Identification of pediatric MASLD using insulin resistance indices

作者：Kyungchul Song, Eun‐Ju Lee, Hye Sun Lee, Young Hoon Youn, Su Jung Baik, Hyun Joo Shin, Hyun Wook Chae, Ji‐Won Lee, Yu‐Jin Kwon · 发表于：JHEP Reports · 年份：2025 · DOI：10.1016/j.jhepr.2025.101419 · 被引用次数：25 · 研究领域：Liver Disease Diagnosis and Treatment、Diabetes, Cardiovascular Risks, and Lipoproteins、Liver Disease and Transplantation

Background & Aims We investigated the triglyceride-to-high density lipoprotein (HDL) ratio (TG/HDL), triglyceride–glucose index (TyG), single-point insulin sensitivity estimator (SPISE), and metabolic score for insulin resistance (METS-IR) as potential predictors of pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) by addressing the limited research on insulin-resistance markers in this population. Methods This cross-sectional study included data from 1,150 and 260 youths from the National Health and Nutrition Examination Survey (NHANES) and a real-world clinic, respectively. Hepatic steatosis was assessed using transient elastography and abdominal sonography. Logistic regression analysis was performed using MASLD as the dependent variable. Receiver operating characteristic (ROC) curves were used to evaluate predictability. Results The MASLD group had higher TG/HDL, TyG, METS-IR, and obesity proportions but lower SPISE than the normal group in both NHANES and real-world data. All markers were significantly related to MASLD in logistic regression analyses, even after adjusting for age and sex, in both the NHANES and real-world clinic data (all p <0.001). The areas under the ROC curves (AUCs) for SPISE and METS-IR were 0.91 and 0.91 in the total group, 0.92 and 0.92 in the male group, and 0.90 and 0.89 in the female group, respectively—all higher than those for TG/HDL and TyG in the NHANES dataset (all p <0.001). In the real-world clinical data, the AUC...