Ultrasound hepatic elastography: A non-invasive indicator of insulin resistance in the pediatric population: A systematic review

Table 1 Inclusion and exclusion criteria

Criterion	Inclusion	Exclusion
Population	Children and adolescents (≤ 18 years) with obesity, NAFLD/MASLD, or metabolic conditions	Adults (>18 years); studies without separate pediatric data
Study design	Observational studies (cross-sectional, cohort, case-control)	Case reports, reviews, editorials, letters, conference abstracts
Intervention/exposure	Ultrasound-based elastography: TE, pSWE, 2D-SWE	Non-elastography imaging (e.g., MRI, CT), invasive biopsy-only studies
Comparator	Validated insulin resistance measures (HOMA-IR, clamp test, fasting indices)	Studies without insulin resistance measures
Outcomes	Correlation, diagnostic accuracy (AUROC, sensitivity, specificity), regression associations	Studies not reporting the elastography-insulin resistance relationship
Language	English	Non-English
Publication year	2000-October 2025	Outside range

NAFLD: Non-alcoholic fatty liver disease; MASLD: Metabolic dysfunction-associated steatotic liver disease; TE: Transient elastography; pSWE: Point shear wave elastography; SWE: Shear wave elastography; MRI: Magnetic resonance imaging; CT: Computed tomography; HOMA-IR: Homeostatic model assessment of insulin resistance; AUROC: Area under the receiver operating curve.