Siriwat R, et al. - In the pediatric obesity clinic, as existing data examining obstructive sleep apnea (OSA) and insulin resistance (IR) are contradictory, the authors investigate OSA and IR. Participants in the study were 80 children (2-18 years) in the obesity clinic (2013-2017), undergoing polysomnography (PSG), anthropometric measurements, and fasting laboratory tests. In a clinic-based obese pediatric cohort, even after adjustment for confounders like obesity identified by the BMI z-score, OSA is related to increased IR. After adjustment for waist circumference z-score and WHR, age ≥ 12 years was linked to AHI relative to IR. Significant IR with moderate sensitivity/specificity could be discriminated by obstructive apnea hypopnea index ≥ 4.9.