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Review
. 2023 Jun 17;23(1):1-10.
doi: 10.1007/s40200-023-01235-z. eCollection 2024 Jun.

The association of the apolipoprotein B/A1 ratio and the metabolic syndrome in children and adolescents: a systematic review and meta-analysis

Kayhan Dinpanah  1 , Toba Kazemi  2 , Sameep Shetty  3 , Saeede Khosravi Bizhaem  4 , Ali Fanoodi  1 , Seyed Mohammad Riahi  5
Affiliations
Review

The association of the apolipoprotein B/A1 ratio and the metabolic syndrome in children and adolescents: a systematic review and meta-analysis

Kayhan Dinpanah et al. J Diabetes Metab Disord. .

Abstract

Objectives: Metabolic syndrome (MetS) is a constellation of coexisting cardiovascular risk factors. This study aimed to assess the evidence for the association between the apolipoprotein B/A1 ratio, apolipoprotein B, and apolipoprotein A1, and the MetS in children and adolescents.

Methods: The English electronic databases including PubMed, Embase, Web of Science, and Scopus were searched up to February 28, 2022. To ascertain the validity of eligible studies, modified JBI scale was used. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using the random-effects model to evaluate the association between the apolipoprotein B/A1 ratio, apolipoprotein B, and apolipoprotein A1 and the MetS. Heterogeneity amongst the studies was determined by the use of the Galbraith diagram, Cochran's Q-test, and I2 test. Publication bias was assessed using Egger's and Begg's tests.

Results: From 7356 records, 5 studies were included in the meta-analysis, representing a total number of 232 participants with MetS and 1320 participants as control group. The results indicated that increased levels of apolipoprotein B/A1 ratio (SMD 1.26; 95% CI: 1.04, 1.47) and apolipoprotein B (SMD 0.75; 95% CI: 0.36, 1.14) and decreased levels of apolipoprotein A1 (SMD -0.53; 95% CI: -0.69, -0.37) are linked to the presence of MetS. The notable findings were, children and adolescents with MetS had elevated levels of the apolipoprotein B/A1 ratio, apolipoprotein B, and decreased levels of apolipoprotein A1.

Conclusions: Our results suggest the need to evaluate the levels of apolipoproteins for detecting the risk of MetS in children and adolescents.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-023-01235-z.

Keywords: Adolescent; Apolipoprotein A-I; Apolipoprotein B; Meta-analysis; Metabolic syndrome.

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Conflict of interest statement

Conflicts of interest/competing interestsThe authors have no conflicts of interest. Authors also indicate that they did not have a financial relationship with the organization that sponsored the research and had full control of all primary data and agree to allow the journal to review their data if requested.

Figures

Fig. 1
Fig. 1
Flowchart of search and study selection strategy
Fig. 2
Fig. 2
Forest plot depicting the standardized mean difference and its 95% confidence interval to determine the association between Apolipoprotein A1 and metabolic syndrome in children and adolescents
Fig. 3
Fig. 3
Galbraith plot of the apolipoprotein A1 levels for the association with metabolic syndrome
Fig. 4
Fig. 4
Funnel plot, using studies reported association of the apolipoprotein B/A1 ratio and metabolic syndrome
Fig. 5
Fig. 5
Meta-analysis random effect estimates study omitted, the association of apolipoprotein B/A1 ratio and metabolic syndrome
See this image and copyright information in PMC

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