Fat-to-lean mass ratio as a new anthropometric indicator in predicting metabolic syndrome among Malay adolescents in Terengganu, Malaysia

Abstract

Background Metabolic syndrome (MetS) is defined as a cluster of risk factors for predicting type 2 diabetes mellitus and cardiovascular disease. Objectives This cross-sectional study aimed to develop a cut-off value for fat versus lean mass ratio (FLMR) in predicting MetS and to investigate the association between this indicator with MetS and its components. Methods Subjects comprised 238 Malay adolescents (79% female) aged 18–19 years old. Anthropometric assessment comprised weight, height and waist circumference (WC). Body composition was measured using bioelectrical impedance analysis techniques while blood pressure was measured using a blood pressure monitor. Fasting blood glucose, total cholesterol , triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol were determined from an overnight fasting blood sample. MetS was determined based on International Diabetes Federation (2007) definition for adolescents aged 16-year-old and above. Results The prevalence of MetS was 2.1%. Receiver Operating Characteristics curve analysis revealed that the optimal cut-off value for FLMR was 0.441 with an Area Under the Curve of 0.874 (95% CI: 0.825, 0.913); with sensitivity of 80.0% and specificity of 71.0%. FLMR cut-off of 0.441 was associated with high WC ( p < .001), low HDL-c ( p < .001) and MetS ( p < .05). Binary Logistic Regression analysis revealed that adolescents with high WC, low HDL-c and MetS had higher odds of developing increased FLMR than the cut-off value with an odds ratio (OR) of 43.4 (95% CI: 9.7,193.9), 4.7 (95% CI: 2.3,9.8) and 13.3 (95% CI: 1.5,121.2), respectively. Conclusion FLMR possesses fair discriminatory ability in identifying MetS among adolescents and significant association exists between FLMR and MetS and some of its components.

Lower fitness levels, higher fat-to-lean mass ratios, and lower cardiorespiratory endurance are more likely to affect the body mass index of Saudi children and adolescents

“…However, these indicators have some shortcomings as they only focus on the effect of fat and non-fat component independently and do not consider the antagonistic effects of fat mass and lean mass on the health of participants. Relevant studies have recognized the role of the fat-to-lean mass ratio in predicting health conditions in adults, such as the prediction of metabolic syndrome in adults ( 49 ). In a recent epidemiological study, Dai et al ( 14 ) found that for each 1 standard deviation increase in the fat-to-lean mass ratio, the odds ratio for the risk of developing the nonalcoholic fatty liver disease was 1.55 vs. 1.33 in non-obese and obese males, and 1.42 vs. 1.29 in non-obese and obese females, respectively.…”

“…Low physical fitness in young people should be carefully monitored as it could affect their maturation and subsequent physical development ( 52 ). In particular, low cardiorespiratory endurance increases the risk of developing metabolic syndrome ( 49 ), cardiovascular diseases ( 53 ), and type 2 diabetes ( 54 ). Poor cardiovascular endurance also increases all-cause mortality rates even in healthy individuals and patients ( 55 ).…”