{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T09:28:10Z","timestamp":1787045290581,"version":"build-2736575974"},"reference-count":55,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013885","name":"Ministry of Health Malaysia","doi-asserted-by":"publisher","award":["NMRR-18-2749-41841"],"award-info":[{"award-number":["NMRR-18-2749-41841"]}],"id":[{"id":"10.13039\/501100013885","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Insulin resistance (IR) plays a central role in metabolic dysfunction and elevates the risk of chronic diseases such as type 2 diabetes mellitus in later life. Early identification of IR in adolescents is therefore important. This study aimed to determine the triglyceride-to-high-density lipoprotein cholesterol (TG:HDL-C) ratio cutoff for IR and assess its association with IR predictors among adolescents with obesity. Methods: A total of 215 blood samples from adolescents aged 13\u201316 years with obesity were analyzed for fasting blood glucose, lipids, insulin, leptin, and adiponectin. Obesity was defined using BMI z-scores, while IR was classified using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR \u2265 4.0). Receiver operating characteristic (ROC) analysis was performed to compare the discriminatory performance between the TG:HDL-C ratio and Leptin:Adiponectin ratio (LAR). Multiple logistic regression was performed to assess associations between the TG:HDL-C ratio and IR-related markers. Results: The area under the ROC curve for the TG:HDL-C ratio was comparable to LAR (0.73 vs. 0.68, p = 0.3). The optimal TG:HDL-C ratio cutoff identified using the maximum Youden index was 0.89, with 62% sensitivity and 75% specificity. A TG:HDL-C ratio \u2265 0.89 was associated with higher odds of elevated insulin (AOR 1.1, 95% CI 1.0\u20131.13), elevated HbA1c (AOR 2.7, 95% CI 1.1\u20136.6), abdominal obesity (AOR 3.6, 95% CI 1.9\u20136.7), and raised LAR (AOR 1.2, 95% CI 1.0\u20131.5). Conclusions: These findings suggest that a TG:HDL-C ratio cutoff of 0.89 may be a useful marker for identifying IR in adolescents with obesity.<\/jats:p>","DOI":"10.3390\/children13081098","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:08:41Z","timestamp":1787040521000},"page":"1098","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ratio That Reveals Risk: Defining TG:HDL-C Ratio Cutoff for Insulin Resistance in Adolescents with Obesity"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7376-4735","authenticated-orcid":false,"given":"Ahmad Kamil Nur Zati","family":"Iwani","sequence":"first","affiliation":[{"name":"Endocrine and Metabolic Unit, Nutrition, Metabolic, and Cardiovascular Research Center, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4513-8444","authenticated-orcid":false,"given":"Muhammad Yazid","family":"Jalaludin","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abqariyah","family":"Yahya","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shazana Rifham","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Endocrine and Metabolic Unit, Nutrition, Metabolic, and Cardiovascular Research Center, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0306-4897","authenticated-orcid":false,"given":"Liyana","family":"Ahmad Zamri","sequence":"additional","affiliation":[{"name":"Endocrine and Metabolic Unit, Nutrition, Metabolic, and Cardiovascular Research Center, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fazliana","family":"Mansor","sequence":"additional","affiliation":[{"name":"Endocrine and Metabolic Unit, Nutrition, Metabolic, and Cardiovascular Research Center, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet Yeow Hua","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya 62250, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8057-313X","authenticated-orcid":false,"given":"Abdul Halim","family":"Mokhtar","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.glohj.2024.08.006","article-title":"Combating Obesity in Southeast Asia Countries: Current Status and the Way Forward","volume":"8","author":"Tee","year":"2024","journal-title":"Glob. 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