Cruz Martha L, Weigensberg Marc J, Huang Terry T-K, Ball Geoff, Shaibi Gabriel Q, Goran Michael I
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California 90089, USA.
J Clin Endocrinol Metab. 2004 Jan;89(1):108-13. doi: 10.1210/jc.2003-031188.
The prevalence of the metabolic syndrome is highest among Hispanic adults. However, studies exploring the metabolic syndrome in overweight Hispanic youth are lacking. Subjects were 126 overweight children (8-13 yr of age) with a family history for type 2 diabetes. The metabolic syndrome was defined as having at least three of the following: abdominal obesity, low high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, hypertension, and/or impaired glucose tolerance. Insulin sensitivity was determined by the frequently sampled iv glucose tolerance test and minimal modeling. The prevalence of abdominal obesity, low HDL cholesterol, hypertriglyceridemia, systolic and diastolic hypertension, and impaired glucose tolerance was 62, 67, 26, 22, 4, and 27%, respectively. The presence of zero, one, two, or three or more features of the metabolic syndrome was 9, 22, 38, and 30%, respectively. After controlling for body composition, insulin sensitivity was positively related to HDL cholesterol (P < 0.01) and negatively related to triglycerides (P < 0.001) and systolic (P < 0.01) and diastolic blood pressure (P < 0.05). Insulin sensitivity significantly decreased (P < 0.001) as the number of features of the metabolic syndrome increased. In conclusion, overweight Hispanic youth with a family history for type 2 diabetes are at increased risk for cardiovascular disease and type 2 diabetes, and this appears to be due to decreased insulin sensitivity. Improving insulin resistance may be crucial for the prevention of chronic disease in this at-risk population.
代谢综合征在西班牙裔成年人中的患病率最高。然而，缺乏对超重西班牙裔青少年代谢综合征的研究。研究对象为126名有2型糖尿病家族史的超重儿童（8 - 13岁）。代谢综合征的定义为至少具备以下三项：腹部肥胖、低高密度脂蛋白（HDL）胆固醇、高甘油三酯血症、高血压和/或糖耐量受损。通过频繁采样静脉葡萄糖耐量试验和最小模型法测定胰岛素敏感性。腹部肥胖、低HDL胆固醇、高甘油三酯血症、收缩压和舒张压高血压以及糖耐量受损的患病率分别为62%、67%、26%、22%、4%和27%。代谢综合征具备零项、一项、两项或三项及以上特征的比例分别为9%、22%、38%和30%。在控制身体成分后，胰岛素敏感性与HDL胆固醇呈正相关（P < 0.01），与甘油三酯呈负相关（P < 0.001），与收缩压（P < 0.01）和舒张压（P < 0.05）呈负相关。随着代谢综合征特征数量的增加，胰岛素敏感性显著降低（P < 0.001）。总之，有2型糖尿病家族史的超重西班牙裔青少年患心血管疾病和2型糖尿病的风险增加，这似乎是由于胰岛素敏感性降低所致。改善胰岛素抵抗对于预防这一高危人群的慢性病可能至关重要。
