The association between skeletal muscle-to-fat mass ratio and insulin resistance in obese children with low skeletal muscle mass

Obesity with low skeletal muscle mass (OLM) is increasingly recognized as a high-risk phenotype in pediatric populations. The skeletal muscle-to-fat mass ratio (MFR) reflects muscle-fat imbalance, but its association with metabolic health in children and adolescents remains incompletely understood. This study examined the associations between MFR and metabolic indicators, with a focus on insulin resistance, in children and adolescents with OLM. This cross-sectional study included 258 children an