ESPE Abstracts

Background: Metabolic syndrome (MetS) is related to increased cardiovascular complications of obesity. The triglyceride-glucose (TyG) index is frequently used as an indicator of insulin resistance in adults. However, there is scant information on the TyG index in the morbidly obese Pediatric population, nor is its correlation with the components of the metabolic syndrome (MetS).

Methods: We compared the use of TyG vs atherogenic index of plasma (AIP) in relation to different components of MetS in morbidly obese children. The TyG index was calculated as = ln [(triglyceride level, mg/dL) × (glucose level, mg/dL) ÷2] under fasting conditions. Data recorded included: age, gender, weight and height, body mass index (BMI), systolic and diastolic blood pressures. Biochemical data including a lipid profile, glycated hemoglobin (A1C), Oral glucose tolerance (OGTT), fasting insulin, and alanine transferase level (ALT) were recorded and HOMA-IR., AIP, and TyG were calculated for 10 morbidly obese children (11.2 +/- 1.8 yrs.), with BMIZ = 3.54 +/- 0.4.

Results: The different glycemic components, MetS components, TyG and AIP are presented in the table. Half of our patients have high ALT and/or sonographic evidence of NAFLD. Although in adult studies TyG of 8 or more was correlated with NAFLD and insulin resistance, NAFLD occurred in our children with lower TyG values. TyG was correlated significantly with AIP (r = 0.83, P< 0.001). TyG and AIP were correlated significantly with systolic (SBP) and diastolic BP (DBP), 2h blood glucose after OGTT. While TyG was more correlated to BIMZ and HbA1C, AIP was more significantly correlated with ALT, fasting insulin, and HOMA-IR.

Conclusions: Both the TyG index and AIP were correlated with the MetS components in morbidly obese non-diabetic children. maybe an important prognostic indicator for later cardiovascular adverse events. However, cut levels for TyG may differ in children vs adults.