Song Kyungchul, Lee Eunju, Lee Hye Sun, Lee Hana, Lee Ji-Won, Chae Hyun Wook, Kwon Yu-Jin
Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
Diabetes Metab J. 2025 Mar;49(2):264-274. doi: 10.4093/dmj.2024.0302. Epub 2024 Oct 29.
Studies on predictive markers of insulin resistance (IR) and elevated liver transaminases in children and adolescents are limited. We evaluated the predictive capabilities of the single-point insulin sensitivity estimator (SPISE) index, metabolic score for insulin resistance (METS-IR), homeostasis model assessment of insulin resistance (HOMA-IR), the triglyceride (TG)/ high-density lipoprotein cholesterol (HDL-C) ratio, and the triglyceride-glucose index (TyG) for IR and alanine aminotransferase (ALT) elevation in this population.
Data from 1,593 participants aged 10 to 18 years were analyzed using a nationwide survey. Logistic regression analysis was performed with IR and ALT elevation as dependent variables. Receiver operating characteristic (ROC) curves were generated to assess predictive capability. Proportions of IR and ALT elevation were compared after dividing participants based on parameter cutoff points.
All parameters were significantly associated with IR and ALT elevation, even after adjusting for age and sex, and predicted IR and ALT elevation in ROC curves (all P<0.001). The areas under the ROC curve of SPISE and METS-IR were higher than those of TyG and TG/HDL-C for predicting IR and were higher than those of HOMA-IR, TyG, and TG/HDL-C for predicting ALT elevation. The proportions of individuals with IR and ALT elevation were higher among those with METS-IR, TyG, and TG/ HDL-C values higher than the cutoff points, whereas they were lower among those with SPISE higher than the cutoff point.
SPISE and METS-IR are superior to TG/HDL-C and TyG in predicting IR and ALT elevation. Thus, this study identified valuable predictive markers for young individuals.
关于儿童和青少年胰岛素抵抗（IR）及肝转氨酶升高的预测标志物的研究有限。我们评估了单点胰岛素敏感性估计值（SPISE）指数、胰岛素抵抗代谢评分（METS-IR）、胰岛素抵抗稳态模型评估（HOMA-IR）、甘油三酯（TG）/高密度脂蛋白胆固醇（HDL-C）比值以及甘油三酯-葡萄糖指数（TyG）对该人群IR和丙氨酸氨基转移酶（ALT）升高的预测能力。
使用一项全国性调查对1593名10至18岁参与者的数据进行分析。以IR和ALT升高作为因变量进行逻辑回归分析。生成受试者工作特征（ROC）曲线以评估预测能力。根据参数切点对参与者进行分组后，比较IR和ALT升高的比例。
即使在调整年龄和性别后，所有参数均与IR和ALT升高显著相关，并在ROC曲线中预测了IR和ALT升高（所有P<0.001）。对于预测IR，SPISE和METS-IR的ROC曲线下面积高于TyG和TG/HDL-C；对于预测ALT升高，其ROC曲线下面积高于HOMA-IR、TyG和TG/HDL-C。METS-IR、TyG和TG/HDL-C值高于切点的个体中IR和ALT升高的比例较高，而SPISE高于切点的个体中该比例较低。
在预测IR和ALT升高方面，SPISE和METS-IR优于TG/HDL-C和TyG。因此，本研究为年轻人确定了有价值的预测标志物。
