Evaluation of metabolic score for insulin resistance index as a sensitive marker of insulin resistance and its ability to predict hepatic steatosis in obese children and adolescents. A pilot study

Introduction:
The metabolic score for insulin resistance (METS-IR) index could be a sensitive marker of insulin resistance and might predict hepatic steatosis in obese children. The aim of the study was to evaluate the METS-IR index as a sensitive marker of insulin resistance and its ability to predict hepatic steatosis in obese children and adolescents.

Material and methods:
A cross-sectional study was conducted with 190 subjects: 50 normal weight, 50 with overweight, and 90 children with obesity. All subjects underwent measurements of height, body weight, body mass index (BMI), waist and hip circumference, and blood pressure. A blood sample was taken for assessment of lipid profile, fasting blood glucose and insulin, and liver enzymes. The homeostatic model assessment for insulin resistance (HOMA-IR), triglyceride-glucose (TyG) index, and METS-IR index were calculated. Abdominal ultrasonography was done to search for fatty liver, to measure subcutaneous fat thickness and visceral fat thickness (VFT). Children were classified into a hepatic steatosis group and a group without hepatic steatosis.

Results:
Body mass index, waist hip ratio, body fat percentage, subcutaneous fat thickness, visceral fat, alanine aminotransferase, METS-IR, and TyG index were significantly higher in the hepatic steatosis group than in the group without hepatic steatosis. The metabolic score for insulin resistance was the best independent predictor for hepatic steatosis.

Conclusions:
The metabolic score for insulin resistance is a sensitive marker of IR among obese children and adolescents and was found to be a strong predictor for hepatic steatosis. The metabolic score for insulin resistance index has significant and positive correlations with ΗΟΜΑ-IR, TyG index, VFT, fasting insulin, and BMI. It could be a used as a screening tool for hepatic steatosis.