ESPE Abstracts

Introduction: Body mass index (BMI) and waist circumference (WC) are the main anthropometric measures of obesity. However, their inability to take into account body fat distribution raises queries for their predictive value of insulin resistance (IR) in youth.

Aim: The aim of this study is to compare BMI and WC with latest anthropometric indices in the assessment of IR in a paediatric Greek population with overweight and obesity.

Materials & Methods: One hundred and two children and adolescents (age range 2,80-14,80, mean 11,75, standard deviation 2,77 years) of Greek origin having overweight and obesity were enrolled in the study. The correlation between adiposity indexes, including body mass index (BMI), waist circumference to height ratio (WtHR) a body shape index (ABSI), body roundness index (BRI), Conicity-index (C-index) and various measures of IR, not only homeostatic assessment of insulin resistance (HOMA-IR) but also HOMA-2IR, quantitative insulin-sensitivity check index (QUICKI), fasting serum insulin (FSI), fasting plasma glucose (FPG)/FSI, and triglycerides to high density lipoprotein ratio (Trig/HDL) were investigated. Statistical analysis was performed using the IBM SPSS Statistics 27.

Results: BMI adjusted for age and sex and WC correlates similarly to many of the newer anthropometric indexes with IR as assessed by HOMA-IR and other main surrogate markers. The highest correlation with HOMA-IR, HOMA-2IR, QUICKI, FSI, FPG/FSI and Trig/HDL was recorded for BMI and WC (r= 0,495 P<0,0001, r= 0,494 P<0,0001, r= 0,481, P<0,0001, r= -0,494 P<0,0001, r= -0,444 P<0,0001, r= 0,283 P=0,004 and r= 0,426 P<0,0001, r= 0,424 P<0,0001, r= 0,415 P<0,0001, r= -0,424 P<0,0001, r= -0,387 P<0,0001, r= 0,318 P=0,001, respectively). WtHR and BRI presented an identical degree of correlation with all of the previously mentioned IR indexes (r= 0,296 P=0,003, r= 0,299 P=0,002, r= 0,282 P=0,005, r= -0,299 P=0,002, r= -0,267 P=0,007, r= 0,259 P=0,008, respectively). On the other hand, ABSI and C-index did not correlate with any of the IR indexes.

Conclusions: BMI adjusted for age and sex and WC reserve their predictive value of IR. WtHR and BRI, more representative of body fat distribution, emerge as reliable anthropometric indexes assessing IR. However, ABSI and C-index, usually applied in adults, appear to have low clinical applicability in the pediatric population. Furthermore, except for HOMA-IR, other IR indexes were proved to be valuable. Larger studies need to further support the usage of new anthropometric and IR indexes in the pediatric population.