title: The value of different insulin resistance indices in assessment of non-alcoholic fatty liver disease in overweight/obese children.
abstract: OBJECTIVE
  The aim of the present study was to determine the association between insulin resistance (IR) and both non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) in a group of Egyptian overweight/obese children and adolescents and to evaluate different IR indices in detection of NAFLD.
  
  
  METHODS
  The study included 76 overweight/obese children aged 2-15 years; 52.6% were males. Laboratory analysis included fasting blood glucose, serum insulin, lipid profile, liver biochemical profile, and liver ultrasound. IR was calculated using the following indices; the homeostasis model assessment method (HOMA-IR), the quantitative insulin-sensitivity check index (QUICKI) and hepatic insulin sensitivity. The National Cholesterol Education Program Adult Treatment Panel III criteria were used to estimate prevalence of MetS. Liver biopsy was done when medically indicated and accepted by parents.
  
  
  RESULTS
  IR was detected in 43.4% and 34.2% by using QUICKI and HOMA, respectively. MetS was detected in 36.8% and NAFLD was detected in 45.5% among those performing liver biopsy. Cases with NAFLD had more frequent IR than children with normal histology. QUICKI showed significant difference between normal subjects and both steatosis and non-alcoholic steatohepatitis; while HOMA-IR was sensitive in cases with NASH only. MetS was present in 100% of patients with NASH and in 75% of those with steatosis and they were all obese. Patients with NASH had significantly higher ALT than those with normal histology.
  
  
  CONCLUSIONS
  IR was significantly associated with NAFLD. QUICKI is considered more sensitive than HOMA-IR in differentiating simple steatosis from normal liver histology.
authors.affiliation: Department of Pediatrics, Cairo University, Cairo, Egypt. Electronic address: hanaakaraksy@kasralainy.edu.eg.
authors.forename: Hanaa M
authors.initials: HM
authors.lastname: El-Karaksy
authors.affiliation: Department of Pediatrics, Cairo University, Cairo, Egypt.
authors.forename: Mona S
authors.initials: MS
authors.lastname: El-Raziky
authors.affiliation: Department of Pediatrics, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
authors.forename: Hanan M
authors.initials: HM
authors.lastname: Fouad
authors.affiliation: Department of Pediatrics, Cairo University, Cairo, Egypt.
authors.forename: Ghada M
authors.initials: GM
authors.lastname: Anwar
authors.affiliation: Department of Chemical Pathology, Cairo University, Cairo, Egypt.
authors.forename: Fatma M
authors.initials: FM
authors.lastname: El-Mougy
authors.affiliation: Department of Pediatrics, Cairo University, Cairo, Egypt.
authors.forename: Nehal M
authors.initials: NM
authors.lastname: El-Koofy
authors.affiliation: Department of Pathology, Cairo University, Cairo, Egypt.
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: El-Hennawy
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D015995:Prevalence; D011379:Prognosis; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Children; Insulin resistance; Metabolic syndrome; Non-alcoholic fatty liver disease; Obesity; Overweight