Table 1.
Studies evaluating the association between insulin resistance, non-alcoholic fatty liver disease (NAFLD), and metabolic syndrome (MetS) in children.
| References | Study design |
Sample size
and Gender-NAFLD prevalence |
Ethnic
group |
IR indexes | Findings |
|---|---|---|---|---|---|
| Sartorio et al. (17) | Cross sectional study | 268 obese children (58% M/42% F) |
Caucasian | OGTT HOMA-IR |
NAFLD is associated with impaired glucose profile and MetS criteria (systolic blood pressure, lipid profile, BMI). |
| Yoo et al. (18) | Cross-sectional study | 909 obese children (78% M/22% F) |
Asian | HOMA-IR Fasting insulin |
Significant association between NAFLD and components of MetS (IR, dyslipidemia, ipertension) |
| Love-Osborne et al. (24) | Cross-sectional study | 85 obese children (42% M/58% F) |
Hispanic Black White American-Indian Asian |
OGTT HOMA-IR Fasting insulin |
Impaired glucose regulation and NAFLD in subjects meeting 3 or more criteria of MetS. Fasting insulin and TG were significantly higher in subjects with steatosis |
| Di Bonito et al. (26) | Cross-sectional study | 564 obese and lean children (37% M/63% F) |
Caucasian | HOMA-IR Fasting insulin Fasting glucose |
A positive correlation between ALT levels, IR, and dyslipidemia |
| Shi et al. (27) | Cross-sectional study | 308 obese children (46% M/76% F) |
Asian | HOMA-IR WBISI |
High prevalence of NAFLD in children with MetS. NAFLD and MetS shared the common mechanism of IR. |
| Fu et al. (19) | Cross-sectional study | 861 obese children (70% M/30% F) |
Asian | OGTT HOMA-IR Fasting insulin Fasting glucose HbA1c WBISI |
Association between NAFLD, hypertension, dyslipidemia, impaired fasting glucose, and MetS. The state of insulin resistance deteriorated as the degree of fatty infiltration increased. |
| Boyraz et al. (22) | Cross-sectional study | 451 obese children (65% M/35% F) |
Caucasian | OGTT Fasting glucose Hyperinsulinemia |
Association between NAFLD, MetS criteria, and IR. |
| Mager et al. (20) | Cross-sectional study | 46 obese and lean children (94% M/6% F) |
Canadian | HOMA-IR | Metabolic dysregulation (insulin resistance, obesity, elevated TG, and lower HDL cholesterol) in children with NAFLD. |
| El-Karaksy et al. (25) | Cross-sectional study | 76 children overweight/obese (31% M/69% F) |
Egyptians | QUICKI HOMA-IR |
36.8% of children with NAFLD presented MetS. IR was higher in children with NAFLD than controls. |
| Lee et al. (21) | Cross-sectional study | 12 obese children (58% M/42% F) |
Black White |
3-h hyperinsulinemic-euglycemic clamp | Association between NAFLD, IR, and adverse cardiometabolic profile. |
NAFLD, non-alcoholic fatty liver disease; MetS, metabolic syndrome; BMI, body mass index; ALT, alanine aminotransferase; IR, insulin resistance; OGTT, oral glucose tolerance test; HOMA-IR, homeostatic model assessment of insulin resistance; WBISI, whole body insulin sensitivity; QUICKI, quantitative insulin-sensitivity check index; HbA1c, hemoglobin A1c; TG, triglycerides; HDL, high-density lipoprotein; M, males; F, females.