Diagnostic Performance of Triglyceride/High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio in Detecting Insulin Resistance Among Obese Children and Adolescents

Background We evaluated the diagnostic performance of the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio for detecting insulin resistance (IR) in obese children and adolescents using sex- and puberty-specific homeostasis model assessment for insulin resistance (HOMA-IR) cutoffs. Methods This retrospective cross-sectional study included 207 obese patients (5-18 years old; 127 girls and 80 boys) assessed at a tertiary pediatric endocrinology clinic. IR was defined using sex-specific and pubertal stage-specific HOMA-IR thresholds. Anthropometric data and fasting glucose, insulin, lipid profile, glycated hemoglobin (HbA1c), and thyroid-stimulating hormone (TSH) were recorded. Receiver operating characteristic (ROC) analysis evaluated the TG/HDL-C ratio for IR discrimination. Results Compared with the IR-negative group, IR-positive participants had higher weight, body mass index (BMI) (and standard deviation score {SDS}), TG/HDL-C ratio, fasting insulin, HOMA-IR, HbA1c, fasting glucose, triglycerides, and TSH (all p