{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:57:02Z","timestamp":1782917822708,"version":"3.54.5"},"reference-count":41,"publisher":"Walter de Gruyter GmbH","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpem-2025-0738_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Hepatic steatosis (HS) represents one of the most frequent metabolic complications of pediatric obesity and is closely linked with insulin resistance (IR). Although the homeostatic model assessment for insulin resistance (HOMA-IR) is widely used, lipid-derived indices such as the triglyceride-glucose (TyG) index and triglyceride\/high-density lipoprotein cholesterol (TG\/HDL-C) ratio have recently emerged as simple IR surrogates. Data comparing these indices with HS severity in children remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0738_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective study included 462 children aged 6\u201318\u00a0years with overweight or obesity who were evaluated between October 2023 and December 2024. Anthropometry, biochemical data, and ultrasonographic HS grading were obtained from medical records. HOMA-IR, TyG, and TG\/HDL-C indices were calculated, and their associations with HS presence and severity were analyzed using correlation and multivariable regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0738_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HS was identified in 53.5\u202f% of participants (grade 1: 29.9\u202f%, grade 2: 16.6\u202f%, grade 3: 6.0\u202f%). Children with HS demonstrated significantly higher HOMA-IR, TyG index, and TG\/HDL-C ratio compared with those without HS (all p&lt;0.001). HOMA-IR increased progressively with HS grade (p&lt;0.05), whereas TyG and TG\/HDL-C did not display a significant gradient. Logistic regression confirmed that HOMA-IR was independently associated with HS severity (\u03b2=0.261; 95\u202f% CI: 0.030\u20130.078; p&lt;0.001), while TyG and TG\/HDL-C were not. ALT levels rose significantly with HS grade, whereas AST showed no severity-related pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0738_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HOMA-IR remains the strongest metabolic predictor of hepatic steatosis severity in pediatric obesity. Although TyG and TG\/HDL-C reliably differentiate HS presence, they do not independently estimate HS progression. Lipid-derived markers may support non-insulin\u2013based screening; however, HOMA-IR should be prioritized when stratifying steatosis\u00a0risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpem-2025-0738","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:33:55Z","timestamp":1782916435000},"source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the relationship between HOMA-IR, triglyceride-glucose index, and triglyceride\/HDL-cholesterol ratio with the presence and severity of hepatic steatosis in children with obesity"],"prefix":"10.1515","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6947-6782","authenticated-orcid":false,"given":"Benay","family":"Turan","sequence":"first","affiliation":[{"name":"\u0130zmir City Hospital , Pediatric Endocrinology Clinic , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3613-8119","authenticated-orcid":false,"given":"Emrullah","family":"Arslan","sequence":"additional","affiliation":[{"name":"\u0130zmir City Hospital , Pediatric Endocrinology Clinic , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4770-0365","authenticated-orcid":false,"given":"Eren","family":"Er","sequence":"additional","affiliation":[{"name":"\u0130zmir City Hospital , Pediatric Endocrinology Clinic , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7506-061X","authenticated-orcid":false,"given":"Bumin Nuri","family":"D\u00fcndar","sequence":"additional","affiliation":[{"name":"Izmir Katip \u00c7elebi University , Pediatric Endocrinology Department , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"2026070113555292399_j_jpem-2025-0738_ref_001","doi-asserted-by":"crossref","unstructured":"Nogueira-de-Almeida, CA, De, MED. 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