Identification of pediatric MASLD using insulin resistance indices

The increasing prevalence of pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) and its strong association with cardiometabolic risk factors underscore the need for effective early detection tools. Our study demonstrates that single-point insulin sensitivity estimator (SPISE) and metabolic score for insulin resistance (METS-IR) are superior, non-invasive markers for predicting MASLD in children and adolescents, with validated cut-off values applicable to both population-based and real-world clinical settings. These findings are particularly relevant for clinicians and healthcare policymakers, as they provide practical, easily accessible screening tools derived from routine laboratory tests, aiding in the early identification and risk stratification of pediatric MASLD. However, given the study's retrospective design and variations in diagnostic methods across datasets, further validation in larger, diverse cohorts is warranted to refine age-specific cut-off values and optimize screening approaches.