Schematic depicting the differences in the IGF-I-cortical bone relationship in the children with high versus normal HOMA-IR. The strength of the relationship between IGF-I and Tt.Ar, Ct.Ar, and Peri.Circ, was suppressed in the children with high HOMA-IR. However, IGF-I was a negative predictor of Ct.vBMD (depicted by shading of the cortical compartment) and a positive predictor of Endo.Circ in the children with normal but not high HOMA-IR. Consequently, IGF-I was a stronger positive predictor of pSSI in those with normal versus high HOMA-IR (depicted by line thickness). *Significant IGF-I by HOMA-IR interaction (pInteraction<0.05) for the corresponding cortical bone outcome.