ESPE Abstracts

Key words: Insulin resistance, triglycerides to high-density lipoprotein cholesterol-(HDL-C), HOMA-IR.

Background: Childhood Obesity is a chronic metabolic disease. The fundamental disorder related to obesity is Insulin Resistance (IR). The gold standard method to measure IR is by use the hyper insulinemic euglycemic clamp, rarely performed in children because of its invasiveness, complexity, time consumption and high costs. Practically, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) is generally used in adults and approved for children and adolescents. On the other hand, triglycerides (TG) to high-density lipoprotein cholesterol-(HDL-C) ratio is done as routine test, part of lipid profile. It is of lower cost compared to HOMA-IR especially in limited resource settings.

Objective: To evaluate TG/HDL-C ratio as an alternative tool used as an IR marker in overweight and obese children.

Patients and Methods: This was a cross-sectional study conducted on 75 children and adolescents with overweight and obesity attending Diabetes, Endocrine and Metabolism Pediatric unit (DEMPU), children Hospital. All subjects were subjected to full history, clinical examination and laboratory investigations including complete lipid profile, TG/HDL-C ratio, HOMA-IR, oral glucose tolerance test. Study group was classified into two subgroups according to the level of TG/HDL-C ratio, comparing their demographic and laboratory data.

Results: Thirty-one (42.3%) males, 44(58.7%) females with mean age 9.55±2.32 years. Sixty-eight percent (90.7%) of the study group were overweight with mean weight (61.33± 20.32 kg). Seventy-four (98.7%) had a high BMI with mean (24.54±3.57). Sixty-five (86.7%) had a high level of HOMA-IR. By comparing clinical and laboratory data of participants with normal and high TG/HDL ratio. It was shown that those with high TG/HDL ratio had higher weight, BMI, waist circumference with p values < 0. 001. The mean values of TC, LDL, TG, LDL/HDL ratio and HOMA-IR were higher among those with high TG/HDL ratio compared to those with normal ratio with statistically significant difference with p values (0.017, 0.014, < 0.001, 0.015, < 0.001 respectively). There was a significant positive correlation between TG/HDL ratio and HOMA-IR with p value < 0.001. By multivariate logistic regression analysis, acanthosis nigricans, and high TG/HDL ratio act as independent predictors of IR. TG/HDL ratio ≥2.5 had 75.4%sensitivity, 90% specificity.

Conclusion: TG/HDL ratio was an easy, non-invasive, and useful indicator of insulin resistance as there was a significant positive correlation between it and HOMA_IR.