Wu Der-Min, Chu Nain-Feng, Shen Muh-Han, Wang Shu-Chuan
School of Public Health, Department of Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Clin Biochem. 2006 Aug;39(8):810-5. doi: 10.1016/j.clinbiochem.2006.05.007. Epub 2006 May 26.
To evaluate the degree of obesity and plasma high sensitivity C-reactive protein (hs-CRP) levels in relation to insulin resistance status among school children in Taiwan.
After multistage sampling, we randomly selected 1438 children (701 boys and 737 girls) with the mean age of 13.4 years (from 12 to 16) in Taipei in 2003. Anthropometric measures and plasma biochemical variables (including lipid profiles, glucose and insulin) were measured using standard methods. Plasma hs-CRP levels were measured using nephelometric methods. We calculated insulin resistance (IR) index using HOMA methods and further calculated a gender-specific insulin resistance syndrome (IRS) summary score by adding the quartile ranks from the distribution of systolic blood pressure (SBP), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and insulin levels of each children. A high IRS summary score corresponds to higher levels of SBP, TG and insulin levels and lower levels of HDL-C.
Boys were taller, heavier, had larger BMI, glucose, IRS summary score and hs-CRP than girls; however, there is no difference in plasma TG, insulin levels, and IR index between genders. Plasma hs-CRP levels were positively correlated with anthropometric measures, TG, insulin levels, IR index, and IRS summary score and negatively correlated with HDL-C. Anthropometric measures, plasma TG, insulin levels, IR index and IRS summary score were significantly higher in children with higher plasma hs-CRP levels (test for trend p<0.05). After adjustment for age, heart rate, smoking and drinking, hs-CRP continued to be positively associated with anthropometric variables (weight and BMI), insulin levels, and IR index and negatively correlated with HDL-C in both genders. Plasma hs-CRP levels were also positively associated with TG and IRS summary score in boys and glucose in girls. However, after further adjusting for BMI, the association of hs-CRP on TG, insulin levels, IR index and IRS summary score disappeared in boys and on body weight, HDL-C, insulin level and IR index disappeared in girls.
Plasma hs-CRP levels are positively related to anthropometric variables, such as body weight and BMI, insulin levels, IR index and IRS summary score and negatively related to HDL-C in Taiwanese children. Moreover, the degree of body fat status (as measured by BMI) plays a more significantly role on insulin resistance status than hs-CRP levels among Taiwanese children.
评估台湾学童的肥胖程度和血浆高敏C反应蛋白（hs-CRP）水平与胰岛素抵抗状态的关系。
在多阶段抽样后，我们于2003年在台北随机选取了1438名儿童（701名男孩和737名女孩），平均年龄为13.4岁（12至16岁）。使用标准方法测量人体测量指标和血浆生化变量（包括血脂谱、血糖和胰岛素）。使用比浊法测量血浆hs-CRP水平。我们使用稳态模型评估法（HOMA）计算胰岛素抵抗（IR）指数，并通过将每个儿童收缩压（SBP）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和胰岛素水平分布的四分位数秩相加，进一步计算特定性别的胰岛素抵抗综合征（IRS）综合评分。较高的IRS综合评分对应较高的SBP、TG和胰岛素水平以及较低的HDL-C水平。
男孩在身高、体重、BMI、血糖、IRS综合评分和hs-CRP方面均高于女孩；然而，男女之间血浆TG、胰岛素水平和IR指数并无差异。血浆hs-CRP水平与人体测量指标、TG、胰岛素水平、IR指数和IRS综合评分呈正相关，与HDL-C呈负相关。血浆hs-CRP水平较高的儿童，其人体测量指标、血浆TG、胰岛素水平、IR指数和IRS综合评分显著更高（趋势检验p<0.05）。在调整年龄、心率、吸烟和饮酒因素后，hs-CRP在男女中均继续与人体测量变量（体重和BMI）、胰岛素水平和IR指数呈正相关，与HDL-C呈负相关。血浆hs-CRP水平在男孩中还与TG和IRS综合评分呈正相关，在女孩中与血糖呈正相关。然而，在进一步调整BMI后，hs-CRP与男孩的TG、胰岛素水平、IR指数和IRS综合评分以及与女孩的体重、HDL-C、胰岛素水平和IR指数之间的关联消失。
在台湾儿童中，血浆hs-CRP水平与人体测量变量如体重和BMI、胰岛素水平、IR指数和IRS综合评分呈正相关，与HDL-C呈负相关。此外，在台湾儿童中，身体脂肪状态程度（以BMI衡量）对胰岛素抵抗状态的影响比hs-CRP水平更为显著。
