Endocrine Abstracts

JOINT1491

Introduction: It remains essential to identify the most relevant lipid parameter ratios for assessing cardiometabolic risk and insulin resistance in obese pediatric patients. This study aims to determine which lipid ratio best identifies these risks in pediatric patients diagnosed with metabolic syndrome (MetS).

Materials and Methods: This study was conducted in the Endocrine Department of the Children’s Hospital in Timisoara, Romania, between January 2018 and December 2024. 215 obese patients (BMI >95th percentile for sex and age), aged 10–16 years, were included. Anthropometric measurements (body weight, blood pressure, and abdominal circumference) and biochemical markers of lipid and glucose metabolism were assessed. The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and lipid ratios (TG: HDL-C, total cholesterol: HDL-C, and LDL: HDL) were calculated.

Results: Patients were stratified based on the presence of MetS according to the International Diabetes Federation (IDF) criteria, resulting in 95 patients with MetS (median age: 13.4 years, 40% boys) and 120 without MetS (median age: 12.5 years, 60% boys). The MetS group exhibited significantly higher insulin levels (23.5 µIU/mL [IQR: 14.7–38.5] vs. 16.3 µIU/mL [IQR: 12.7–26.8], P = 0.03) and HOMA-IR values (23.3 [IQR: 14.7–38.8] vs. 16.3 [IQR: 12.7–28.8], P = 0.03). Lipid ratios were also significantly elevated in the MetS group (P < 0.01), including TG: HDL-C (3.7 [IQR: 2.4–5.1] vs. 1.59 [IQR: 1.2–2.43]), total cholesterol: HDL-C (4.0 [IQR: 3.4–4.9] vs. 3.2 [IQR: 2.48–3.78]), and LDL: HDL (2.3 [IQR: 1.9–2.88] vs. 1.88 [IQR: 1.25–2.36]). MetS presence was strongly correlated with HOMA-IR and lipid indices, particularly TG: HDL-C (r = 0.549). Logistic regression confirmed TG: HDL-C as a significant predictor of MetS (P < 0.01).

Conclusion: The TG: HDL-C ratio is a strong marker for identifying cardiometabolic risk in obese children with MetS diagnosis.