The Indian Journal of Pediatrics

, Volume 77, Issue 11, pp 1261–1265 | Cite as

Utility of ApoB/ApoA1 Ratio for the Prediction of Cardiovascular Risk in Children with Metabolic Syndrome

  • S. Savas Erdeve
  • E. Simsek
  • Yildiz Dallar
  • Zeynep Biyikli
Original Article



To assess whether apoB/apoA1 ratio is associated or not with metabolic syndrome in obese children.


A 198 obese children and 41 healthy control subjects were enrolled in a cross-sectional study. The apoB/apoA1 ratio and other metabolic sydrome components in obese children with/without metabolic syndrome were compared to healthy controls.


The apoA1 level did not show significant difference (p = 0.664) but apoB level (p = 0.000) and apoB/apoA1 ratio (p = 0.001) were significantly higher in obese group than in control group. Also, the apoB/apoA1 ratio was significantly higher in obese children with metabolic syndrome when compared to obese children without metabolic syndrome (p = 0.007) and showed positive correlation with triglyceride (r = 0.404, p = 0.000) and negative correlation with high-density lipoprotein cholesterol (r = −0.593, p = 0.000).


The apoB/apoA1 ratio is associated with metabolic syndrome in obese children. An elevated apoB/apoA1 ratio may constitute an important feature of the metabolic syndrome. There is a need for long term follow-up studies concerning cardiovascular risk in obese children with metabolic syndrome and high apoB/apoA1 ratio.


Apolipoprotein AI Apolipoprotein B Apolipoprotein B/Apolipoprotein AI ratio Child Metabolic syndrome 


  1. 1.
    Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diab Care. 2001;24:683–9.CrossRefGoogle Scholar
  2. 2.
    Klein BE, Klein R, Lee KE. Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in beaver dam. Diab Care. 2002;25:1790–4.CrossRefGoogle Scholar
  3. 3.
    Gami AS, Witt BJ, Howard DE, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007;49:403–14.CrossRefPubMedGoogle Scholar
  4. 4.
    Walldius G, Jungner I. The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy-a review of the evidence. J Intern Med. 2006;259:493–519.CrossRefPubMedGoogle Scholar
  5. 5.
    Bachorik PS, Lovejoy KL, Carroll MD, Johnson CL. Apolipoprotein B and AI distribution in the United States, 1988-1991: results of the National Health and Nutrition Examination Survey III (NHANES III). Clin Chem. 1997;43:2364–78.PubMedGoogle Scholar
  6. 6.
    Bachorik PS, Kwiterovich PO. The measurement of plasma cholesterol, low density lipoprotein- and high density lipoprotein cholesterol. In: Hommes FA, editor. Techniques in diagnostic human biochemical genetics: a laboratory manual. New York: Wiley-Liss, Inc.; 1991. p. 425–9.Google Scholar
  7. 7.
    Sierra-Johnson J, Romero-Corral A, Somers VK, Lopez-Jimenez F. The Apolipoprotein b/apolipoprotein AI ratio in the metabolic syndrome-should we start using it? J Cardiometab Syndr. 2008;3(1):53–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Sierra-Johnson J, Somers VK, Kuniyoshi H, et al. Comparison of apolipoprotein-B/apolipoprotein-AI in subjects with versus without the metabolic syndrome. Am J Cardiol. 2006;98(10):1369–73.CrossRefPubMedGoogle Scholar
  9. 9.
    Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL. Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolesc Med. 1995;149:1085–91.PubMedGoogle Scholar
  10. 10.
    Tumer N, Yalçinkaya F, Ince E, et al. Blood pressure normograms for children and adolescents in Turkey. Pediatr Nephrol. 1999;13:438–43.CrossRefPubMedGoogle Scholar
  11. 11.
    American Diabetes Association. Standards of medical care in diabetes. Diab Care. 2007;30:S4–S41.CrossRefGoogle Scholar
  12. 12.
    National Cholesterol Education Program (NCEP): highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 1992;89:495-501.Google Scholar
  13. 13.
    Hatipoglu N, Ozturk A, Mazicioglu MM, Kurtoglu S, Seyhan S, Lokoglu F. Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr. 2007;167:383–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Zonderland ML, Erich WB, Erkelens DW, et al. Plasma lipids and apoproteins, body fat distribution and body fatness in early pubertal children. Int J Obes. 1990;14:1039–46.PubMedGoogle Scholar
  15. 15.
    Zwiaueer KFM, Pakosta R, Mueller T, Widhalm K. Cardiovascular risk factors in obese children in relation to weight and body fat distribution. J Am Coll Nutr. 1992;11:41S–50S.Google Scholar
  16. 16.
    Wallenfeldt K, Bokemark L, Wikstrand J, Hulthe J, Fageberg B. Apolipoprotein B/apolipoprotein A-I in relation to the metabolic syndrome and change in carotid artery intima-media thickness during 3 years in middle-aged men. Stroke. 2004;35:2248–52.CrossRefPubMedGoogle Scholar
  17. 17.
    Retnakaran R, Zinman B, Connelly PW, Haris SB, Hanley AJ. Nontraditional cardiovascular risk factors in pediatric metabolic syndrome. J Pediatr. 2006;148:176–82.CrossRefPubMedGoogle Scholar
  18. 18.
    Bueno G, Bueno O, Moreno LA, et al. Diversity of metabolic syndrome risk factors in obese children and adolescents. J Physiol Biochem. 2006;62:125–33.CrossRefPubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2010

Authors and Affiliations

  • S. Savas Erdeve
    • 1
  • E. Simsek
    • 2
  • Yildiz Dallar
    • 3
  • Zeynep Biyikli
    • 4
  1. 1.Department of Pediatrics, Division of Pediatric EndocrinologyAnkara University School of MedicineAnkaraTurkey
  2. 2.Division of Pediatric Endocrinology, Department of PediatricsOsmangazi University School of MedicineKonuralp-DuzceTurkey
  3. 3.Department of PediatricsAnkara Research and Training HospitalAnkaraTurkey
  4. 4.Department of BiostatisticsAnkara University School of MedicineAnkaraTurkey

Personalised recommendations