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超重和肥胖的青春期前儿童的胰岛素敏感性与皮下脂肪有关,而与内脏脂肪无关。

Insulin sensitivity is correlated with subcutaneous but not visceral body fat in overweight and obese prepubertal children.

作者信息

Maffeis Claudio, Manfredi Riccardo, Trombetta Maddalena, Sordelli Silvia, Storti Monica, Benuzzi Teresa, Bonadonna Riccardo C

机构信息

Department of Mother and Child, Biology-Genetics, Section of Pediatrics, University of Verona, Piazzale L.A. Scuro 10, Verona, Italy.

出版信息

J Clin Endocrinol Metab. 2008 Jun;93(6):2122-8. doi: 10.1210/jc.2007-2089. Epub 2008 Apr 8.

Abstract

AIM

Our aim was to explore the relationship between insulin sensitivity, body fat distribution, ectopic (liver and skeletal muscle) fat deposition, adipokines (leptin and adiponectin), and inflammation markers (highly sensitive C-reactive protein, IL-6, IL-10, and TNF-alpha) in prepubertal children.

SUBJECTS AND METHODS

Thirty overweight and obese children (16 males and 14 females with body mass index z-score range of 1.1-3.2) were recruited. Body fat distribution and fat accumulation in liver and skeletal muscle were measured using magnetic resonance imaging. Insulin sensitivity was assessed by iv glucose tolerance test.

RESULTS

Insulin sensitivity was associated with sc abdominal adipose tissue (SAT) (r = -0.52; P < 0.01) and liver fat content (r = -0.44; P < 0.02) but not with visceral abdominal adipose tissue (VAT) (r = -0.193; P value not significant) and fat accumulation in skeletal muscle (r = -0.210; P value not significant). Adipokines, but not inflammation markers, were significantly correlated to insulin sensitivity. VAT correlated with C-reactive protein (r = 0.55; P < 0.01) as well as adiponectin (r = -0.53; P <0.01). Multiple regression analysis showed that only SAT and liver fat content were independently correlated to insulin sensitivity (P < 0.01; 20 and 16% of explained variance, respectively).

CONCLUSIONS

In overweight and moderately obese prepubertal children, insulin sensitivity was negatively correlated with SAT and liver fat content. Furthermore, contrary to adults, VAT and inflammation markers were not correlated with insulin sensitivity in children.

摘要

目的

我们的目的是探讨青春期前儿童胰岛素敏感性、体脂分布、异位(肝脏和骨骼肌)脂肪沉积、脂肪因子(瘦素和脂联素)以及炎症标志物(高敏C反应蛋白、白细胞介素-6、白细胞介素-10和肿瘤坏死因子-α)之间的关系。

受试者与方法

招募了30名超重和肥胖儿童(16名男性和14名女性,体重指数z评分范围为1.1 - 3.2)。使用磁共振成像测量体脂分布以及肝脏和骨骼肌中的脂肪堆积情况。通过静脉葡萄糖耐量试验评估胰岛素敏感性。

结果

胰岛素敏感性与腹部皮下脂肪组织(SAT)相关(r = -0.52;P < 0.01)以及肝脏脂肪含量相关(r = -0.44;P < 0.02),但与腹部内脏脂肪组织(VAT)无关(r = -0.193;P值无统计学意义)以及骨骼肌中的脂肪堆积无关(r = -0.210;P值无统计学意义)。脂肪因子与胰岛素敏感性显著相关,而炎症标志物则不然。VAT与C反应蛋白相关(r = 0.55;P < 0.01)以及脂联素相关(r = -0.53;P < 0.01)。多元回归分析表明,只有SAT和肝脏脂肪含量与胰岛素敏感性独立相关(P < 0.01;分别解释20%和16%的方差)。

结论

在超重和中度肥胖的青春期前儿童中,胰岛素敏感性与SAT和肝脏脂肪含量呈负相关。此外,与成年人相反,儿童中的VAT和炎症标志物与胰岛素敏感性无关。

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