title: The Homeostasis Model Assessment-adiponectin (HOMA-AD) is the most sensitive predictor of insulin resistance in obese children.
abstract: OBJECTIVE
  The aim of this study was to examine the efficacy of three indices i.e. adiponectin/leptin ratio, HOMA-IR and HOMA-AD in assessing insulin resistance among obese children.
  
  
  METHODS
  One hundred and twenty-two obese children (57 girls, 65 boys): mean age 13.7±1.3 years, BMI 30.1±4.5kg/m(2), eight tanner stage I, 48 tanner stage II-III, 66 tanner stage IV-V, participated in this study. They were classified into four groups according to sex and the presence of metabolic syndrome characteristics: with metabolic syndrome (MS; 21 girls and 36 boys) and controls without metabolic syndrome (CON, 36 girls and 29 boys). The correlations between these three indices of insulin resistance and the MS criteria were analyzed using linear and multiple regressions and receiver operating characteristics (ROC) curves analysis.
  
  
  RESULTS
  The majority of anthropometric and biological parameters as well as adiponectin/leptin ratio, HOMA-IR and HOMA-AD were significantly different between MS and CON in both sexes. Both HOMA-AD and HOMA-IR were significantly correlated with the majority of metabolic syndrome components than was the adiponectin/leptin ratio in MS of both sexes. In boys and girls with and without MS, multiple regression analyses highlighted that both HOMA-AD and adiponectin/leptin ratio (r=-0.99 and r=-0.54 for MS girls and boys respectively, 0.05<P<0.001), and HOMA-AD and HOMA-IR (r=0.66 and r=0.31 for MS girls and boys respectively, 0.05<P<0.01) affected each other but did not adiponectin/leptin ratio and HOMA-IR. Additionally, the area under the ROC curves for predicting insulin resistance were 0.69 (CI 95%, 0.60-0.77), 0.68 (CI 95%, 0.59-0.76) and 0.71 (CI 95%, 0.62-0.79) for adiponectin/leptin ratio, HOMA-IR and HOMA-AD, respectively.
  
  
  CONCLUSIONS
  The current study strengthens the validity of the HOMA-AD as an adequate tool for determining insulin resistance among obese children with MS.
authors.affiliation: Laboratory of cardiocirculatory, respiratory, and hormonal adaptations to muscular exercise, Sousse University, Sousse, Tunisia. makni e@yahoo.fr
authors.forename: Emna
authors.initials: E
authors.lastname: Makni
authors.forename: Wassim
authors.initials: W
authors.lastname: Moalla
authors.forename: Gérard
authors.initials: G
authors.lastname: Lac
authors.forename: Chirine
authors.initials: C
authors.lastname: Aouichaoui
authors.forename: Daniel
authors.initials: D
authors.lastname: Cannon
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elloumi
authors.forename: Zouhair
authors.initials: Z
authors.lastname: Tabka
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D005260:Female; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D020738:Leptin / Q000097:blood; D008297:Male; D008954:Models, Biological; D009765:Obesity / Q000378:metabolism*
chemical_list: D052242:Adiponectin; D020738:Leptin