="left" valign="top"> <a id="id519"><!-- named anchor --></a>0</td> <td align="left" valign="top"> <a id="id520"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id521"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id522"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id523"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id524"><!-- named anchor --></a>0.0</td> </tr> <tr> <a id="id525"><!-- named anchor --></a><td align="left" valign="top"> <a id="id526"><!-- named anchor --></a>High</td> <td align="left" valign="top"> <a id="id527"><!-- named anchor --></a>577</td> <td align="left" valign="top"> <a id="id528"><!-- named anchor --></a>92.4</td> <td align="left" valign="top"> <a id="id529"><!-- named anchor --></a>31.7</td> <td align="left" valign="top"> <a id="id530"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id531"><!-- named anchor --></a>529</td> <td align="left" valign="top"> <a id="id532"><!-- named anchor --></a>92.5</td> <td align="left" valign="top"> <a id="id533"><!-- named anchor --></a>30.6</td> <td align="left" valign="top"> <a id="id534"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id535"><!-- named anchor --></a>48</td> <td align="left" valign="top"> <a id="id536"><!-- named anchor --></a>92.3</td> <td align="left" valign="top"> <a id="id537"><!-- named anchor --></a>61.4</td> <td align="left" valign="top"> <a id="id538"><!-- named anchor --></a>68.5</td> <td align="left" valign="top"> <a id="id539"><!-- named anchor --></a>4.10 (0.00004)</td> <td align="left" valign="top"> <a id="id540"><!-- named anchor --></a>3.26 (0.001)</td> </tr> <tr> <a id="id541"><!-- named anchor --></a><td align="left" valign="top" rowspan="3"> <a id="id542"><!-- named anchor --></a>HDL</td> <td align="left" valign="top"> <a id="id543"><!-- named anchor --></a>High</td> <td align="left" valign="top"> <a id="id544"><!-- named anchor --></a>431</td> <td align="left" valign="top"> <a id="id545"><!-- named anchor --></a>69.1</td> <td align="left" valign="top"> <a id="id546"><!-- named anchor --></a>31.2</td> <td align="left" valign="top"> <a id="id547"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id548"><!-- named anchor --></a>342</td> <td align="left" valign="top"> <a id="id549"><!-- named anchor --></a>59.8</td> <td align="left" valign="top"> <a id="id550"><!-- named anchor --></a>30.0</td> <td align="left" valign="top"> <a id="id551"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id552"><!-- named anchor --></a>12</td> <td align="left" valign="top"> <a id="id553"><!-- named anchor --></a>23.1</td> <td align="left" valign="top"> <a id="id554"><!-- named anchor --></a>49.3</td> <td align="left" valign="top"> <a id="id555"><!-- named anchor --></a>67.0</td> <td align="left" valign="top"> <a id="id556"><!-- named anchor --></a>1.51 (0.13)</td> <td align="left" valign="top"> <a id="id557"><!-- named anchor --></a>1.71 (0.09)</td> </tr> <tr> <a id="id558"><!-- named anchor --></a><td align="left" valign="top"> <a id="id559"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id560"><!-- named anchor --></a>39</td> <td align="left" valign="top"> <a id="id561"><!-- named anchor --></a>30.9</td> <td align="left" valign="top"> <a id="id562"><!-- named anchor --></a>22.4</td> <td align="left" valign="top"> <a id="id563"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id564"><!-- named anchor --></a>1</td> <td align="left" valign="top"> <a id="id565"><!-- named anchor --></a>0.2</td> <td align="left" valign="top"> <a id="id566"><!-- named anchor --></a>17.3</td> <td align="left" valign="top"> <a id="id567"><!-- named anchor --></a>74.0</td> <td align="left" valign="top"> <a id="id568"><!-- named anchor --></a>1</td> <td align="left" valign="top"> <a id="id569"><!-- named anchor --></a>1.9</td> <td align="left" valign="top"> <a id="id570"><!-- named anchor --></a>14.0</td> <td align="left" valign="top"> <a id="id571"><!-- named anchor --></a>57.0</td> <td align="left" valign="top"> <a id="id572"><!-- named anchor --></a>1.00 (0.32)</td> <td align="left" valign="top"> <a id="id573"><!-- named anchor --></a>1.00 (0.32)</td> </tr> <tr> <a id="id574"><!-- named anchor --></a><td align="left" valign="top"> <a id="id575"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id576"><!-- named anchor --></a>154</td> <td align="left" valign="top"> <a id="id577"><!-- named anchor --></a>24.7</td> <td align="left" valign="top"> <a id="id578"><!-- named anchor --></a>33.7</td> <td align="left" valign="top"> <a id="id579"><!-- named anchor --></a>65.0</td> <td align="left" valign="top"> <a id="id580"><!-- named anchor --></a>229</td> <td align="left" valign="top"> <a id="id581"><!-- named anchor --></a>40.0</td> <td align="left" valign="top"> <a id="id582"><!-- named anchor --></a>30.8</td> <td align="left" valign="top"> <a id="id583"><!-- named anchor --></a>64.0</td> <td align="left" valign="top"> <a id="id584"><!-- named anchor --></a>39</td> <td align="left" valign="top"> <a id="id585"><!-- named anchor --></a>75.0</td> <td align="left" valign="top"> <a id="id586"><!-- named anchor --></a>67.8</td> <td align="left" valign="top"> <a id="id587"><!-- named anchor --></a>69.0</td> <td align="left" valign="top"> <a id="id588"><!-- named anchor --></a>4.30 (0.00002)</td> <td align="left" valign="top"> <a id="id589"><!-- named anchor --></a>3.00 (0.003)</td> </tr> </tbody> </table> <div class="sap__table-wrap-foot"><p class="sap__attrib">BMI, body mass index; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MetS, metabolic syndrome; SBP, systolic blood pressure; T-Chol, total cholesterol; TG, triglyceride. Shapiro–Wilk <i>W</i> test value = 0.92; <i>p</i>-value < 0.00001. Decision: Reject normality.</p></div> </div> <div class="sap__table-wrap sap__figure_panel"> <a id="table003"><!-- named anchor --></a><h5 class="sap__label">Table 3</h5> <div class="sap__caption"><h4 class="sap__subsection-title">Mean, median, and frequency distribution of categorical components of metabolic syndrome among adolescents with and without metabolic syndrome</h4></div> <table frame="box" rules="all" cellpadding="10"> <a id="id590"><!-- named anchor --></a><thead> <a id="id591"><!-- named anchor --></a><tr> <a id="id592"><!-- named anchor --></a><th align="left" valign="top" rowspan="2"> <a id="id593"><!-- named anchor --></a>Criteria for MetS</th> <th align="left" valign="top" rowspan="2"> <a id="id594"><!-- named anchor --></a>Category</th> <th align="left" valign="top" colspan="2"> <a id="id595"><!-- named anchor --></a>All</th> <th align="left" valign="top" colspan="2"> <a id="id596"><!-- named anchor --></a>MetS < 90th percentile (<i>n</i> = 572)</th> <th align="left" valign="top" colspan="2"> <a id="id597"><!-- named anchor --></a>MetS ≥ 90th percentile (<i>n</i> = 52)</th> <th align="left" valign="top" rowspan="2"> <a id="id598"><!-- named anchor --></a><i>t</i>-Test</th> <th align="left" valign="top" rowspan="2"> <a id="id599"><!-- named anchor --></a><i>p</i>-Value</th> </tr> <tr> <a id="id600"><!-- named anchor --></a><th align="left" valign="top"> <a id="id601"><!-- named anchor --></a>Freq. (%)</th> <th align="left" valign="top"> <a id="id602"><!-- named anchor --></a>Mean (±sd)</th> <th align="left" valign="top"> <a id="id603"><!-- named anchor --></a>Freq. (%)</th> <th align="left" valign="top"> <a id="id604"><!-- named anchor --></a>Mean (±sd)</th> <th align="left" valign="top"> <a id="id605"><!-- named anchor --></a>Freq. (%)</th> <th align="left" valign="top"> <a id="id606"><!-- named anchor --></a>Mean (±sd)</th> </tr> </thead> <tbody> <a id="id607"><!-- named anchor --></a><tr> <a id="id608"><!-- named anchor --></a><td align="left" valign="top" rowspan="6"> <a id="id609"><!-- named anchor --></a>SBP(mmHg)</td> <td align="left" valign="top"> <a id="id610"><!-- named anchor --></a>All</td> <td align="left" valign="top"> <a id="id611"><!-- named anchor --></a>624 (100.0)</td> <td align="left" valign="top"> <a id="id612"><!-- named anchor --></a>108.3 (12.4)</td> <td align="left" valign="top"> <a id="id613"><!-- named anchor --></a>572 (91.7)</td> <td align="left" valign="top"> <a id="id614"><!-- named anchor --></a>107.8 (12.4)</td> <td align="left" valign="top"> <a id="id615"><!-- named anchor --></a>52 (8.3)</td> <td align="left" valign="top"> <a id="id616"><!-- named anchor --></a>113.6 (11.6)</td> <td align="left" valign="top"> <a id="id617"><!-- named anchor --></a> –3.43</td> <td align="left" valign="top"> <a id="id618"><!-- named anchor --></a>0.001</td> </tr> <tr> <a id="id619"><!-- named anchor --></a><td align="left" valign="top"> <a id="id620"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id621"><!-- named anchor --></a>41 (6.6)</td> <td align="left" valign="top"> <a id="id622"><!-- named anchor --></a>83.9 (5.1)</td> <td align="left" valign="top"> <a id="id623"><!-- named anchor --></a>40 (7.0)</td> <td align="left" valign="top"> <a id="id624"><!-- named anchor --></a>83.7 (5.1)</td> <td align="left" valign="top"> <a id="id625"><!-- named anchor --></a>1 (1.9)</td> <td align="left" valign="top"> <a id="id626"><!-- named anchor --></a>89.0 (0.0)</td> <td align="left" valign="top"> <a id="id627"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id628"><!-- named anchor --></a>0.0</td> </tr> <tr> <a id="id629"><!-- named anchor --></a><td align="left" valign="top"> <a id="id630"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id631"><!-- named anchor --></a>472 (75.6)</td> <td align="left" valign="top"> <a id="id632"><!-- named anchor --></a>106.2 (7.7)</td> <td align="left" valign="top"> <a id="id633"><!-- named anchor --></a>435 (92.2)</td> <td align="left" valign="top"> <a id="id634"><!-- named anchor --></a>106.0 (7.7)</td> <td align="left" valign="top"> <a id="id635"><!-- named anchor --></a>37 (71.2)</td> <td align="left" valign="top"> <a id="id636"><!-- named anchor --></a>108.7 (7.4)</td> <td align="left" valign="top"> <a id="id637"><!-- named anchor --></a>–2.12</td> <td align="left" valign="top"> <a id="id638"><!-- named anchor --></a>0.04</td> </tr> <tr> <a id="id639"><!-- named anchor --></a><td align="left" valign="top"> <a id="id640"><!-- named anchor --></a>Elevated</td> <td align="left" valign="top"> <a id="id641"><!-- named anchor --></a>84 (13.5)</td> <td align="left" valign="top"> <a id="id642"><!-- named anchor --></a>123.9 (2.9)</td> <td align="left" valign="top"> <a id="id643"><!-- named anchor --></a>77 (13.5)</td> <td align="left" valign="top"> <a id="id644"><!-- named anchor --></a>123.9 (2.9)</td> <td align="left" valign="top"> <a id="id645"><!-- named anchor --></a>7 (13.5)</td> <td align="left" valign="top"> <a id="id646"><!-- named anchor --></a>124.4 (3.4)</td> <td align="left" valign="top"> <a id="id647"><!-- named anchor --></a>–0.38</td> <td align="left" valign="top"> <a id="id648"><!-- named anchor --></a>0.72</td> </tr> <tr> <a id="id649"><!-- named anchor --></a><td align="left" valign="top"> <a id="id650"><!-- named anchor --></a>Stage 1</td> <td align="left" valign="top"> <a id="id651"><!-- named anchor --></a>24 (3.9)</td> <td align="left" valign="top"> <a id="id652"><!-- named anchor --></a>132.9 (2.0)</td> <td align="left" valign="top"> <a id="id653"><!-- named anchor --></a>17 (3.0)</td> <td align="left" valign="top"> <a id="id654"><!-- named anchor --></a>133.2 (2.1)</td> <td align="left" valign="top"> <a id="id655"><!-- named anchor --></a>7 (13.5)</td> <td align="left" valign="top"> <a id="id656"><!-- named anchor --></a>132.1 (1.8)</td> <td align="left" valign="top"> <a id="id657"><!-- named anchor --></a>1.29</td> <td align="left" valign="top"> <a id="id658"><!-- named anchor --></a>0.22</td> </tr> <tr> <a id="id659"><!-- named anchor --></a><td align="left" valign="top"> <a id="id660"><!-- named anchor --></a>Stage 2</td> <td align="left" valign="top"> <a id="id661"><!-- named anchor --></a>3 (0.5)</td> <td align="left" valign="top"> <a id="id662"><!-- named anchor --></a>147.3 (9.3)</td> <td align="left" valign="top"> <a id="id663"><!-- named anchor --></a>3 (0.5)</td> <td align="left" valign="top"> <a id="id664"><!-- named anchor --></a>147.3 (9.3)</td> <td align="left" valign="top"> <a id="id665"><!-- named anchor --></a>0 (0.0)</td> <td align="left" valign="top"> <a id="id666"><!-- named anchor --></a>0.0 (0.0)</td> <td align="left" valign="top"> <a id="id667"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id668"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id669"><!-- named anchor --></a><td align="left" valign="top" rowspan="5"> <a id="id670"><!-- named anchor --></a>DBP(mmHg)</td> <td align="left" valign="top"> <a id="id671"><!-- named anchor --></a>All</td> <td align="left" valign="top"> <a id="id672"><!-- named anchor --></a>624 (100.0)</td> <td align="left" valign="top"> <a id="id673"><!-- named anchor --></a>66.2 (9.5)</td> <td align="left" valign="top"> <a id="id674"><!-- named anchor --></a>572</td> <td align="left" valign="top"> <a id="id675"><!-- named anchor --></a>66.1 (9.5)</td> <td align="left" valign="top"> <a id="id676"><!-- named anchor --></a>52 (8.3)</td> <td align="left" valign="top"> <a id="id677"><!-- named anchor --></a>68.1 (10.1)</td> <td align="left" valign="top"> <a id="id678"><!-- named anchor --></a>–1.37</td> <td align="left" valign="top"> <a id="id679"><!-- named anchor --></a>0.17</td> </tr> <tr> <a id="id680"><!-- named anchor --></a><td align="left" valign="top"> <a id="id681"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id682"><!-- named anchor --></a>299 (47.9)</td> <td align="left" valign="top"> <a id="id683"><!-- named anchor --></a>58.4 (5.6)</td> <td align="left" valign="top"> <a id="id684"><!-- named anchor --></a>279 (48.8)</td> <td align="left" valign="top"> <a id="id685"><!-- named anchor --></a>58.4 (5.7)</td> <td align="left" valign="top"> <a id="id686"><!-- named anchor --></a>20 (38.5)</td> <td align="left" valign="top"> <a id="id687"><!-- named anchor --></a>58.7 (4.4)</td> <td align="left" valign="top"> <a id="id688"><!-- named anchor --></a>–0.29</td> <td align="left" valign="top"> <a id="id689"><!-- named anchor --></a>0.78</td> </tr> <tr> <a id="id690"><!-- named anchor --></a><td align="left" valign="top"> <a id="id691"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id692"><!-- named anchor --></a>278 (44.6)</td> <td align="left" valign="top"> <a id="id693"><!-- named anchor --></a>71.4 (3.7)</td> <td align="left" valign="top"> <a id="id694"><!-- named anchor --></a>253 (44.2)</td> <td align="left" valign="top"> <a id="id695"><!-- named anchor --></a>71.5 (3.7)</td> <td align="left" valign="top"> <a id="id696"><!-- named anchor --></a>25 (48.1)</td> <td align="left" valign="top"> <a id="id697"><!-- named anchor --></a>70.6 (3.3)</td> <td align="left" valign="top"> <a id="id698"><!-- named anchor --></a>1.29</td> <td align="left" valign="top"> <a id="id699"><!-- named anchor --></a>0.21</td> </tr> <tr> <a id="id700"><!-- named anchor --></a><td align="left" valign="top"> <a id="id701"><!-- named anchor --></a>Elevated</td> <td align="left" valign="top"> <a id="id702"><!-- named anchor --></a>39 (6.2)</td> <td align="left" valign="top"> <a id="id703"><!-- named anchor --></a>83.3 (2.9)</td> <td align="left" valign="top"> <a id="id704"><!-- named anchor --></a>34 (5.9)</td> <td align="left" valign="top"> <a id="id705"><!-- named anchor --></a>83.4 (3.0)</td> <td align="left" valign="top"> <a id="id706"><!-- named anchor --></a>5 (9.6)</td> <td align="left" valign="top"> <a id="id707"><!-- named anchor --></a>82.6 (2.4)</td> <td align="left" valign="top"> <a id="id708"><!-- named anchor --></a>0.67</td> <td align="left" valign="top"> <a id="id709"><!-- named anchor --></a>0.53</td> </tr> <tr> <a id="id710"><!-- named anchor --></a><td align="left" valign="top"> <a id="id711"><!-- named anchor --></a>Stage 1</td> <td align="left" valign="top"> <a id="id712"><!-- named anchor --></a>8 (1.3)</td> <td align="left" valign="top"> <a id="id713"><!-- named anchor --></a>93.6 (3.4)</td> <td align="left" valign="top"> <a id="id714"><!-- named anchor --></a>6 (1.1)</td> <td align="left" valign="top"> <a id="id715"><!-- named anchor --></a>92.8 (3.7)</td> <td align="left" valign="top"> <a id="id716"><!-- named anchor --></a>2 (3.8)</td> <td align="left" valign="top"> <a id="id717"><!-- named anchor --></a>96.0 (0.0)</td> <td align="left" valign="top"> <a id="id718"><!-- named anchor --></a>–2.12</td> <td align="left" valign="top"> <a id="id719"><!-- named anchor --></a>0.09</td> </tr> <tr> <a id="id720"><!-- named anchor --></a><td align="left" valign="top" colspan="2"><a id="id721"><!-- named anchor --></a></td> <td align="left" valign="top"> <a id="id722"><!-- named anchor --></a><b>Freq. (%)</b> </td> <td align="left" valign="top"> <a id="id723"><!-- named anchor --></a><b>Median</b> </td> <td align="left" valign="top"> <a id="id724"><!-- named anchor --></a><b>Freq. (%)</b> </td> <td align="left" valign="top"> <a id="id725"><!-- named anchor --></a><b>Median</b> </td> <td align="left" valign="top"> <a id="id726"><!-- named anchor --></a><b>Freq. (%)</b> </td> <td align="left" valign="top"> <a id="id727"><!-- named anchor --></a><b>Median</b> </td> <td align="left" valign="top"> <a id="id728"><!-- named anchor --></a><b>Mann–Whitney <i>U</i> test</b> </td> <td align="left" valign="top"> <a id="id729"><!-- named anchor --></a><b><i>p</i>-Value</b> </td> </tr> <tr> <a id="id730"><!-- named anchor --></a><td align="left" valign="top" rowspan="5"> <a id="id731"><!-- named anchor --></a>FPG (mg/dL)</td> <td align="left" valign="top"> <a id="id732"><!-- named anchor --></a>All</td> <td align="left" valign="top"> <a id="id733"><!-- named anchor --></a>624 (100.0)</td> <td align="left" valign="top"> <a id="id734"><!-- named anchor --></a>87.5</td> <td align="left" valign="top"> <a id="id735"><!-- named anchor --></a>572 (91.7)</td> <td align="left" valign="top"> <a id="id736"><!-- named anchor --></a>85.7</td> <td align="left" valign="top"> <a id="id737"><!-- named anchor --></a>52 (8.3)</td> <td align="left" valign="top"> <a id="id738"><!-- named anchor --></a>115.0</td> <td align="left" valign="top"> <a id="id739"><!-- named anchor --></a>7.26</td> <td align="left" valign="top"> <a id="id740"><!-- named anchor --></a><0.000001</td> </tr> <tr> <a id="id741"><!-- named anchor --></a><td align="left" valign="top"> <a id="id742"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id743"><!-- named anchor --></a>198 (31.7)</td> <td align="left" valign="top"> <a id="id744"><!-- named anchor --></a>52.6</td> <td align="left" valign="top"> <a id="id745"><!-- named anchor --></a>193 (33.6)</td> <td align="left" valign="top"> <a id="id746"><!-- named anchor --></a>52.0</td> <td align="left" valign="top"> <a id="id747"><!-- named anchor --></a>5 (9.6)</td> <td align="left" valign="top"> <a id="id748"><!-- named anchor --></a>66.3</td> <td align="left" valign="top"> <a id="id749"><!-- named anchor --></a>2.25</td> <td align="left" valign="top"> <a id="id750"><!-- named anchor --></a>0.02</td> </tr> <tr> <a id="id751"><!-- named anchor --></a><td align="left" valign="top"> <a id="id752"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id753"><!-- named anchor --></a>234 (37.5)</td> <td align="left" valign="top"> <a id="id754"><!-- named anchor --></a>88.0</td> <td align="left" valign="top"> <a id="id755"><!-- named anchor --></a>226 (39.5)</td> <td align="left" valign="top"> <a id="id756"><!-- named anchor --></a>87.6</td> <td align="left" valign="top"> <a id="id757"><!-- named anchor --></a>8 (15.4)</td> <td align="left" valign="top"> <a id="id758"><!-- named anchor --></a>91.9</td> <td align="left" valign="top"> <a id="id759"><!-- named anchor --></a>1.61</td> <td align="left" valign="top"> <a id="id760"><!-- named anchor --></a>0.11</td> </tr> <tr> <a id="id761"><!-- named anchor --></a><td align="left" valign="top"> <a id="id762"><!-- named anchor --></a>Impaired</td> <td align="left" valign="top"> <a id="id763"><!-- named anchor --></a>119 (19.1)</td> <td align="left" valign="top"> <a id="id764"><!-- named anchor --></a>109.8</td> <td align="left" valign="top"> <a id="id765"><!-- named anchor --></a>100 (17.5)</td> <td align="left" valign="top"> <a id="id766"><!-- named anchor --></a>109.7</td> <td align="left" valign="top"> <a id="id767"><!-- named anchor --></a>19 (36.5)</td> <td align="left" valign="top"> <a id="id768"><!-- named anchor --></a>111.3</td> <td align="left" valign="top"> <a id="id769"><!-- named anchor --></a>0.97</td> <td align="left" valign="top"> <a id="id770"><!-- named anchor --></a>0.33</td> </tr> <tr> <a id="id771"><!-- named anchor --></a><td align="left" valign="top"> <a id="id772"><!-- named anchor --></a>Diabetic</td> <td align="left" valign="top"> <a id="id773"><!-- named anchor --></a>73 (11.7)</td> <td align="left" valign="top"> <a id="id774"><!-- named anchor --></a>149.2</td> <td align="left" valign="top"> <a id="id775"><!-- named anchor --></a>53 (9.3)</td> <td align="left" valign="top"> <a id="id776"><!-- named anchor --></a>137.8</td> <td align="left" valign="top"> <a id="id777"><!-- named anchor --></a>20 (38.5)</td> <td align="left" valign="top"> <a id="id778"><!-- named anchor --></a>199.7</td> <td align="left" valign="top"> <a id="id779"><!-- named anchor --></a>5.11</td> <td align="left" valign="top"> <a id="id780"><!-- named anchor --></a><0.000001</td> </tr> <tr> <a id="id781"><!-- named anchor --></a><td align="left" valign="top" rowspan="4"> <a id="id782"><!-- named anchor --></a>TG(mg/dL)</td> <td align="left" valign="top"> <a id="id783"><!-- named anchor --></a>All</td> <td align="left" valign="top"> <a id="id784"><!-- named anchor --></a>624 (100.0)</td> <td align="left" valign="top"> <a id="id785"><!-- named anchor --></a>180.8</td> <td align="left" valign="top"> <a id="id786"><!-- named anchor --></a>572 (91.7)</td> <td align="left" valign="top"> <a id="id787"><!-- named anchor --></a>176.8</td> <td align="left" valign="top"> <a id="id788"><!-- named anchor --></a>52 (8.3)</td> <td align="left" valign="top"> <a id="id789"><!-- named anchor --></a>234.1</td> <td align="left" valign="top"> <a id="id790"><!-- named anchor --></a>4.31</td> <td align="left" valign="top"> <a id="id791"><!-- named anchor --></a>0.00002</td> </tr> <tr> <a id="id792"><!-- named anchor --></a><td align="left" valign="top"> <a id="id793"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id794"><!-- named anchor --></a>15 (2.4)</td> <td align="left" valign="top"> <a id="id795"><!-- named anchor --></a>25.6</td> <td align="left" valign="top"> <a id="id796"><!-- named anchor --></a>14 (2.5)</td> <td align="left" valign="top"> <a id="id797"><!-- named anchor --></a>25.8</td> <td align="left" valign="top"> <a id="id798"><!-- named anchor --></a>1 (1.9)</td> <td align="left" valign="top"> <a id="id799"><!-- named anchor --></a>6.7</td> <td align="left" valign="top"> <a id="id800"><!-- named anchor --></a>–0.23</td> <td align="left" valign="top"> <a id="id801"><!-- named anchor --></a>0.82</td> </tr> <tr> <a id="id802"><!-- named anchor --></a><td align="left" valign="top"> <a id="id803"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id804"><!-- named anchor --></a>193 (30.9)</td> <td align="left" valign="top"> <a id="id805"><!-- named anchor --></a>105.8</td> <td align="left" valign="top"> <a id="id806"><!-- named anchor --></a>185 (32.3)</td> <td align="left" valign="top"> <a id="id807"><!-- named anchor --></a>105.5</td> <td align="left" valign="top"> <a id="id808"><!-- named anchor --></a>8 (15.4)</td> <td align="left" valign="top"> <a id="id809"><!-- named anchor --></a>120.7</td> <td align="left" valign="top"> <a id="id810"><!-- named anchor --></a>1.02</td> <td align="left" valign="top"> <a id="id811"><!-- named anchor --></a>0.31</td> </tr> <tr> <a id="id812"><!-- named anchor --></a><td align="left" valign="top"> <a id="id813"><!-- named anchor --></a>High</td> <td align="left" valign="top"> <a id="id814"><!-- named anchor --></a>416 (66.7)</td> <td align="left" valign="top"> <a id="id815"><!-- named anchor --></a>223.4</td> <td align="left" valign="top"> <a id="id816"><!-- named anchor --></a>373 (65.2)</td> <td align="left" valign="top"> <a id="id817"><!-- named anchor --></a>219.1</td> <td align="left" valign="top"> <a id="id818"><!-- named anchor --></a>43 (82.7)</td> <td align="left" valign="top"> <a id="id819"><!-- named anchor --></a>295.5</td> <td align="left" valign="top"> <a id="id820"><!-- named anchor --></a>3.49</td> <td align="left" valign="top"> <a id="id821"><!-- named anchor --></a>0.0005</td> </tr> <tr> <a id="id822"><!-- named anchor --></a><td align="left" valign="top" rowspan="4"> <a id="id823"><!-- named anchor --></a>T-Chol(mg/dL)</td> <td align="left" valign="top"> <a id="id824"><!-- named anchor --></a>All</td> <td align="left" valign="top"> <a id="id825"><!-- named anchor --></a>624 (100.0)</td> <td align="left" valign="top"> <a id="id826"><!-- named anchor --></a>199.4</td> <td align="left" valign="top"> <a id="id827"><!-- named anchor --></a>572 (91.7)</td> <td align="left" valign="top"> <a id="id828"><!-- named anchor --></a>204.6</td> <td align="left" valign="top"> <a id="id829"><!-- named anchor --></a>52 (8.3)</td> <td align="left" valign="top"> <a id="id830"><!-- named anchor --></a>164.1</td> <td align="left" valign="top"> <a id="id831"><!-- named anchor --></a>–2.85</td> <td align="left" valign="top"> <a id="id832"><!-- named anchor --></a>0.004</td> </tr> <tr> <a id="id833"><!-- named anchor --></a><td align="left" valign="top"> <a id="id834"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id835"><!-- named anchor --></a>174 (28.9)</td> <td align="left" valign="top"> <a id="id836"><!-- named anchor --></a>119.7</td> <td align="left" valign="top"> <a id="id837"><!-- named anchor --></a>155 (27.1)</td> <td align="left" valign="top"> <a id="id838"><!-- named anchor --></a> 118.9</td> <td align="left" valign="top"> <a id="id839"><!-- named anchor --></a>19 (36.5)</td> <td align="left" valign="top"> <a id="id840"><!-- named anchor --></a>130.5</td> <td align="left" valign="top"> <a id="id841"><!-- named anchor --></a>0.69</td> <td align="left" valign="top"> <a id="id842"><!-- named anchor --></a>0.49</td> </tr> <tr> <a id="id843"><!-- named anchor --></a><td align="left" valign="top"> <a id="id844"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id845"><!-- named anchor --></a>72 (11.5)</td> <td align="left" valign="top"> <a id="id846"><!-- named anchor --></a>172.4</td> <td align="left" valign="top"> <a id="id847"><!-- named anchor --></a>59 (10.3)</td> <td align="left" valign="top"> <a id="id848"><!-- named anchor --></a>172.5</td> <td align="left" valign="top"> <a id="id849"><!-- named anchor --></a>13 (25.0)</td> <td align="left" valign="top"> <a id="id850"><!-- named anchor --></a>166.6</td> <td align="left" valign="top"> <a id="id851"><!-- named anchor --></a>–0.83</td> <td align="left" valign="top"> <a id="id852"><!-- named anchor --></a>0.41</td> </tr> <tr> <a id="id853"><!-- named anchor --></a><td align="left" valign="top"> <a id="id854"><!-- named anchor --></a>High</td> <td align="left" valign="top"> <a id="id855"><!-- named anchor --></a>378 (60.6)</td> <td align="left" valign="top"> <a id="id856"><!-- named anchor --></a>239.5</td> <td align="left" valign="top"> <a id="id857"><!-- named anchor --></a>358 (62.6)</td> <td align="left" valign="top"> <a id="id858"><!-- named anchor --></a>240.2</td> <td align="left" valign="top"> <a id="id859"><!-- named anchor --></a>20 (38.5)</td> <td align="left" valign="top"> <a id="id860"><!-- named anchor --></a>230.3</td> <td align="left" valign="top"> <a id="id861"><!-- named anchor --></a>–0.72</td> <td align="left" valign="top"> <a id="id862"><!-- named anchor --></a>0.47</td> </tr> <tr> <a id="id863"><!-- named anchor --></a><td align="left" valign="top" rowspan="4"> <a id="id864"><!-- named anchor --></a>LDL(mg/dL)</td> <td align="left" valign="top"> <a id="id865"><!-- named anchor --></a>All</td> <td align="left" valign="top"> <a id="id866"><!-- named anchor --></a>624 (100.0)</td> <td align="left" valign="top"> <a id="id867"><!-- named anchor --></a>289.6</td> <td align="left" valign="top"> <a id="id868"><!-- named anchor --></a>572 (91.7)</td> <td align="left" valign="top"> <a id="id869"><!-- named anchor --></a>280.8</td> <td align="left" valign="top"> <a id="id870"><!-- named anchor --></a>52 (8.3)</td> <td align="left" valign="top"> <a id="id871"><!-- named anchor --></a>325.0</td> <td align="left" valign="top"> <a id="id872"><!-- named anchor --></a>1.45</td> <td align="left" valign="top"> <a id="id873"><!-- named anchor --></a>0.15</td> </tr> <tr> <a id="id874"><!-- named anchor --></a><td align="left" valign="top"> <a id="id875"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id876"><!-- named anchor --></a>46 (7.4)</td> <td align="left" valign="top"> <a id="id877"><!-- named anchor --></a>40.4</td> <td align="left" valign="top"> <a id="id878"><!-- named anchor --></a>42 (7.3)</td> <td align="left" valign="top"> <a id="id879"><!-- named anchor --></a>43.4</td> <td align="left" valign="top"> <a id="id880"><!-- named anchor --></a>4 (7.7)</td> <td align="left" valign="top"> <a id="id881"><!-- named anchor --></a>26.4</td> <td align="left" valign="top"> <a id="id882"><!-- named anchor --></a>–0.68</td> <td align="left" valign="top"> <a id="id883"><!-- named anchor --></a>0.50</td> </tr> <tr> <a id="id884"><!-- named anchor --></a><td align="left" valign="top"> <a id="id885"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id886"><!-- named anchor --></a>1 (0.1)</td> <td align="left" valign="top"> <a id="id887"><!-- named anchor --></a>87.8</td> <td align="left" valign="top"> <a id="id888"><!-- named anchor --></a>1 (0.2)</td> <td align="left" valign="top"> <a id="id889"><!-- named anchor --></a>87.8</td> <td align="left" valign="top"> <a id="id890"><!-- named anchor --></a>0 (0.0)</td> <td align="left" valign="top"> <a id="id891"><!-- named anchor --></a>0.0</td> <td align="left" valign="top"> <a id="id892"><!-- named anchor --></a>-</td> <td align="left" valign="top"> <a id="id893"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id894"><!-- named anchor --></a><td align="left" valign="top"> <a id="id895"><!-- named anchor --></a>High</td> <td align="left" valign="top"> <a id="id896"><!-- named anchor --></a>577 (92.5)</td> <td align="left" valign="top"> <a id="id897"><!-- named anchor --></a>295.7</td> <td align="left" valign="top"> <a id="id898"><!-- named anchor --></a>529 (92.5)</td> <td align="left" valign="top"> <a id="id899"><!-- named anchor --></a>292.4</td> <td align="left" valign="top"> <a id="id900"><!-- named anchor --></a>48 (92.3)</td> <td align="left" valign="top"> <a id="id901"><!-- named anchor --></a>326.2</td> <td align="left" valign="top"> <a id="id902"><!-- named anchor --></a>1.67</td> <td align="left" valign="top"> <a id="id903"><!-- named anchor --></a>0.09</td> </tr> <tr> <a id="id904"><!-- named anchor --></a><td align="left" valign="top" rowspan="4"> <a id="id905"><!-- named anchor --></a>HDL(mg/dL)</td> <td align="left" valign="top"> <a id="id906"><!-- named anchor --></a>All</td> <td align="left" valign="top"> <a id="id907"><!-- named anchor --></a>624 (100.0)</td> <td align="left" valign="top"> <a id="id908"><!-- named anchor --></a>55.9</td> <td align="left" valign="top"> <a id="id909"><!-- named anchor --></a>572 (91.7)</td> <td align="left" valign="top"> <a id="id910"><!-- named anchor --></a>57.9</td> <td align="left" valign="top"> <a id="id911"><!-- named anchor --></a>52 (8.3)</td> <td align="left" valign="top"> <a id="id912"><!-- named anchor --></a>35.1</td> <td align="left" valign="top"> <a id="id913"><!-- named anchor --></a>–6.99</td> <td align="left" valign="top"> <a id="id914"><!-- named anchor --></a><0.00001</td> </tr> <tr> <a id="id915"><!-- named anchor --></a><td align="left" valign="top"> <a id="id916"><!-- named anchor --></a>High</td> <td align="left" valign="top"> <a id="id917"><!-- named anchor --></a>354 (56.7)</td> <td align="left" valign="top"> <a id="id918"><!-- named anchor --></a>73.8</td> <td align="left" valign="top"> <a id="id919"><!-- named anchor --></a>342 (59.8)</td> <td align="left" valign="top"> <a id="id920"><!-- named anchor --></a>74.6</td> <td align="left" valign="top"> <a id="id921"><!-- named anchor --></a>12 (23.1)</td> <td align="left" valign="top"> <a id="id922"><!-- named anchor --></a>55.2</td> <td align="left" valign="top"> <a id="id923"><!-- named anchor --></a>–3.78</td> <td align="left" valign="top"> <a id="id924"><!-- named anchor --></a>0.0002</td> </tr> <tr> <a id="id925"><!-- named anchor --></a><td align="left" valign="top"> <a id="id926"><!-- named anchor --></a>Normal</td> <td align="left" valign="top"> <a id="id927"><!-- named anchor --></a>2 (0.3)</td> <td align="left" valign="top"> <a id="id928"><!-- named anchor --></a>53.3</td> <td align="left" valign="top"> <a id="id929"><!-- named anchor --></a>1 (0.2)</td> <td align="left" valign="top"> <a id="id930"><!-- named anchor --></a>53.2</td> <td align="left" valign="top"> <a id="id931"><!-- named anchor --></a>1 (1.9)</td> <td align="left" valign="top"> <a id="id932"><!-- named anchor --></a>53.5</td> <td align="left" valign="top"> <a id="id933"><!-- named anchor --></a>–1.00</td> <td align="left" valign="top"> <a id="id934"><!-- named anchor --></a>0.32</td> </tr> <tr> <a id="id935"><!-- named anchor --></a><td align="left" valign="top"> <a id="id936"><!-- named anchor --></a>Low</td> <td align="left" valign="top"> <a id="id937"><!-- named anchor --></a>268 (43.0)</td> <td align="left" valign="top"> <a id="id938"><!-- named anchor --></a>36.6</td> <td align="left" valign="top"> <a id="id939"><!-- named anchor --></a>229 (40.0)</td> <td align="left" valign="top"> <a id="id940"><!-- named anchor --></a>38.5</td> <td align="left" valign="top"> <a id="id941"><!-- named anchor --></a>39 (75.0)</td> <td align="left" valign="top"> <a id="id942"><!-- named anchor --></a>25.4</td> <td align="left" valign="top"> <a id="id943"><!-- named anchor --></a>–3.90</td> <td align="left" valign="top"> <a id="id944"><!-- named anchor --></a>0.0001</td> </tr> </tbody> </table> </div> <div class="sap__table-wrap sap__figure_panel"> <a id="table004"><!-- named anchor --></a><h5 class="sap__label">Table 4</h5> <div class="sap__caption"><h4 class="sap__subsection-title">Binary logistic regression analysis with each component of metabolic syndrome as dependent variable and BMI-for-age percentile and waist circumference as predictor variables</h4></div> <table frame="box" rules="all" cellpadding="17"> <a id="id945"><!-- named anchor --></a><thead> <a id="id946"><!-- named anchor --></a><tr> <a id="id947"><!-- named anchor --></a><th align="left" valign="top" rowspan="3"> <a id="id948"><!-- named anchor --></a>Independent variables</th> <th align="left" valign="top" colspan="2"><a id="id949"><!-- named anchor --></a></th> <th align="center" valign="top" colspan="14"> <a id="id950"><!-- named anchor --></a>Cardiometabolic risk factors</th> </tr> <tr> <a id="id951"><!-- named anchor --></a><th align="left" valign="top" colspan="2"> <a id="id952"><!-- named anchor --></a>MetS</th> <th align="left" valign="top" colspan="2"> <a id="id953"><!-- named anchor --></a>High SBP</th> <th align="left" valign="top" colspan="2"> <a id="id954"><!-- named anchor --></a>High DBP</th> <th align="left" valign="top" colspan="2"> <a id="id955"><!-- named anchor --></a>Dysglycemia</th> <th align="left" valign="top" colspan="2"> <a id="id956"><!-- named anchor --></a>High TG</th> <th align="left" valign="top" colspan="2"> <a id="id957"><!-- named anchor --></a>High T-Chol</th> <th align="left" valign="top" colspan="2"> <a id="id958"><!-- named anchor --></a>High LDL-C</th> <th align="left" valign="top" colspan="2"> <a id="id959"><!-- named anchor --></a>Low HDL-C</th> </tr> <tr> <a id="id960"><!-- named anchor --></a><th align="left" valign="top"> <a id="id961"><!-- named anchor --></a>OR</th> <th align="left" valign="top"> <a id="id962"><!-- named anchor --></a>95% CI</th> <th align="left" valign="top"> <a id="id963"><!-- named anchor --></a>OR</th> <th align="left" valign="top"> <a id="id964"><!-- named anchor --></a>95% CI</th> <th align="left" valign="top"> <a id="id965"><!-- named anchor --></a>OR</th> <th align="left" valign="top"> <a id="id966"><!-- named anchor --></a>95% CI</th> <th align="left" valign="top"> <a id="id967"><!-- named anchor --></a>OR</th> <th align="left" valign="top"> <a id="id968"><!-- named anchor --></a>95% CI</th> <th align="left" valign="top"> <a id="id969"><!-- named anchor --></a>OR</th> <th align="left" valign="top"> <a id="id970"><!-- named anchor --></a>95% CI</th> <th align="left" valign="top"> <a id="id971"><!-- named anchor --></a>OR</th> <th align="left" valign="top"> <a id="id972"><!-- named anchor --></a>95% CI</th> <th align="left" valign="top"> <a id="id973"><!-- named anchor --></a>OR</th> <th align="left" valign="top"> <a id="id974"><!-- named anchor --></a>95% CI</th> <th align="left" valign="top"> <a id="id975"><!-- named anchor --></a>OR</th> <th align="left" valign="top"> <a id="id976"><!-- named anchor --></a>95% CI</th> </tr> </thead> <tbody> <a id="id977"><!-- named anchor --></a><tr> <a id="id978"><!-- named anchor --></a><td align="left" valign="top"> <a id="id979"><!-- named anchor --></a>BMI-for-age pctl</td> <td align="left" valign="top"> <a id="id980"><!-- named anchor --></a>1.005#</td> <td align="left" valign="top"> <a id="id981"><!-- named anchor --></a>0.996, 1.013</td> <td align="left" valign="top"> <a id="id982"><!-- named anchor --></a>1.006*</td> <td align="left" valign="top"> <a id="id983"><!-- named anchor --></a>0.998, 1.014</td> <td align="left" valign="top"> <a id="id984"><!-- named anchor --></a>1.006#</td> <td align="left" valign="top"> <a id="id985"><!-- named anchor --></a>0.978, 1.034</td> <td align="left" valign="top"> <a id="id986"><!-- named anchor --></a>1.003#</td> <td align="left" valign="top"> <a id="id987"><!-- named anchor --></a>0.993, 1.013</td> <td align="left" valign="top"> <a id="id988"><!-- named anchor --></a>0.997#</td> <td align="left" valign="top"> <a id="id989"><!-- named anchor --></a>0.990, 1.004</td> <td align="left" valign="top"> <a id="id990"><!-- named anchor --></a>1.001#</td> <td align="left" valign="top"> <a id="id991"><!-- named anchor --></a>0.994, 1.007</td> <td align="left" valign="top"> <a id="id992"><!-- named anchor --></a>1.000#</td> <td align="left" valign="top"> <a id="id993"><!-- named anchor --></a>0.991, 1.009</td> <td align="left" valign="top"> <a id="id994"><!-- named anchor --></a>1.001#</td> <td align="left" valign="top"> <a id="id995"><!-- named anchor --></a>0.994, 1.008</td> </tr> <tr> <a id="id996"><!-- named anchor --></a><td align="left" valign="top"> <a id="id997"><!-- named anchor --></a>WC</td> <td align="left" valign="top"> <a id="id998"><!-- named anchor --></a>1.013#</td> <td align="left" valign="top"> <a id="id999"><!-- named anchor --></a>0.977, 1.051</td> <td align="left" valign="top"> <a id="id1000"><!-- named anchor --></a>1.082*</td> <td align="left" valign="top"> <a id="id1001"><!-- named anchor --></a>1.043, 1.123</td> <td align="left" valign="top"> <a id="id1002"><!-- named anchor --></a>0.995#</td> <td align="left" valign="top"> <a id="id1003"><!-- named anchor --></a>0.876, 1.129</td> <td align="left" valign="top"> <a id="id1004"><!-- named anchor --></a>0.963#</td> <td align="left" valign="top"> <a id="id1005"><!-- named anchor --></a>0.918, 1.011</td> <td align="left" valign="top"> <a id="id1006"><!-- named anchor --></a>1.041!</td> <td align="left" valign="top"> <a id="id1007"><!-- named anchor --></a>1.006, 1.077</td> <td align="left" valign="top"> <a id="id1008"><!-- named anchor --></a>1.006#</td> <td align="left" valign="top"> <a id="id1009"><!-- named anchor --></a>0.976, 1.037</td> <td align="left" valign="top"> <a id="id1010"><!-- named anchor --></a>1.022#</td> <td align="left" valign="top"> <a id="id1011"><!-- named anchor --></a>0.978, 1.068</td> <td align="left" valign="top"> <a id="id1012"><!-- named anchor --></a>0.972#</td> <td align="left" valign="top"> <a id="id1013"><!-- named anchor --></a>0.942, 1.002</td> </tr> </tbody> </table> <div class="sap__table-wrap-foot"><p class="sap__attrib">* = <i>p</i>-value < 0.0001; ! = <i>p</i>-value < 0.05; # = <i>p</i>-value > 0.05. BMI, body mass index; DBP, diastolic blood pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; SBP, systolic blood pressure; T-Chol, total cholesterol; TG, triglyceride; WC, waist circumference.</p></div> </div> <div class="sap__table-wrap sap__figure_panel"> <a id="table005"><!-- named anchor --></a><h5 class="sap__label">Table 5</h5> <div class="sap__caption"><h4 class="sap__subsection-title">Multivariate regression analysis with each component of metabolic syndrome as dependent variable and BMI-for-age percentile and waist circumference as predictor variables</h4></div> <table frame="box" rules="all" cellpadding="6"> <a id="id1014"><!-- named anchor --></a><thead> <a id="id1015"><!-- named anchor --></a><tr> <a id="id1016"><!-- named anchor --></a><th align="left" valign="top" rowspan="4"> <a id="id1017"><!-- named anchor --></a>Predictor variables</th> <th align="left" valign="top" colspan="5"> <a id="id1018"><!-- named anchor --></a>Dependent variable = SBP</th> </tr> <tr> <a id="id1019"><!-- named anchor --></a><th align="left" valign="top" colspan="5"><a id="id1020"><!-- named anchor --></a></th> </tr> <tr> <a id="id1021"><!-- named anchor --></a><th align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1022"><!-- named anchor --></a><i>R</i><sup>2</sup> = 0.164</th> <th align="left" valign="top" colspan="2" style="background-color: #F3F3F3;"> <a id="id1023"><!-- named anchor --></a><i>F</i>-ratio = 60.71</th> <th align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1024"><!-- named anchor --></a><i>p</i>-Value = <0.0001</th> <th align="left" valign="top" rowspan="2"> <a id="id1025"><!-- named anchor --></a>95% CI</th> </tr> <tr> <a id="id1026"><!-- named anchor --></a><th align="left" valign="top"> <a id="id1027"><!-- named anchor --></a>Regression Coefficient</th> <th align="left" valign="top"> <a id="id1028"><!-- named anchor --></a>Standard Error</th> <th align="left" valign="top"> <a id="id1029"><!-- named anchor --></a><i>T</i>-Statistic to Test H0: β(i) = 0</th> <th align="left" valign="top"> <a id="id1030"><!-- named anchor --></a><i>p</i>-Value</th> </tr> </thead> <tbody> <a id="id1031"><!-- named anchor --></a><tr> <a id="id1032"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1033"><!-- named anchor --></a>Constant</td> <td align="left" valign="top"> <a id="id1034"><!-- named anchor --></a>65.343</td> <td align="left" valign="top"> <a id="id1035"><!-- named anchor --></a>5.158</td> <td align="left" valign="top"> <a id="id1036"><!-- named anchor --></a>12.67</td> <td align="left" valign="top"> <a id="id1037"><!-- named anchor --></a><0.0001</td> <td align="left" valign="top"> <a id="id1038"><!-- named anchor --></a>55.22, 75.47</td> </tr> <tr> <a id="id1039"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1040"><!-- named anchor --></a>BMI-for-age percentile</td> <td align="left" valign="top"> <a id="id1041"><!-- named anchor --></a>0.039</td> <td align="left" valign="top"> <a id="id1042"><!-- named anchor --></a>0.018</td> <td align="left" valign="top"> <a id="id1043"><!-- named anchor --></a>2.11</td> <td align="left" valign="top"> <a id="id1044"><!-- named anchor --></a>0.035</td> <td align="left" valign="top"> <a id="id1045"><!-- named anchor --></a>0.003, 0.075</td> </tr> <tr> <a id="id1046"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1047"><!-- named anchor --></a>Waist circumference (cm)</td> <td align="left" valign="top"> <a id="id1048"><!-- named anchor --></a>0.634</td> <td align="left" valign="top"> <a id="id1049"><!-- named anchor --></a>0.084</td> <td align="left" valign="top"> <a id="id1050"><!-- named anchor --></a>7.52</td> <td align="left" valign="top"> <a id="id1051"><!-- named anchor --></a><0.0001</td> <td align="left" valign="top"> <a id="id1052"><!-- named anchor --></a>0.469, 0.800</td> </tr> <tr> <a id="id1053"><!-- named anchor --></a><td align="left" valign="top" rowspan="2"><a id="id1054"><!-- named anchor --></a></td> <td align="left" valign="top" colspan="5"> <a id="id1055"><!-- named anchor --></a>Dependent variable = DBP</td> </tr> <tr> <a id="id1056"><!-- named anchor --></a><td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1057"><!-- named anchor --></a><i>R</i><sup>2</sup> = 0.112</td> <td align="left" valign="top" colspan="2" style="background-color: #F3F3F3;"> <a id="id1058"><!-- named anchor --></a><i>F</i>-ratio = 39.35</td> <td align="left" valign="top"> <a id="id1059"><!-- named anchor --></a><i>p</i>-Value = <0.0001</td> <td align="left" valign="top"> <a id="id1060"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id1061"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1062"><!-- named anchor --></a>Constant</td> <td align="left" valign="top"> <a id="id1063"><!-- named anchor --></a>39.463</td> <td align="left" valign="top"> <a id="id1064"><!-- named anchor --></a>4.083</td> <td align="left" valign="top"> <a id="id1065"><!-- named anchor --></a>9.665</td> <td align="left" valign="top"> <a id="id1066"><!-- named anchor --></a><0.0001</td> <td align="left" valign="top"> <a id="id1067"><!-- named anchor --></a>31.45, 47.48</td> </tr> <tr> <a id="id1068"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1069"><!-- named anchor --></a>BMI-for-age percentile</td> <td align="left" valign="top"> <a id="id1070"><!-- named anchor --></a>0.028</td> <td align="left" valign="top"> <a id="id1071"><!-- named anchor --></a>0.015</td> <td align="left" valign="top"> <a id="id1072"><!-- named anchor --></a>1.931</td> <td align="left" valign="top"> <a id="id1073"><!-- named anchor --></a>0.054</td> <td align="left" valign="top"> <a id="id1074"><!-- named anchor --></a>0.00, 0.06</td> </tr> <tr> <a id="id1075"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1076"><!-- named anchor --></a>Waist circumference (cm)</td> <td align="left" valign="top"> <a id="id1077"><!-- named anchor --></a>0.393</td> <td align="left" valign="top"> <a id="id1078"><!-- named anchor --></a>0.067</td> <td align="left" valign="top"> <a id="id1079"><!-- named anchor --></a>5.882</td> <td align="left" valign="top"> <a id="id1080"><!-- named anchor --></a><0.0001</td> <td align="left" valign="top"> <a id="id1081"><!-- named anchor --></a>0.26, 0.52</td> </tr> <tr> <a id="id1082"><!-- named anchor --></a><td><a id="id1083"><!-- named anchor --></a></td> <td align="left" valign="top" colspan="5"> <a id="id1084"><!-- named anchor --></a>Dependent variable = FPG</td> </tr> <tr> <a id="id1085"><!-- named anchor --></a><td><a id="id1086"><!-- named anchor --></a></td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1087"><!-- named anchor --></a><i>R</i><sup>2</sup> = 0.00</td> <td align="left" valign="top" colspan="2" style="background-color: #F3F3F3;"> <a id="id1088"><!-- named anchor --></a><i>F</i>-ratio = 0.017</td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1089"><!-- named anchor --></a><i>p</i>-Value = 0.098</td> <td align="left" valign="top"> <a id="id1090"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id1091"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1092"><!-- named anchor --></a>Constant</td> <td align="left" valign="top"> <a id="id1093"><!-- named anchor --></a>84.309</td> <td align="left" valign="top"> <a id="id1094"><!-- named anchor --></a>48.820</td> <td align="left" valign="top"> <a id="id1095"><!-- named anchor --></a>4.480</td> <td align="left" valign="top"> <a id="id1096"><!-- named anchor --></a><0.0001</td> <td align="left" valign="top"> <a id="id1097"><!-- named anchor --></a>47.35, 121.27</td> </tr> <tr> <a id="id1098"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1099"><!-- named anchor --></a>BMI-for-age percentile</td> <td align="left" valign="top"> <a id="id1100"><!-- named anchor --></a>–0.004</td> <td align="left" valign="top"> <a id="id1101"><!-- named anchor --></a>0.067</td> <td align="left" valign="top"> <a id="id1102"><!-- named anchor --></a>–0.063</td> <td align="left" valign="top"> <a id="id1103"><!-- named anchor --></a>0.950</td> <td align="left" valign="top"> <a id="id1104"><!-- named anchor --></a>–0.14, 0.13</td> </tr> <tr> <a id="id1105"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1106"><!-- named anchor --></a>Waist circumference (cm)</td> <td align="left" valign="top"> <a id="id1107"><!-- named anchor --></a>0.055</td> <td align="left" valign="top"> <a id="id1108"><!-- named anchor --></a>0.308</td> <td align="left" valign="top"> <a id="id1109"><!-- named anchor --></a>0.178</td> <td align="left" valign="top"> <a id="id1110"><!-- named anchor --></a>0.859</td> <td align="left" valign="top"> <a id="id1111"><!-- named anchor --></a>–0.55, 0.66</td> </tr> <tr> <a id="id1112"><!-- named anchor --></a><td><a id="id1113"><!-- named anchor --></a></td> <td align="left" valign="top" colspan="5"> <a id="id1114"><!-- named anchor --></a>Dependent variable = TG</td> </tr> <tr> <a id="id1115"><!-- named anchor --></a><td><a id="id1116"><!-- named anchor --></a></td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1117"><!-- named anchor --></a><i>R</i><sup>2</sup> = 0.011</td> <td align="left" valign="top" colspan="2" style="background-color: #F3F3F3;"> <a id="id1118"><!-- named anchor --></a><i>F</i>-ratio = 3.519</td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1119"><!-- named anchor --></a><i>p</i>-Value = 0.030</td> <td align="left" valign="top"> <a id="id1120"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id1121"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1122"><!-- named anchor --></a>Constant</td> <td align="left" valign="top"> <a id="id1123"><!-- named anchor --></a>64.465</td> <td align="left" valign="top"> <a id="id1124"><!-- named anchor --></a>51.058</td> <td align="left" valign="top"> <a id="id1125"><!-- named anchor --></a>1.263</td> <td align="left" valign="top"> <a id="id1126"><!-- named anchor --></a>0.207</td> <td align="left" valign="top"> <a id="id1127"><!-- named anchor --></a>–35.80, 164.73</td> </tr> <tr> <a id="id1128"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1129"><!-- named anchor --></a>BMI-for-age percentile</td> <td align="left" valign="top"> <a id="id1130"><!-- named anchor --></a>–0.237</td> <td align="left" valign="top"> <a id="id1131"><!-- named anchor --></a>0.183</td> <td align="left" valign="top"> <a id="id1132"><!-- named anchor --></a>–1.294</td> <td align="left" valign="top"> <a id="id1133"><!-- named anchor --></a>0.196</td> <td align="left" valign="top"> <a id="id1134"><!-- named anchor --></a>–0.60, 0.12</td> </tr> <tr> <a id="id1135"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1136"><!-- named anchor --></a>Waist circumference (cm)</td> <td align="left" valign="top"> <a id="id1137"><!-- named anchor --></a>2.199</td> <td align="left" valign="top"> <a id="id1138"><!-- named anchor --></a>0.835</td> <td align="left" valign="top"> <a id="id1139"><!-- named anchor --></a>2.635</td> <td align="left" valign="top"> <a id="id1140"><!-- named anchor --></a>0.009</td> <td align="left" valign="top"> <a id="id1141"><!-- named anchor --></a>0.56, 3.84</td> </tr> <tr> <a id="id1142"><!-- named anchor --></a><td><a id="id1143"><!-- named anchor --></a></td> <td align="left" valign="top" colspan="5"> <a id="id1144"><!-- named anchor --></a>Dependent variable = T-Chol</td> </tr> <tr> <a id="id1145"><!-- named anchor --></a><td><a id="id1146"><!-- named anchor --></a></td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1147"><!-- named anchor --></a><i>R</i><sup>2</sup> = 0.000</td> <td align="left" valign="top" colspan="2" style="background-color: #F3F3F3;"> <a id="id1148"><!-- named anchor --></a><i>F</i>-ratio = 0.097</td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1149"><!-- named anchor --></a><i>p</i>-Value = 0.908</td> <td align="left" valign="top"> <a id="id1150"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id1151"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1152"><!-- named anchor --></a>Constant</td> <td align="left" valign="top"> <a id="id1153"><!-- named anchor --></a>217.070</td> <td align="left" valign="top"> <a id="id1154"><!-- named anchor --></a>39.55</td> <td align="left" valign="top"> <a id="id1155"><!-- named anchor --></a>5.489</td> <td align="left" valign="top"> <a id="id1156"><!-- named anchor --></a>0.000</td> <td align="left" valign="top"> <a id="id1157"><!-- named anchor --></a>139.40, 294.74</td> </tr> <tr> <a id="id1158"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1159"><!-- named anchor --></a>BMI-for-age percentile</td> <td align="left" valign="top"> <a id="id1160"><!-- named anchor --></a>0.061</td> <td align="left" valign="top"> <a id="id1161"><!-- named anchor --></a>0.142</td> <td align="left" valign="top"> <a id="id1162"><!-- named anchor --></a>0.432</td> <td align="left" valign="top"> <a id="id1163"><!-- named anchor --></a>0.666</td> <td align="left" valign="top"> <a id="id1164"><!-- named anchor --></a>–0.22, 0.34</td> </tr> <tr> <a id="id1165"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1166"><!-- named anchor --></a>Waist circumference (cm)</td> <td align="left" valign="top"> <a id="id1167"><!-- named anchor --></a>–0.208</td> <td align="left" valign="top"> <a id="id1168"><!-- named anchor --></a>0.647</td> <td align="left" valign="top"> <a id="id1169"><!-- named anchor --></a>–0.321</td> <td align="left" valign="top"> <a id="id1170"><!-- named anchor --></a>0.748</td> <td align="left" valign="top"> <a id="id1171"><!-- named anchor --></a>–1.48, 1.06</td> </tr> <tr> <a id="id1172"><!-- named anchor --></a><td><a id="id1173"><!-- named anchor --></a></td> <td align="left" valign="top" colspan="5"> <a id="id1174"><!-- named anchor --></a>Dependent variable = LDL-C</td> </tr> <tr> <a id="id1175"><!-- named anchor --></a><td><a id="id1176"><!-- named anchor --></a></td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1177"><!-- named anchor --></a><i>R</i><sup>2</sup> = 0.005</td> <td align="left" valign="top" colspan="2" style="background-color: #F3F3F3;"> <a id="id1178"><!-- named anchor --></a><i>F</i>-ratio = 1.658</td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1179"><!-- named anchor --></a><i>p</i>-Value = 0.191</td> <td align="left" valign="top"> <a id="id1180"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id1181"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1182"><!-- named anchor --></a>Constant</td> <td align="left" valign="top"> <a id="id1183"><!-- named anchor --></a>502.893</td> <td align="left" valign="top"> <a id="id1184"><!-- named anchor --></a>116.316</td> <td align="left" valign="top"> <a id="id1185"><!-- named anchor --></a>4.323</td> <td align="left" valign="top"> <a id="id1186"><!-- named anchor --></a><0.0001</td> <td align="left" valign="top"> <a id="id1187"><!-- named anchor --></a>274.47, 731.31</td> </tr> <tr> <a id="id1188"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1189"><!-- named anchor --></a>BMI-for-age percentile</td> <td align="left" valign="top"> <a id="id1190"><!-- named anchor --></a>0.622</td> <td align="left" valign="top"> <a id="id1191"><!-- named anchor --></a>0.417</td> <td align="left" valign="top"> <a id="id1192"><!-- named anchor --></a>1.491</td> <td align="left" valign="top"> <a id="id1193"><!-- named anchor --></a>0.136</td> <td align="left" valign="top"> <a id="id1194"><!-- named anchor --></a>–0.20, 1.44</td> </tr> <tr> <a id="id1195"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1196"><!-- named anchor --></a>Waist circumference (cm)</td> <td align="left" valign="top"> <a id="id1197"><!-- named anchor --></a>–3.273</td> <td align="left" valign="top"> <a id="id1198"><!-- named anchor --></a>1.902</td> <td align="left" valign="top"> <a id="id1199"><!-- named anchor --></a>–1.721</td> <td align="left" valign="top"> <a id="id1200"><!-- named anchor --></a>0.086</td> <td align="left" valign="top"> <a id="id1201"><!-- named anchor --></a>–7.01, 0.46</td> </tr> <tr> <a id="id1202"><!-- named anchor --></a><td><a id="id1203"><!-- named anchor --></a></td> <td align="left" valign="top" colspan="5"> <a id="id1204"><!-- named anchor --></a>Dependent variable = HDL-C</td> </tr> <tr> <a id="id1205"><!-- named anchor --></a><td><a id="id1206"><!-- named anchor --></a></td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1207"><!-- named anchor --></a><i>R</i><sup>2</sup> = 0.013</td> <td align="left" valign="top" colspan="2" style="background-color: #F3F3F3;"> <a id="id1208"><!-- named anchor --></a><i>F</i>-ratio = 4.164</td> <td align="left" valign="top" style="background-color: #F3F3F3;"> <a id="id1209"><!-- named anchor --></a><i>p</i>-Value = 0.016</td> <td align="left" valign="top"> <a id="id1210"><!-- named anchor --></a>-</td> </tr> <tr> <a id="id1211"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1212"><!-- named anchor --></a>Constant</td> <td align="left" valign="top"> <a id="id1213"><!-- named anchor --></a>96.357</td> <td align="left" valign="top"> <a id="id1214"><!-- named anchor --></a>18.802</td> <td align="left" valign="top"> <a id="id1215"><!-- named anchor --></a>5.125</td> <td align="left" valign="top"> <a id="id1216"><!-- named anchor --></a><0.0001</td> <td align="left" valign="top"> <a id="id1217"><!-- named anchor --></a>59.43, 133.28</td> </tr> <tr> <a id="id1218"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1219"><!-- named anchor --></a>BMI-for-age percentile</td> <td align="left" valign="top"> <a id="id1220"><!-- named anchor --></a>–0.085</td> <td align="left" valign="top"> <a id="id1221"><!-- named anchor --></a>0.067</td> <td align="left" valign="top"> <a id="id1222"><!-- named anchor --></a>–1.260</td> <td align="left" valign="top"> <a id="id1223"><!-- named anchor --></a>0.208</td> <td align="left" valign="top"> <a id="id1224"><!-- named anchor --></a>–0.22, 0.05</td> </tr> <tr> <a id="id1225"><!-- named anchor --></a><td align="left" valign="top"> <a id="id1226"><!-- named anchor --></a>Waist circumference (cm)</td> <td align="left" valign="top"> <a id="id1227"><!-- named anchor --></a>–0.419</td> <td align="left" valign="top"> <a id="id1228"><!-- named anchor --></a>0.307</td> <td align="left" valign="top"> <a id="id1229"><!-- named anchor --></a>–1.364</td> <td align="left" valign="top"> <a id="id1230"><!-- named anchor --></a>0.173</td> <td align="left" valign="top"> <a id="id1231"><!-- named anchor --></a>–1.02, 0.18</td> </tr> </tbody> </table> <div class="sap__table-wrap-foot"><p class="sap__attrib">BMI, body mass index; DBP, diastolic blood pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; SBP, systolic blood pressure; T-Chol, total cholesterol; TG, triglyceride; WC, waist circumference.</p></div> </div> </div> <div class="sap__section"> <a id="sec4"><!-- named anchor --></a><h2 class="sap__main-title">4. Discussion</h2> <p id="id1232">The prevalence of MetS among secondary school students in Nigeria may be increasing and probably higher than what has previously been reported. This could further exacerbate illness and death from noncommunicable diseases. Therefore, it is critical to recognize adolescents at high risk of developing the condition as early as possible to prevent future complications. In this study, 8.3% of participants demonstrated the five cardinal components of MetS—high FPG level, low level of HDL, high level of TG, large WC, and high BP. To date, studies on anthropometric indicators of MetS recognition among Black African adolescents in sub-Saharan Africa are rare, and to the best of our knowledge, no report has previously investigated the possibility of predicting MetS and its components in Nigerians using BMI-for-age pctl and WC. Thus, this study was designed to clarify the association between these two anthropometric indices and the components of MetS among adolescents in this country. Results from this study add to the body of knowledge on this group of people by recognizing that both WC and BMI-for-age pctl cutoff points identified MetS in adolescents. Camhi et al. reported a similar finding that both anthropometric measures were useful screening tools to identify MetS, though WC was a better predictor of MetS [<a href="#ref47">47</a>]. BMI is often the most commonly recommended and used index to group general obesity in clinical and epidemiological studies [<a href="#ref48">48</a>], and it has been used to categorize subjects into malnourished, well-nourished, overweight, and obese. In adults, visceral adipose tissue (VAT) has also been identified as a risk factor for MetS [<a href="#ref49">49</a>], but this relationship is harder to establish in adolescents. Trandafir et al. noted that in adolescents, VAT is a vital predictive risk factor for the occurrence of left ventricular hypertrophy and greater epicardial fat [<a href="#ref50">50</a>], and accumulation of VAT is a major cause of cardiometabolic disease [<a href="#ref51">51</a>]. Many studies have reported that cardiometabolic disorder often occurs in people with normal weight [<a href="#ref52">52</a>, <a href="#ref53">53</a>], thus indicating that WC, as a measure of central adiposity, may be a more specific and sensitive tool than BMI-for-age pctl for identifying MetS in Nigerian adolescents. In this study, adolescents of varying BMI-for-age pctl and WC were recruited as the study subjects, and MetS was taken as the disease. Studies have also identified WC as a strong anthropometric discriminator of MetS [<a href="#ref54">54</a>, <a href="#ref55">55</a>]. The WC cutoff point to predict MetS among adolescents in this study population was 69.00 cm, which may be considered for other Black African populations. WC seemed to be better to predict hypertriglyceridemia than BMI-for-age pctl, with an AUC of 0.5525, a cutoff of ≥65.50, a sensitivity of 0.4864, and a specificity of 0.6304. Over two decades ago, Lemiuex et al. brought up the idea of the hypertriglyceridemic waist phenotype. They observed that excess VAT is associated with hypertriglyceridemia and associated MetS in otherwise healthy patients with elevated WC [<a href="#ref56">56</a>] and pancreatitis [<a href="#ref57">57</a>]. Yu et al. observed that insulin resistance, cardiovascular disease, and type 2 diabetes are associated with hypertriglyceridemia, especially among blacks with normal TG levels [<a href="#ref58">58</a>]. A study reported ethnic differences in TG level and related factors; however, further investigations are required to confirm ethnicity-specific cutoffs [<a href="#ref59">59</a>], especially among Black African adolescents among whom the study of hypertriglyceridemia is very limited. Many studies have established an association of WC and hypertriglyceridemia with coronary heart disease and cardiovascular disease [<a href="#ref60">60</a>, <a href="#ref61">61</a>]. The median TG level of 296.5 mg/dL among the MetS-positive subjects in this study was higher than the mean (±sd) of 87.0 (36.7) among HIV-positive adolescents observed by Salako et al. [<a href="#ref62">62</a>] and the mean (±sd) of 212.20 (76.74) among diabetic adolescents reported by Jaja and Yarhere [<a href="#ref63">63</a>] both in Nigeria. There are other observations in this study. BMI-for-age pctl was significantly higher among MetS-positive than among MetS-negative subjects, and was strongly, positively correlated with SBP and DBP in all study subjects, and in both MetS-positive and MetS-negative subjects. Various studies have also reported that higher BMI or BMI-for-age pctl is directly related to higher prevalence of MetS than lower BMI-for-age pctl (or BMI), indicating normal or underweight people [<a href="#ref64">64</a>, <a href="#ref65">65</a>]. High BMI-for-age pctl that determines overweight/obesity had been associated with overactivity of the sympathetic nervous system (SNS) leading to increased heart rate, BP, and tachypnea [<a href="#ref66">66</a>, <a href="#ref67">67</a>]. One study reports that the increase in the mass of white adipose tissue, leading to altered regulation of adipocytokines, is probably the catalyst for the genesis of diseases such as obesity, atherosclerosis, T2DM, and MetS [<a href="#ref68">68</a>], especially in those with high BMI-for-age pctl or high WC. BMI-for-age pctl and WC were weakly and positively correlated with systolic hypertension in all subjects. Zhang et al. suggested that as a crucial aspect of innate immune system, naturally activated macrophages (M1), neutrophils, and dendritic cells promote hypertension by secreting inflammatory cytokines such as interferon-gamma (IFN-γ) and interleukin-17 (IL-17), which are produced by activated T lymphocytes and induce oxidative stress injury and endothelial dysfunction [<a href="#ref69">69</a>]. This may likely be the explanation of the observed higher mean systolic BP observed in the study subjects. On their part, Guzik et al. suggested that immune cells thus activated drift to target organs such as arteries (especially the perivascular fat and adventitia), kidneys, the heart, and the brain; release effector cytokines that elevate BP; and cause, among others, cardiac hypertrophy, cognitive impairment, and dementia [<a href="#ref70">70</a>]. The higher levels of TG and LDL may have originated from artificially produced processed foods such as commercial baked cakes, cookies, pies, microwaved popcorn, frozen pizza, and refrigerated biscuits and rolls, to which some affluent adolescents may have been exposed. These artificially produced processed foods (containing high levels of unsaturated fats) contain lipid molecules in one or more double bonds in trans geometric configuration. Regular ingestion of such processed food items (containing high levels of trans fatty acid) for a long time may have significantly exacerbated hypertriglyceridemia and MetS in the study subjects. Further studies are needed to clarify the association of hypertriglyceridemia with diet among Nigerian adolescents.</p> </div> <div class="sap__section"> <a id="sec5"><!-- named anchor --></a><h2 class="sap__main-title">5. Study limitations</h2> <p id="id1233">Certain limitations in the study need to be considered. Primarily, the study’s relatively small sample size may have restricted its ability to fully uncover the deteriorating metabolic conditions in this population and limit its external validity. However, since the study participants were mainly from the southern part of the country, the results may be representative of adolescents in that specific geographical location. Second, bias may have been introduced in the sample selection as the proportion of girls outweighed that of boys, and some of the overweight or obese students may have been left out. The study was conducted in the southwestern area bordering the Atlantic Ocean, but not in the northern arid area or the mountainous middle area of the country. For this reason, the results may not be generalized or interpreted as national, requesting a nation-wide study on dyslipidemia and MetS among secondary school adolescents. The study did not use the cutoff points established by Katzmarzyk et al. [<a href="#ref71">71</a>] because these cutoff points may be inappropriate for Indigenous Black African adolescent population. Finally, sex, stage of adolescence, and ethnicity were not considered in this study and are reserved for a future evaluation.</p> </div> <div class="sap__section"> <a id="sec6"><!-- named anchor --></a><h2 class="sap__main-title">6. Conclusions/Recommendation</h2> <p id="id1234">The results from this cross-sectional study indicate that BMI-for-age pctl and WC have significant positive association with MetS and its components among Nigerian adolescents. Thus, both could be useful screening tools for identifying MetS in this group of people. Both these anthropometric indices are affordable, easily available, and easy to evaluate and identify adolescents at risk of cardiometabolic diseases for further clinical investigations, especially in resource-constrained settings. These novel anthropometric indices should be explored in future studies to predict the cardiometabolic risk factors for MetS among Nigerian youths and even adults.</p> </div> </div> <div id="article-back" class="sap__back"> <div class="sap__back-section"> <a id="sec7"><!-- named anchor --></a><h2 class="sap__main-title">Funding</h2> <p id="id1235">The authors declare no financial support for the research, authorship, or publication of this article.</p> </div> <div class="sap__back-section"> <a id="sec8"><!-- named anchor --></a><h2 class="sap__main-title">Author contributions</h2> <p id="id1236">Conceptualization, S.J.H. and B.M.A.; methodology, S.J.H. and B.M.A.; software, B.M.A.; validation, S.J.H., O.O.O. and B.M.A.; formal analysis, B.M.A., I.O.S. and O.T.L.; investigation, S.J.H. and I.O.S.; resources, S.J.H.; data curation, B.M.A.; writing—original draft preparation, B.M.A.; writing—review and editing, B.M.A., S.J.H. and I.O.S.; visualization, S.J.H., O.O.O., I.O.S. and O.T.L.; supervision, B.M.A. and O.O.O.; project administration, S.J.H. and B.M.A.; funding acquisition, S.J.H. All authors have read and agreed to the published version of the manuscript.</p> </div> <div class="sap__back-section"> <a id="id1238"><!-- named anchor --></a><h2 class="sap__main-title">Conflict of interest</h2> <p id="id1237">The authors declare no conflict of interest.</p> </div> <div class="sap__back-section"> <a id="sec10"><!-- named anchor --></a><h2 class="sap__main-title">Data availability statement</h2> <p id="id1239">Data supporting these findings are available within the article, at <a target="xrefwindow" href="https://doi.org/10.20935/AcadMed7492" id="id1240">https://doi.org/10.20935/AcadMed7492</a>, or upon request.</p> </div> <div class="sap__back-section"> <a id="sec11"><!-- named anchor --></a><h2 class="sap__main-title">Institutional review board statement</h2> <p id="id1241">This study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of the Nigerian Institute of Medical Research (IRB/28/062, approved on February 3, 2020).</p> </div> <div class="sap__back-section"> <a id="sec12"><!-- named anchor --></a><h2 class="sap__main-title">Informed consent statement</h2> <p id="id1242">Not applicable.</p> </div> <div class="sap__back-section"> <a id="sec14"><!-- named anchor --></a><h2 class="sap__main-title">Publisher’s note</h2> <p id="id1243">Academia.edu Journals stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. 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