Diabetes Metab J.  2025 Mar;49(2):264-274. 10.4093/dmj.2024.0302.

Comparison of SPISE and METS-IR and Other Markers to Predict Insulin Resistance and Elevated Liver Transaminases in Children and Adolescents

• Song K
• Lee E
• Lee HS
• Lee H
• Lee JW
• Chae HW
• Kwon YJ

• KMID: 2565349
• DOI: http://doi.org/10.4093/dmj.2024.0302

Abstract

Background
Studies on predictive markers of insulin resistance (IR) and elevated liver transaminases in children and adolescents are limited. We evaluated the predictive capabilities of the single-point insulin sensitivity estimator (SPISE) index, metabolic score for insulin resistance (METS-IR), homeostasis model assessment of insulin resistance (HOMA-IR), the triglyceride (TG)/ high-density lipoprotein cholesterol (HDL-C) ratio, and the triglyceride-glucose index (TyG) for IR and alanine aminotransferase (ALT) elevation in this population.
Methods
Data from 1,593 participants aged 10 to 18 years were analyzed using a nationwide survey. Logistic regression analysis was performed with IR and ALT elevation as dependent variables. Receiver operating characteristic (ROC) curves were generated to assess predictive capability. Proportions of IR and ALT elevation were compared after dividing participants based on parameter cutoff points.
Results
All parameters were significantly associated with IR and ALT elevation, even after adjusting for age and sex, and predicted IR and ALT elevation in ROC curves (all P<0.001). The areas under the ROC curve of SPISE and METS-IR were higher than those of TyG and TG/HDL-C for predicting IR and were higher than those of HOMA-IR, TyG, and TG/HDL-C for predicting ALT elevation. The proportions of individuals with IR and ALT elevation were higher among those with METS-IR, TyG, and TG/ HDL-C values higher than the cutoff points, whereas they were lower among those with SPISE higher than the cutoff point.
Conclusion
SPISE and METS-IR are superior to TG/HDL-C and TyG in predicting IR and ALT elevation. Thus, this study identified valuable predictive markers for young individuals.

Keyword

Adolescent; Biomarkers; Child; Insulin resistance; Non-alcoholic fatty liver disease

Figure

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  Fig. 1. Receiver operating characteristic curve of each parameter for predicting (A) insulin resistance and (B) alanine transaminase elevation. The dots on the curves represent cutoff points of each parameter. HOMA-IR, homeostasis model assessment of insulin resistance; AUC, area under the receiver operating characteristic curve; METS-IR, metabolic score for insulin resistance; TyG, triglyceride-glucose index; TG/HDL-C, triglyceride/high-density lipoprotein cholesterol; SPISE, single-point insulin sensitivity estimator.

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  Fig. 2. Proportion of participants with (A) insulin resistance (IR) and (B) alanine transaminase (ALT) elevation relative to the cutoff points of each parameter.The numbers on the bars indicate the proportion (%) of participants. METS-IR, metabolic score for insulin resistance; TyG, triglyceride-glucose index; TG/HDL-C, triglyceride/high-density lipoprotein cholesterol; SPISE, single- point insulin sensitivity estimator; HOMA-IR, homeostasis model assessment of insulin resistance.

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