Goran Michael I, Shaibi Gabriel Q, Weigensberg Marc J, Davis Jamie N, Cruz Martha L
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles 90033, USA.
Int J Pediatr Obes. 2006;1(3):139-45. doi: 10.1080/17477160600780423.
To examine 1-year changes in insulin dynamics in overweight Hispanic children at high-risk of type 2 diabetes as a function of body composition and pubertal transition.
Longitudinal changes in insulin dynamics, body composition and maturation were determined in 132 Hispanic children (70 boys/62 girls; aged 10.9 +/- 1.8 years).
Body composition was determined by dual energy x-ray absorptiometry and Tanner stage by physical examination. Insulin sensitivity (SI), the acute insulin response to glucose (AIR) and the disposition index (DI; an index of beta-cell function) were determined using an insulin modified intravenous glucose tolerance test. These measures were conducted at baseline and 1-year later.
Fat mass increased by 13% (3.0 kg) and SI declined by 24%. In repeated measures analysis of variance, the fall in insulin sensitivity over 1 year remained highly significant even after adjusting for baseline fat mass, age, gender and change in fat mass. The fall in SI was not significantly influenced by Tanner stage. However, subjects in earlier maturation showed a compensatory increase in AIR (i.e. appropriate beta-cell compensation), whereas subjects in the latter stages of maturation did not (i.e. poor compensation).
These results indicate that failure to increase AIR in response to the fall in SI may be one factor in the pathogenesis of the progression of pediatric type 2 diabetes in this at risk population.
研究2型糖尿病高危超重西班牙裔儿童胰岛素动力学的1年变化，及其与身体成分和青春期过渡的关系。
对132名西班牙裔儿童（70名男孩/62名女孩；年龄10.9±1.8岁）的胰岛素动力学、身体成分和成熟度进行纵向研究。
采用双能X线吸收法测定身体成分，通过体格检查确定坦纳分期。使用改良胰岛素静脉葡萄糖耐量试验测定胰岛素敏感性（SI）、葡萄糖急性胰岛素反应（AIR）和处置指数（DI；β细胞功能指标）。这些测量在基线和1年后进行。
脂肪量增加了13%（3.0千克），SI下降了24%。在重复测量方差分析中，即使在调整了基线脂肪量、年龄、性别和脂肪量变化后，1年内胰岛素敏感性的下降仍然非常显著。SI的下降不受坦纳分期的显著影响。然而，早熟的受试者AIR有代偿性增加（即适当的β细胞代偿），而成熟后期的受试者则没有（即代偿不良）。
这些结果表明，未能因应SI下降而增加AIR可能是该高危人群儿童2型糖尿病进展发病机制中的一个因素。
