HOMA-IR levels in pediatric metabolic syndrome: characterization and associated clinical and biochemical factors

Flores-Palacios R.; Aduviri-Poma M.; Encinas-Llica R.; Huaycani-Aduviri J.; Ramos-Vilca A.; Chara-Saenz V. · Horizonte Medico (2025) · DOI: 10.24265/horizmed.2025.v25n4.06

Resumen

Objective: To characterize insulin resistance (IR) levels using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) in children and adolescents with metabolic syndrome (MS), to analyze the clinical and biochemical factors associated with its elevation, and to evaluate the performance of the triglyceride-glucose – waist circumference (TyG-WC) index as a surrogate marker in this population. Materials and methods: A cross-sectional study was conducted at Hospital Hipólito Unanue in Tacna, Peru. Patients aged 10–17 years with a clinical diagnosis of MS between January 2015 and December 2024 were included, according to the National Cholesterol Education Program – Adult Treatment Panel III (NCEP-ATP III) criteria adapted for the pediatric population. A generalized linear model (GLM) was used to identify clinical factors associated with elevated HOMA-IR. Additionally, the diagnostic performance of the variables significantly associated with high HOMA-IR was assessed. Results: A total of 68 children and adolescents with MS were included, with a mean age of 13.2 ± 2.2 years; females accounted for 51.50 % of the sample. HOMA-IR levels were elevated, with a median of 6.69, and 23.50 % of patients were above the 75th percentile (HOMA-IR ≥ 10). In the GLM-adjusted analysis, lack of health insurance and elevated TyG-WC index were significantly associated with high HOMA-IR. The TyG-WC index showed a cutoff point > 980 for discriminating high HOMA-IR, with 45.00 % sensitivity and 85.40 % specificity, reliably identifying adolescents with marked insulin resistance. These findings support the usefulness of incorporating simple anthropometric and biochemical indices into clinical practice, particularly in settings with limited access to specialized testing. Conclusions: In children and adolescents with MS, insulin resistance was elevated, with one-fourth of the sample above the 75th percentile. Lack of health insurance and elevated TyG-WC index were significantly associated with high HOMA-IR, underscoring their relevance as indicators of metabolic risk in this population.

Instituciones: Universidad Nacional Jorge Basadre Grohmann