O-47: Can Triglyceride-Based indices reliably screen for hepatic steatosis in adolescents with overweight and obesity?
M Uçar, Z Küpçü, M Eltan, D Güneş Kaya, G Velioğlu Haşlak, İ Altun, E Bayramoğlu, O Evliyaoğlu, H TuranAbstract
Introduction
Childhood obesity is closely linked to metabolic dysfunction and is associated with an increased risk of hepatic steatosis(HS). Early detection of HS is essential, yet reliable, non-invasive screening tools validated for adolescents remain limited.
Objectives
The main aim of the study was to assess the diagnostic performance of metabolic indices for detecting HS and identify independent predictors of its presence and severity.
Methods
This multicenter cross-sectional study included 236 adolescents aged 12-18 years at Tanner stage 5 with body mass index(BMI) standard deviation score(SDS) ≥1 who underwent an oral glucose tolerance test (OGTT) between January 2024 and November 2025. Individuals with chronic diseases, using medications that alter glucose and lipid metabolism, monogenic or syndromic obesity, missing abdominal ultrasonography(US) results, or an interval>3 months between the OGTT and abdominal US were excluded. Six indices (HOMA-IR, QUICKI, TyG, SPISE, Matsuda, and TIS) were evaluated. HS was assessed and graded semi-quantitatively. Diagnostic performance was evaluated using ROC analysis, and optimal cut-offs were determined. Independent predictors of HS presence and severity were identified using multivariable logistic regression analysis.
Results
HS was present in 177 participants(75 %). The TyG index demonstrated the highest diagnostic accuracy with a cut-off of 8.25, followed by the SPISE index (Figure 1). Multivariate analysis showed that BMI and triglycerides independently predicted the presence of HS (Model 1); for HS severity (Model 2), BMI, ALT, HDL, and triglycerides were significant predictors.
Conclusions
Triglyceride-based indices represent effective non-invasive tools for screening hepatic steatosis in adolescents with overweight and obesity. BMI and triglyceride levels are independent determinants of steatosis risk and progression, supporting their integration into clinical screening strategies.