Paper Title
Comparison of Tri-Ponderalmass Index and Body Mass Indexin The Prediction of Pediatric Metabolic Syndrome: The Caspian-V Study

Background: Body mass index (BMI) and tri-ponderal mass index (TMI) are anthropometric measuresfor assessment of body adiposityin the various age groups. This study aims to compare the predictive value of TMI and BMI for metabolic syndrome (MetS) in children and adolescents. Methods: This nationwide cross-sectional study was conducted on 4200 Iranian children and adolescents aged 7–18 years. They were selected by random cluster sampling from 30 provinces of Iran. MetS was defined based on the Adult Treatment Panel III (ATP III) criteria modified for the pediatric age group.The predictive value of BMI (weight divided height squared) and TMI(weight divided by height cubed) for MetS were determined using Receiver-operator curves (ROC), the area under curve (AUC) was determined. Logistic regression analysis was used to assess the relationship between these indices and MetS. Results: Data of 3843 participants (52.4% boys) were available for the current study. The mean (standard deviation) age was 12.62 (3.02) and 12.25 (3.05) years for boys and girls, respectively. Overall, for boys and girls, the AUC (95% CI) of TMI were0.72 (0.67, 0.77) for boys and 0.67 (0.61, 074) for girls, respectively) , the corresponding figures were 0.69 (0.63, 0.74) and 0.67 (0.60, 073) for BMI. These values showed that in both genders, AUC was higher for TMI than BMI. Conclusion: In this study, TMI and BMI had moderate diagnostic accuracy for identifying MetS. In both genders, TMI was a better predictor of MetS than BMI; and it can be considered as anappropriate anthropometric index for large studies in the pediatric population. Keywords - Metabolic syndrome; body mass index; tri-ponderal mass index; children and adolescents