Identification of pediatric MASLD using insulin resistance indices

Area of Science:

• Pediatric Endocrinology
• Hepatology
• Metabolic Syndrome Research

Background:

• Pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing, linked to cardiometabolic risks.
• Limited research exists on effective insulin resistance markers for pediatric MASLD prediction.
• Early detection is crucial for managing pediatric MASLD and associated comorbidities.

Purpose of the Study:

• To investigate triglyceride-to-HDL ratio (TG/HDL), triglyceride-glucose index (TyG), SPISE, and METS-IR as predictors of pediatric MASLD.
• To evaluate the diagnostic performance of these markers using receiver operating characteristic (ROC) curves.
• To identify non-invasive markers for early detection and clinical management of pediatric MASLD.

Main Methods:

• Cross-sectional study using data from NHANES (1,150 youths) and a real-world clinic (260 youths).
• Hepatic steatosis assessed via transient elastography and abdominal sonography.
• Logistic regression and ROC curve analyses performed to evaluate marker predictability for MASLD.

Main Results:

• MASLD group showed higher TG/HDL, TyG, METS-IR, and obesity, with lower SPISE compared to the normal group.
• All investigated markers significantly correlated with MASLD in logistic regression analyses (p <0.001).
• SPISE and METS-IR demonstrated superior predictive performance (higher AUCs) compared to TG/HDL and TyG in both datasets.

Conclusions:

• METS-IR and SPISE are effective, non-invasive markers for predicting pediatric MASLD.
• These markers provide valuable tools for early identification and risk stratification of pediatric MASLD.
• Validated cut-off values offer practical screening applications in both population-based and clinical settings.