ArticlePhysical activity and nutrition2026
Screening for insulin resistance in children with abdominal obesity: sex-specific performance of TyG index, FGIR, and VAI.
Article in Physical activity and nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aimed to compare the diagnostic performance of the triglyceride-glucose index (TyG), fasting glucose-to-insulin ratio (FGIR), and visceral adiposity index (VAI) for detecting insulin resistance (IR) and to establish sex-specific IR cutoffs in Korean schoolchildren with abdominal obesity.
methodsThis cross-sectional study included 728 fourth- to sixth-grade students (398 boys and 330 girls; mean age, 11.5 ± 1.1 years) from P City, Gyeonggi-do (June 2018-August 2019). Abdominal obesity was defined as waist circumference and waist-to-height ratio ≥ 90th percentile (high-risk subgroup, n = 192). IR was classified using sex-specific homeostasis model assessment of insulin resistance cutoffs (boys ≥ 3.54, girls ≥ 3.69). Receiver operating characteristic analysis with the Youden index was performed to compare TyG index, FGIR, and VAI in the high-risk subgroup.
resultsFGIR demonstrated superior performance in both sexes. The area under the curve (AUC) was 0.939 (95% confidence interval [CI], 0.903-0.976) for boys and 0.894 (95% CI, 0.835-0.954) for girls. Corresponding cutoff values were 8.435 and 7.473, with sensitivities of 94.9% and 91.2% and specificities of 79.6% and 81.2%, respectively. TyG and VAI exhibited lower AUCs (0.726‒0.768 and 0.679‒0.740, respectively). High-risk abdominal obesity was strongly associated with IR (adjusted odds ratio 6.175, 95% CI, 3.958-9.633).
conclusionAmong Korean school-aged children with abdominal obesity, FGIR outperformed TyG and VAI as surrogate markers of IR. Accounting for pubertal insulin dynamics with sex-specific cutoff values supports the use of FGIR as a practical, low-cost tool for early screening and intervention in high-risk groups.
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