Hidden indicators of insulin resistance in childhood obesity

Background Insulin resistance (IR) is a significant health concern that is associated with childhood obesity. Traditional indicators like BMI may not accurately reflect body composition, necessitating alternative measures like fat mass index (FMI), fat mass percentage (FM %), and visceral adiposity index (VAI). Objective To determine whether anthropometric or adiposity-related measures best predict IR in obese children who tested positive using the homeostatic model assessment for insulin resistance. Patients and methods A cross-sectional study was conducted involving 100 children (50 obese children and 50 controls) from the Pediatric Clinical Nutrition Unit at Tanta University Hospital. Anthropometric data, bioelectrical impedance analysis, and laboratory tests were performed. Results Obese children had significantly higher BMI, FMI, FM %, and homeostatic model assessment for insulin resistance. The prevalence of IR was 72% in obese children versus 22% in controls ( P <0.001). BMI showed the highest area under the curve at 0.865, followed by FMI at 0.850 and FM % at 0.831. VAI had the lowest area under the curve of 0.791. BMI and FMI exhibit the highest sensitivity at 88.46%, while VAI exhibited the highest specificity at 88.24%. Conclusion While BMI is a sensitive indicator of IR in obese children, the FMI and VAI can provide additional value. Therefore, combining body composition analysis with BMI enhances the detection of IR in obese children, facilitating early diagnosis and intervention.