A novel diagnostic tool in determining insulin resistance in obese children: Triglyceride / HDL ratio
Keywords:TG / HDL ratio, Insulin resistance, Obese children
Background/Aim: It is known that the frequency of obesity and insulin resistance is increased in children. Diagnostic laboratory criteria of insulin resistance are unclear in children despite the widespread use of the Homeostasis model assessment for insulin resistance (HOMA-IR). Serum triglyceride (TG)/high-density lipoprotein (HDL) ratio is reported to reflect insulin resistance in recent studies. We aimed to investigate the usefulness of the TG/HDL ratio in determining insulin resistance and its correlation with the HOMA-IR index in overweight/obese children. Methods: Patients who presented to the Pediatric Endocrinology outpatient clinic with excessive weight were examined in this retrospective cohort study. The patients were divided into subgroups according to BMI, sex, pubertal stage, and presence of hepatosteatosis, and the HOMA-IR index and TG/HDL ratios were compared. Results: One hundred and fifty-nine patients aged 5-18 years, with a mean age of 11.4 (3.13) years, were included in the study. Of the patients, 93 (58%) were girls, 99 (62%) were pubertal, and 141 (88.6%) were obese. Seventy-nine (49.6%) patients had insulin resistance. The mean HOMA-IR and TG/HDL were 3.89 (2.29) and 2.71 (1.86), respectively. A positive correlation was found between HOMA-IR value and TG / HDL ratio (r= 0.283, P<0.001). TG/HDL ratio was significantly higher in patients who had insulin resistance and hepatosteatosis than those who did not (P=0.008, P=0.032 respectively). There was no significant difference regarding TG/HDL ratio between female-male, prepubertal-pubertal, overweight/obese patients. There was no correlation between age, body mass index standard deviation score (SDS), and TG/HDL ratio. Conclusion: TG/HDL ratio is an easy to use, non-invasive, and useful marker of insulin resistance in overweight/obese children regardless of age, gender, pubertal condition, and body mass index standard deviation score.
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