Association with Metabolic Syndrome in Children Diagnosed with Type 1 Diabetes Mellitus: A Cross-sectional Study.

Objective: This study aimed to evaluate the prevalence of metabolic syndrome (MetS) in children with Type 1 Diabetes Mellitus (T1DM) and to determine the predictive value of simple anthropometric measurements-particularly neck circumference (NC) and waist circumference (WC)-in identifying MetS.

Methods: A total of 168 children (aged 6-18 years) with T1DM were included in this cross-sectional study. Anthropometric (NC, WC, BMI, TMI) and laboratory parameters (lipid profile, HbA1c) were recorded. MetS diagnosis was established according to the International Diabetes Federation (IDF) criteria. Receiver operating characteristic (ROC) curve analysis and LASSO regression were employed to identify key predictors.

Results: The prevalence of MetS was 8.9%. Children with MetS had significantly higher BMI, WC, NC, HC, and TMI values compared to non-MetS counterparts. ROC analysis revealed WC z-score had the highest discriminative power (AUC: 0.954), followed by NC z-score (AUC: 0.906). LASSO regression identified NC z-score and BMI percentile as the most robust predictors. A strong positive correlation was observed between NC and WC (r = 0.812, p <0.001), and NC showed a mild inverse correlation with HDL cholesterol.

Conclusion: NC and WC are simple, non-invasive, and reliable tools for early detection of MetS in pediatric T1DM patients. Their routine measurement could enhance risk stratification and guide preventive interventions targeting obesity and dyslipidemia. These findings support incorporating NC and WC into standard clinical assessments to improve long-term cardiometabolic outcomes in children with T1DM (i.e., NC z>1.04 or WC z >1.41 as actionable thresholds.