García Cuartero B, García Lacalle C, Jiménez Lobo C, González Vergaz A, Calvo Rey C, Alcázar Villar M J, Díaz Martínez E
Unidad de Endocrinología Pediátrica, Hospital Severo Ochoa, Leganés, Spain.
An Pediatr (Barc). 2007 May;66(5):481-90. doi: 10.1157/13102513.
The aim of this study was to establish the reference values of the Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check (QUICKI) indexes, as well as those of insulin and C-peptide levels in healthy children and adolescents with a view to determining reference percentiles to detect those at cardiovascular risk.
A total of 372 children boys and girls of different ages and at distinct pubertal stages with normal body mass index participated in the study. Fasting glucose, insulin and C-peptide values were measured by chemiluminescence and the HOMA and QUICKI indexes were calculated.
Fasting glucose levels were normal in all children. The mean values obtained for each variable were (mean (SD)): fasting glucose 87(7.75) mg/dL, insulin 7.74 (5.35) microU/mL, C-peptide: 1.76 (0.79) ng/mL, HOMA index 1.72 (1.27) and QUICKI index 0.72 (0.29). All the variables progressively increased with age, with statistically significant differences between prepubertal and pubertal children. The QUICKI index showed an inverse relationship. In addition, significant differences were found between sexes. The 90th percentile for all the variables was as follows: insulin 15.05 microU/mL, C-peptide: 2.85 ng/mL, HOMA index 3.43 and QUICKI index 1.10.
Values of fasting glucose, insulin, C-peptide and the HOMA index significantly increased with age and pubertal stage, while the QUICKI index decreased. We defined the 90th percentile for all the parameters studied as the cut-off point to identify children at cardiovascular risk in our population.
本研究旨在建立健康儿童和青少年的稳态模型评估（HOMA）和定量胰岛素敏感性检查指数（QUICKI）以及胰岛素和C肽水平的参考值，以确定参考百分位数，从而检测出有心血管疾病风险的人群。
共有372名不同年龄、处于不同青春期阶段且体重指数正常的儿童（男童和女童）参与了本研究。通过化学发光法测量空腹血糖、胰岛素和C肽值，并计算HOMA和QUICKI指数。
所有儿童的空腹血糖水平均正常。每个变量获得的平均值为（均值（标准差））：空腹血糖87（7.75）mg/dL，胰岛素7.74（5.35）微单位/毫升，C肽：1.76（0.79）纳克/毫升，HOMA指数1.72（1.27），QUICKI指数0.72（0.29）。所有变量均随年龄增长而逐渐升高，青春期前儿童和青春期儿童之间存在统计学显著差异。QUICKI指数呈负相关。此外，性别之间也存在显著差异。所有变量的第90百分位数如下：胰岛素15.05微单位/毫升，C肽：2.85纳克/毫升，HOMA指数3.43，QUICKI指数1.10。
空腹血糖、胰岛素、C肽和HOMA指数的值随年龄和青春期阶段显著增加，而QUICKI指数则下降。我们将所研究的所有参数的第90百分位数定义为识别我们人群中有心血管疾病风险儿童的临界点。
