OBJECTIVE A high apolipoprotein B/apolipoprotein A1 (apoB/A1) ratio is strongly associated with cardiometabolic diseases. However, few studies have examined this ratio in children and adolescents. The aim of our study was to determine significant factors related to the apoB/A1 ratio and examine its association with paediatric metabolic syndrome.

PATIENTS AND METHODS Sixty-seven male children and adolescents were recruited. We measured anthropometric parameters, fat areas by abdominal computed tomography, fasting glucose, insulin, lipid profiles, apoB, apoA1, adiponectin, free androgen index (FAI) and oestradiol.

RESULTS Thirty per cent of participants (n = 20) were identified as having paediatric metabolic syndrome. The apoB/A1 ratio was significantly correlated with BMI z-score, waist circumference, waist-to-hip ratio (WHR), waist-to-height ratio, abdominal fat areas, total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, adiponectin and leptin. In addition to lipid profiles, WHR was identified as a significant independent variable correlated with the apoB/A1 ratio. Obese boys with a high FAI (>75th percentile) had significantly lower adiponectin and higher apoB/A1 ratios than those with a low FAI. The apoB/A1 ratio was higher in subjects with high visceral fat (>50th percentile) and a high FAI when compared with subjects with low visceral fat and a low FAI. The prevalence of paediatric metabolic syndrome was significantly associated with increasing tertiles of the apoB/A1 ratio (highest tertile; odds ratio = 18·8 [95% confidence interval = 1·8-198·8], P < 0·05).

CONCLUSION ApoB/A1 ratio was significantly higher in viscerally obese male children and adolescents with high levels of FAI and was associated with increased frequency of paediatric metabolic syndrome.