{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:46:01Z","timestamp":1760060761247,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background\/Objectives: Childhood obesity is associated with early metabolic complications, particularly insulin resistance (IR), which significantly elevates the long-term risk for type 2 diabetes and cardiovascular disease. Standard measures such as BMI may inadequately capture metabolic risk, particularly in children with atypical phenotypes such as TOFI (Thin Outside, Fat Inside). This study aimed to evaluate the prevalence and predictors of IR in a pediatric population with overweight and obesity, using both conventional biomarkers and bioelectrical impedance analysis (BIA). We also examined the predictive value of lipid ratios and fasting glucose and applied Principal Component Analysis (PCA) to identify underlying body composition dimensions. Methods: A retrospective cohort of 210 children aged 1\u201318 years, assessed in a tertiary pediatric endocrinology center in Romania, was analyzed. Clinical data included anthropometric measures, fasting laboratory results, and body composition parameters obtained via Tanita PRO DC430 MA BIA. Insulin resistance was defined as HOMA-IR &gt; 2. ROC analysis assessed the predictive performance of triglyceride-to-HDL (Tg\/HDL) ratio, fasting glucose, and BIA metrics. PCA was applied to BIA variables to explore dimensional structure. Results: Insulin resistance was present in 54.8% of the cohort. It was significantly associated with higher age, pubertal status, ALT, LDL-cholesterol, triglycerides, and BIA-derived fat-free mass (FFM), TBW, and PMM. ROC analyses showed moderate predictive power for Tg\/HDL (AUROC = 0.645) and triglycerides (AUROC = 0.656) in identifying IR. BIA metrics had comparable discriminatory performance (AUROC~0.61). PCA reduced eight BIA parameters into two components: a fat-free mass axis (TBW, FFM, PMM, WATERM) and an adiposity axis (BMI, FATP, FATM, WATERP). Conclusions: This study highlights the high burden of insulin resistance among children with excess weight and supports the integration of BIA and composite biomarkers into early screening protocols. PCA-derived components may improve metabolic phenotyping in pediatric obesity.<\/jats:p>","DOI":"10.3390\/medicina61091709","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T12:33:32Z","timestamp":1758285212000},"page":"1709","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Insulin Resistance and Body Composition in Children with Overweight and Obesity: A Pilot Study Using Bioimpedance and Principal Component Analysis"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1079-6028","authenticated-orcid":false,"given":"Bogdan Mihai","family":"Pascu","sequence":"first","affiliation":[{"name":"Pediatric Department, Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 030167 Bucharest, Romania"},{"name":"National Institute for Mother and Child Health \u201cAlessandrescu-Rusescu\u201d, 020395 Bucharest, Romania"},{"name":"Yuno Clinic, EASO COM Obesity Center, 020459 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5581-0041","authenticated-orcid":false,"given":"Anca","family":"B\u0103l\u0103nescu","sequence":"additional","affiliation":[{"name":"Pediatric Department, Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 030167 Bucharest, Romania"},{"name":"Yuno Clinic, EASO COM Obesity Center, 020459 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul Cristian","family":"B\u0103l\u0103nescu","sequence":"additional","affiliation":[{"name":"Pediatric Department, Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 030167 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corina","family":"Delia","sequence":"additional","affiliation":[{"name":"National Institute for Mother and Child Health \u201cAlessandrescu-Rusescu\u201d, 020395 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"C\u00e2mpean","sequence":"additional","affiliation":[{"name":"Faculty of Chemistry, University of Bucharest, 050663 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioan","family":"Gherghina","sequence":"additional","affiliation":[{"name":"Pediatric Department, Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 030167 Bucharest, Romania"},{"name":"National Institute for Mother and Child Health \u201cAlessandrescu-Rusescu\u201d, 020395 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Luo, Y., Luo, D., Li, M., and Tang, B. 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