Clinical utility of the SPISE index as an indicator of insulin resistance in pediatric obesity

Purpose: Single Point Insulin Sensitivity Estimator (SPISE) index is a lipid-based marker of insulin sensitivity, but data on its role in pediatric obesity are limited. This study evaluated its performance in identifying metabolic syndrome (MetS) and related metabolic risk factors in children and adolescents with obesity.Materials and Methods: In this retrospective study, anthropometric and laboratory data were collected, and the SPISE index was calculated based on BMI, triglyceride, and HDL cholesterol levels. Correlation analyses and receiver operating characteristic (ROC) analyses were performed to assess the association of SPISE with metabolic parameters and its performance, compared with HOMA-IR, in detecting MetS.Results: A total of 213 participants (58.7% female) with a mean age of 12.6 ± 3.2 years were included. The SPISE index showed inverse correlations with BMI SDS (r = −0.714), TG/HDL ratio (r = −0.559), TyG index (r = −0.457), HOMA-IR (r = −0.395), and age (r = −0.327). Lower SPISE values were observed in participants with severe obesity, elevated HOMA-IR, hepatic steatosis, hypertension, and metabolic syndrome. For the detection of MetS, the SPISE index demonstrated an AUC of 0.833 (95% CI: 0.767–0.886), with 96.7% sensitivity and 62.0% specificity at a cut-off value of