Evaluation of TG-HDL Ratio Instead of HOMA Ratio as Insulin Resistance Marker in Overweight and Children with Obesity

Background: Homeostasis model assessment for insulin resistance (HOMA-IR) is widely used as a marker of insulin resistance in adults and has also been validated in children and adolescents. Triglyceride (TG) and HDL-C on the other hand is a routine test and inexpensive compared to insulin. Previous studies reported conflicting findings on the usefulness of the triglyceride to HDL-C ratio (TG:HDL-C ratio) as predictor or marker of IR. The aim of this work was to investigate the usefulness of Triglyceride to HDL-C ratio (TG/HDL-C) as an Insulin Resistance (IR) marker in overweight and children with obesity. Methods: This study was a comparative cross sectional study which was conducted on ninety overweight and children with obesity attending National Nutrition Institute Pediatric obesity clinic. They were classified into 2 groups as follows: group (1) included overweight and children with obesity with insulin resistance, group (2) included overweight and children with obesity with non-insulin resistance. All the subjects were subjected to history, clinical examination and laboratory investigations including total lipid profile, fasting glucose, insulin and TG:HDL-C ratio instead of HOMA ratio. Results: Prevalence of IR among the studied sample was 42 (46.7%). Mean value of TG/HDL-C ratio was greater among the insulin resistance group than non insulin resistance group (p value= < 0.001 )value). TG/HDL ratio >= 1.36 had 85.7% sensitivity, 66.7% specificity. There was statistically significant positive correlation between TG/HDL ratio and HOMA-IR. Conclusion: TG:HDL ratio >= 1.36 is a significant early and sensitive predictor of insulin resistance in children instead of HOMA-IR.