ObMetrics: A Shiny app to assist in metabolic syndrome assessment in paediatric obesity.

Objective: To introduce ObMetrics, a free and user-friendly Shiny app that simplifies the calculation, data analysis, and interpretation of Metabolic Syndrome (MetS) outcomes according to multiple definitions in epidemiological studies of paediatric populations. We illustrate its usefulness using ethnically different populations in a comparative study of prevalence across cohorts and definitions.

Methods: We conducted a case study using data from two ethnically diverse paediatric populations: a Hispanic-American cohort (N = 1759) and a Hispanic-European cohort (N = 2411). Using ObMetrics, we computed MetS classifications (Cook, Zimmet, Ahrens) and component-specific z-scores for each participant to compare prevalences.

Results: The analysis revealed significant heterogeneity in MetS prevalence across different definitions and cohorts. According to Cook, Zimmet, and Ahrens's definitions, MetS prevalence in children with obesity was 25%, 12%, and 48%, respectively, in the Hispanic-European cohort, and 38%, 27%, and 66% in the Hispanic-American cohort. Calculating component-specific z-scores in each cohort also highlighted ethnic-specific differences in lipid metabolism and blood pressure. By automating these complex calculations, ObMetrics considerably reduced analysis time and minimised the potential for errors.

Conclusion: ObMetrics proved to be a powerful tool for paediatric research, generating detailed reports on the prevalence of MetS and its components based on various definitions and reference standards. Our case study further provides valuable insights into the challenges of characterising metabolic health in paediatric populations. Future efforts should focus on developing unified consensus guidelines for paediatric MetS. Meanwhile, ObMetrics enables earlier identification and targeted intervention for high-risk children and adolescents.