Identifying Children With Obesity at High Risk for Metabolic Syndrome: Sensitivity and Specificity of the Monocyte/HDL Index.

Background: Visceral fat accumulation causes a low-grade chronic inflammatory state in individuals with Metabolic Syndrome (MetS). MetS detection, with simple and non-invasive tests, is crucial.

Objective: To establish the sensitivity and specificity of the monocyte/HDL (MHR), neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR) and lymphocytes/monocytes (LMR) ratios to identify clinical characteristics of MetS in prepubertal children.

Methods: Prospective cross-sectional study comparing 79 children fulfilling MetS IDF criteria and 75 control children. A clinical history and physical examination were performed. Blood glucose levels, lipid profile, ESR, usCRP, and complete blood count were determined, and the different ratios were calculated manually. The sensitivity and specificity of each ratio were determined using ROC curves.

Results: MHR was the most sensitive and specific haematological index to determine clinical characteristics of MetS with a cut-off point of 8.62, allowing for the identification of low HDL, hypertriglyceridemia, large waist circumference, high blood pressure, sedentary lifestyle, and a family history of obesity as the main factors related to MetS in childhood.

Conclusion: MHR is the best proxy of MetS and reveals the early elevation of proinflammatory factors in childhood, suggesting that it serves as a diagnostic tool in patients under 10 years of age, where the identification of MetS is controversial.