Comparison of single-point insulin sensitivity estimator and other markers to predict metabolic syndrome in children and adolescents

Abstract

Background: Reliable markers are crucial for the early detection and management of pediatric metabolic syndrome (MS). Methods: 1593 children and adolescents were included from Korea National Health and Nutrition Examination Survey 2019-2021. We assessed homeostasis model assessment of insulin resistance (HOMA-IR), triglyceridesglucose index (TyG), triglycerides/high-density lipoprotein cholesterol (TG/HDL), the Metabolic Score for IR (METS-IR), and single-point insulin sensitivity estimator (SPISE) as predictors of MS. Logistic regression analysis was employed for MS according to the parameters. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to compare the markers to predict MS. Results: In logistic regression analyses, HOMA-IR, METS-IR, TyG, TG/HDL, and SPISE scores were significantly associated with the prevalence of MS after adjusting for age, sex and body mass index standard deviation score. In ROC curve, AUCs (95 % confidence intervals) for IDF-defined MS according to HOMA-IR, METS-IR, TyG, TG/ HDL, and SPISE were 0.884 (0.848-0.920), 0.959 (0.945 -0.972), 0.922 (0.889-0.954), 0.941 (0.913-0.969), and 0.961 (0.947-0.975), respectively, and those for NCEP-ATP III-defined MS were 0.886 (0.828-0.900), 0.959 (0.946 -0.972), 0.915 (0.891-0.938), 0.942 (0.925-0.959), and 0.965 (0.954-0.977), respectively. SPISE was superior to all other markers for prediction of NCEP ATP III-defined MS. For predicting IDF-defined MS, AUCs of METS-IR, TG/HDL, and SPISE were higher than those of HOMA-IR and TyG. Conclusion: These findings highlight the potential of SPISE and METS-IR for early identification and intervention of MS in children and adolescents.