A proteomic–lipidomic analysis has identified novel plasma biomarkers that can enhance early detection of insulin resistance (IR) in children with obesity, as reported in Pediatric Diabetes.

In this two-cohort design, fasting plasma samples from prepubertal children were profiled to uncover candidate biomarkers of IR. The discovery cohort included 30 children with obesity and 20 lean controls, while the validation cohort comprised 25 obese-IR and 25 obese-non-IR participants.

Among validated biomarkers, fatty acid binding protein 4 (FABP4) and serpin family E member 1 (PAI-1) were elevated in obese-IR children, whereas insulin-like growth factor binding protein 1 (IGFBP-1) and paraoxonase 3 (PON3) were reduced. Lipid species including sphingosine (d16:0), coenzyme Q8, and phosphatidylcholine (18:1e_16:0) also showed significant differences between groups. IGFBP-1 (AUROC 0.89) and PON3 (0.81) outperformed adiponectin and leptin in diagnosing IR.

These results demonstrate the potential of combined proteomic and lipidomic profiling as a superior, mechanism-based strategy for early risk detection and personalized metabolic care in pediatric obesity.