Utility of the MetS-IR and SPISE indices for identifying insulin resistance in Mexican children

To evaluate the utility of MetS-IR and SPISE indices for identifying insulin resistance in Mexican children and adolescents.

A cross-sectional study was conducted using clinical and biochemical records from 934 children aged 8-17 years. Insulin resistance was defined as a HOMA-IR value above the 85th percentile (3.37) of a healthy reference subgroup. MetS-IR and SPISE were calculated using BMI, triglycerides, HDL-C, and glucose. ROC curves were used to evaluate diagnostic performance. Logistic regression models adjusted for age and sex were developed to obtain adjusted AUC values.

Of the total sample, 55 % were classified as having insulin resistance. Both indices showed high discriminative capacity: AUC was 0.894 for MetS-IR (cutoff 35.966) and 0.895 for SPISE (cutoff 6.594). After adjusting for age and sex, both AUCs increased slightly to 0.899. Sensitivities and specificities exceeded 80 %, and positive likelihood ratios were close to 5.

MetS-IR and SPISE are accurate and low-cost tools for identifying insulin resistance in Mexican pediatric population. These findings support the utility of context-specific cutoff points and highlight the potential of these indices for early screening in primary care settings.