Morrison John A, Glueck Charles J, Horn Paul S, Schreiber George B, Wang Ping
Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Metabolism. 2009 Mar;58(3):290-5. doi: 10.1016/j.metabol.2008.09.027.
If homeostasis model assessment of insulin resistance (HOMA-IR) interactions with obesity (body mass index [BMI]) at ages 9 to 10 years predict aggregate metabolic syndrome risk factors at ages 18 to 19 years, this would identify novel avenues for primary prevention of metabolic syndrome. Our hypothesis was that HOMA-IRBMI interactions at ages 9 to 10 years would predict aggregate metabolic syndrome risk factor z scores at ages 18 to 19 years in prospective studies of a biracial population of girls. Two centers in the National Heart, Lung, and Blood Institute Growth and Health Study measured serum insulin and glucose at ages 9 to 10 years and 5 metabolic syndrome risk factors at ages 18 to 19 years (triglyceride, high-density lipoprotein cholesterol, systolic/diastolic blood pressure, waist circumference, and glucose). Studies in Cincinnati, OH, included girls from public and parochial schools in the inner city, within-city residential neighborhoods, and suburban areas; and those in Washington, DC, included girls from a health maintenance organization. Girls (194 white, 281 black) were studied first at ages 9 to 10 years, then at ages 18 to 19 years. We assessed HOMA-IRBMI interactions at ages 9 to 10 years with race-specific z scores for 5 metabolic syndrome risk factors at ages 18 to 19 years. The lowest summed z score (mean +/- SD) was observed for subjects in the lowest tertiles for both HOMA-IR and BMI (-1.15 +/- 2.05), and the highest z score (2.58 +/- 3.11) was for subjects in the highest tertiles for both HOMA-IR and BMI (P < .0001). For the top BMI tertile, there was a progressive increase in z score (increasing risk of metabolic syndrome) as HOMA-IR increased. Interaction of BMI with HOMA-IR at ages 9 to 10 years predicts aggregate metabolic risk score at ages 18 to 19 years, with progressive risk increments within the top BMI tertile as HOMA-IR increases, opening avenues for intervention to reduce both BMI and HOMA-IR at ages 9 to 10 years as a primary approach to prevention of metabolic syndrome at ages 18 to 19 years.
如果9至10岁时胰岛素抵抗的稳态模型评估（HOMA-IR）与肥胖（体重指数[BMI]）之间的相互作用能够预测18至19岁时代谢综合征的总体风险因素，那么这将为代谢综合征的一级预防找到新途径。我们的假设是，在一项针对双种族女孩群体的前瞻性研究中，9至10岁时的HOMA-IRBMI相互作用能够预测18至19岁时代谢综合征总体风险因素的z分数。美国国立心肺血液研究所生长与健康研究中的两个中心在9至10岁时测量了血清胰岛素和葡萄糖，并在18至19岁时测量了5种代谢综合征风险因素（甘油三酯、高密度脂蛋白胆固醇、收缩压/舒张压、腰围和血糖）。俄亥俄州辛辛那提市的研究纳入了来自市中心公立和教会学校、市内居民区以及郊区的女孩；华盛顿特区的研究纳入了来自一个健康维护组织的女孩。女孩们（194名白人，281名黑人）先在9至10岁时接受研究，然后在18至19岁时再次接受研究。我们用18至19岁时5种代谢综合征风险因素的种族特异性z分数评估了9至10岁时的HOMA-IRBMI相互作用。HOMA-IR和BMI均处于最低三分位数的受试者的z分数总和最低（均值±标准差）（-1.15±2.05），而HOMA-IR和BMI均处于最高三分位数的受试者的z分数最高（2.58±3.11）（P<.0001）。对于BMI最高的三分位数，随着HOMA-IR升高，z分数逐渐增加（代谢综合征风险增加）。9至10岁时BMI与HOMA-IR的相互作用能够预测18至19岁时的总体代谢风险评分，在BMI最高的三分位数内，随着HOMA-IR升高风险逐渐增加，这为在9至10岁时降低BMI和HOMA-IR作为预防18至19岁时代谢综合征的主要方法开辟了干预途径。
