['The aim of this study was to examine the efficacy of three indices i.e. adiponectin/leptin ratio, HOMA-IR and HOMA-AD in assessing insulin resistance among obese children.', 'One hundred and twenty-two obese children (57\xa0girls, 65\xa0boys): mean age 13.7±1.3\xa0years, BMI 30.1±4.5kg/m(2), eight tanner stage\xa0I, 48\xa0tanner stage\xa0II-III, 66\xa0tanner stage\xa0IV-V, participated in this study. They were classified into four groups according to sex and the presence of metabolic syndrome characteristics: with metabolic syndrome (MS; 21\xa0girls and 36\xa0boys) and controls without metabolic syndrome (CON, 36\xa0girls and 29\xa0boys). The correlations between these three indices of insulin resistance and the MS criteria were analyzed using linear and multiple regressions and receiver operating characteristics (ROC) curves analysis.', 'The majority of anthropometric and biological parameters as well as adiponectin/leptin ratio, HOMA-IR and HOMA-AD were significantly different between MS and CON in both sexes. Both HOMA-AD and HOMA-IR were significantly correlated with the majority of metabolic syndrome components than was the adiponectin/leptin ratio in MS of both sexes. In boys and girls with and without MS, multiple regression analyses highlighted that both HOMA-AD and adiponectin/leptin ratio (r=-0.99 and r=-0.54 for MS girls and boys respectively, 0.05<P<0.001), and HOMA-AD and HOMA-IR (r=0.66 and r=0.31 for MS girls and boys respectively, 0.05<P<0.01) affected each other but did not adiponectin/leptin ratio and HOMA-IR. Additionally, the area under the ROC curves for predicting insulin resistance were 0.69 (CI 95%, 0.60-0.77), 0.68 (CI 95%, 0.59-0.76) and 0.71 (CI 95%, 0.62-0.79) for adiponectin/leptin ratio, HOMA-IR and HOMA-AD, respectively.'] Is the Homeostasis Model Assessment-adiponectin ( HOMA-AD ) the most sensitive predictor of insulin resistance in obese children?