Hypertriglyceridemic waist phenotype, hypertriglyceridemic waist-to-height ratio phenotype and abnormal glucose metabolism in adolescents

Objective: The purpose of this study was to evaluate the relationship between hypertriglyceridemic waist (HW) phenotype,hypertriglyceridemic waist-to-height ratio (HWHtR) phenotype and abnormal glucose metabolism in adolescents. Methods: A secondary analysis was conducted on 2626 adolescents aged 12-19 years in United States. Abnormal glucose metabolism was defined as fasting plasma glucose >= 5.6 mmol/L or oral glucose tolerance test 2-h plasma glucose >= 7.8 mmol/L or glycohemoglobin A1c >= 5.7% or a previous diagnosis of diabetes. The HW phenotype was defined as triglyceride(TG) concentrations >= 1.47 mmol/L and waist circumference (WC) >= 90th percentile. The HWHtR phenotype was defined as TG concentrations >= 1.47 mmol/L and waist-to-height ratio (WHtR) >= 0.5. Results: 621(23.6%) adolescents had abnormal glucose metabolism. The prevalences of abnormal glucose metabolism were 22.7% and 40.6% in adolescents without and with HW phenotype. The prevalences of abnormal glucose metabolism were 22.4% and 38.6% in adolescents without and with HWHtR phenotype. Adolescents with HWHtR phenotype were more likely to have abnormal glucose metabolism (OR = 1.548, P = 0.010). The levels of homeostasis model assessment insulin resistance and beta cell fuction index were higher in adolescents with HWHtR phenotype than in adolescents without HWHtR phenotype (P < 0.001). Conclusion: The study demonstrates that HWHtR phenotype was closely associated with an increased risk of abnormal glucose metabolism in adolescents. Adolescents with HWHtR phenotype had worsen insulin resistance and increased insulin secretion as a result of compensation. Impact statement: The study provided a simple method, HWHtR phenotype, for evaluating the status of glucose metabolism in adolescents.