Best Insulin Resistance Index for Pediatric Obesity?

TOPLINE:

A recent study found that the homeostasis model assessment insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), and fasting glucose/insulin ratio (FGIR) were stronger predictors of insulin resistance than the triglyceride glucose index (TyG) in children with overweight or obesity.

METHODOLOGY:

• Researchers conducted a single-center retrospective study to establish the correlation between insulin resistance indices in children with overweight or obesity.
• They included 143 children with obesity (mean age, 13.1 years; 62.2%), 133 children with overweight (mean age, 13 years; 46.6% girls), and 100 children with normal weight (mean age, 12.7 years; 49% girls).
• Obesity was defined as body mass index (BMI) ≥ 95th percentile, overweight as BMI in the 85th-94th percentile, and normal weight as BMI < 85th percentile. All participants underwent blood tests, including a complete blood count; tests for liver enzymes (alanine aminotransferase [ALT] and aspartate aminotransferase), fasting glucose, insulin, and A1c; and lipid profile (total cholesterol, triglycerides, high-density lipoprotein [HDL] cholesterol, and low-density lipoprotein [LDL] cholesterol).
• Insulin resistance indices such as HOMA-IR, QUICKI, FGIR, and TyG and lipid-derived ratios were assessed. A receiver operating characteristic curve analysis was used to determine cutoff values for the indices.

TAKEAWAY:

• Significant differences were observed in fasting glucose, HOMA-IR, ALT, HDL, triglycerides, total cholesterol, LDL, various lipid ratios, TyG index, QUICKI, and FGIR between children with normal weight, overweight, and obesity (P < .05).
• HOMA-IR was positively correlated with TyG (correlation coefficient [r], 0.193; P < .001). In contrast, QUICKI and FGIR were both negatively correlated with TyG (r, −0.456 and −0.392, respectively; P < .001 for both).
• Area under the values showed that HOMA-IR (0.996), FGIR (0.980), and QUICKI (0.986) are stronger predictors of insulin resistance than the TyG index (0.717) in children with overweight and obesity.

IN PRACTICE:

“HOMA-IR, FGIR, and QUICKI constitute stronger predictors of IR than TyG index in children with overweight and obesity,” the authors wrote. “It is essential to prevent development and occurrence of IR in children and adolescents with overweight/obesity due to increased metabolic and cardiovascular risks.”

SOURCE:

The study, by Derya Kalyoncu and Melis Kavrak Kulsun, Istinye State Hospital, Istanbul, Turkey, was published online in BMC Endocrine Disorders.

LIMITATIONS:

Study limitations include its single-center retrospective design, small sample size, and the inability to perform anthropometric measurements beyond BMI, such as waist circumference. Additionally, additional insulin resistance tests could not be conducted due to limitations in the hospital’s capabilities.

DISCLOSURES:

No funding was received for this study. The authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.