Ehtisham Sarah, Crabtree Nicola, Clark Penelope, Shaw Nick, Barrett Timothy
Department of Diabetes and Endocrinology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, United Kingdom.
J Clin Endocrinol Metab. 2005 Jul;90(7):3963-9. doi: 10.1210/jc.2004-2001. Epub 2005 Apr 19.
Type 2 diabetes is increasingly recognized in childhood, occurring more frequently in the United Kingdom in South Asians and in girls. South Asian children have been shown to be more insulin resistant than white European children, and girls more insulin resistant than boys. It is not clear how these sex and ethnic differences relate to body composition in childhood.
The goal was to evaluate sex and ethnic differences in insulin sensitivity and body composition in healthy adolescents.
This was a cross-sectional cohort study.
This was a community-based study.
One hundred twenty-nine healthy white European and South Asian 14- to 17-yr-old adolescents participated.
Body composition was assessed by anthropometry and dual-energy x-ray absorptiometry, and insulin sensitivity by homeostasis model assessment.
The main outcome measures were body fat percentage and insulin sensitivity.
We confirmed that South Asian adolescents were less insulin sensitive than white European adolescents (homeostasis model assessment of insulin sensitivity, 52.4 vs. 58.9%, P < 0.05), with a trend toward lower insulin sensitivity in girls. South Asian adolescents had significantly more body fat than white European adolescents (girls, 30.6 vs. 26.0%, P < 0.005; boys, 20.8 vs. 14.8%, P < 0.001), with more central fat (waist-thigh ratio in girls, 1.36 vs. 1.25, P < 0.001; boys, 1.52 vs. 1.42, P < 0.001). The sex-ethnic differences in insulin sensitivity were no longer seen when body fat was included as a covariate.
Ethnic differences in insulin sensitivity are associated with ethnic differences in body fat. South Asian adolescents are more insulin resistant, with more body fat than white European adolescents, which may contribute to their increased risk of developing type 2 diabetes.
2型糖尿病在儿童中越来越常见，在英国，南亚裔儿童和女孩中更为频发。研究表明，南亚裔儿童比欧洲白人儿童更具胰岛素抵抗性，女孩比男孩更具胰岛素抵抗性。目前尚不清楚这些性别和种族差异与儿童期身体组成有何关联。
评估健康青少年中胰岛素敏感性和身体组成的性别及种族差异。
这是一项横断面队列研究。
这是一项基于社区的研究。
129名14至17岁的欧洲白人和南亚裔健康青少年参与了研究。
通过人体测量学和双能X线吸收法评估身体组成，通过稳态模型评估法评估胰岛素敏感性。
主要观察指标为体脂百分比和胰岛素敏感性。
我们证实，南亚裔青少年的胰岛素敏感性低于欧洲白人青少年（胰岛素敏感性的稳态模型评估分别为52.4%和58.9%，P<0.05），女孩的胰岛素敏感性有降低趋势。南亚裔青少年的体脂明显多于欧洲白人青少年（女孩分别为30.6%和26.0%，P<0.005；男孩分别为20.8%和14.8%，P<0.001），且中心脂肪更多（女孩腰臀比分别为1.36和1.25，P<0.001；男孩分别为1.52和1.42，P<0.001）。将体脂作为协变量纳入后，胰岛素敏感性的性别-种族差异不再明显。
胰岛素敏感性的种族差异与体脂的种族差异相关。南亚裔青少年比欧洲白人青少年更具胰岛素抵抗性，且体脂更多，这可能导致他们患2型糖尿病的风险增加。
