Liu Bo-wei, Lu Quiang, Ma Chun-ming, Wang Shu-yi, Lou Dong-hui, Lou Xiao-li, Yin Fu-zai
The First Hospital of Qinhuangdao, Endocrionology, Qinhuangado, China.
Exp Clin Endocrinol Diabetes. 2009 Nov;117(10):600-4. doi: 10.1055/s-0029-1225353. Epub 2009 Jul 17.
To investigate the changes of insulin resistance and fasting plasma ghrelin levels in adolescents with obesity and family history of type 2 diabetes mellitus (FHD) and analyze its related factors.
The study included 159 adolescents aged 13-15 years. Anthropometric- measurements, including height, weight and waist. Blood samples were collected and fasting plasma glucose (FPG), serum lipids, true insulin (TI) and fasting plasma ghrelin were assayed. They were divided into four groups according to body mass index (BMI) and FHD: 40 non-obese adolescents without FHD in group A; 40 overweight and obese adolescents without FHD in group B; 40 non-obese adolescents with FHD in group C; 39 overweight and obese adolescents with FHD in group D.
Group B, C and D had significantly higher levels of HOMA-IR and HOMA-beta index than group A, especially Group D (p<0.01). Group C and D had significantly higher levels of FPG and lower levels of ghrelin than group A (p<0.01). HOMA-IR showed positive correlation with BMI (r=0.445), waist (r=0.435), waist-to-height ratio (WHtR)(r=0.471) (p<0.01). Ghrelin showed negative correlation with FPG (r=-0.339), TI (r=-0.237) and HOMA-IR (r=-0.269) (p<0.01). In multiple linear regression analysis, WHtR (beta=4.925, p=0.000) and FHD (beta=0.492, p=0.000) were significant independent predictors for HOMA-IR. FHD (beta=-289.856, p=0.000) and FPG (beta=-228.203, p=0.001) were significant independent predictors for ghrelin.
This study showed that the subjects with FHD and obesity who are predisposed to diabetes have insulin resistance in adolescent stage. The lower ghrelin levels in subjects with FHD may be the result of elevated FPG.
探讨有肥胖症且有2型糖尿病家族史（FHD）的青少年胰岛素抵抗及空腹血浆胃饥饿素水平的变化，并分析其相关因素。
该研究纳入了159名13 - 15岁的青少年。进行人体测量，包括身高、体重和腰围。采集血样并检测空腹血糖（FPG）、血脂、真胰岛素（TI）和空腹血浆胃饥饿素。根据体重指数（BMI）和FHD将他们分为四组：A组为40名无FHD的非肥胖青少年；B组为40名无FHD的超重和肥胖青少年；C组为40名有FHD的非肥胖青少年；D组为39名有FHD的超重和肥胖青少年。
B组、C组和D组的HOMA - IR和HOMA - β指数水平显著高于A组，尤其是D组（p<0.01）。C组和D组的FPG水平显著高于A组，胃饥饿素水平低于A组（p<0.01）。HOMA - IR与BMI（r = 0.445）、腰围（r = 0.435）、腰高比（WHtR）（r = 0.471）呈正相关（p<0.01）。胃饥饿素与FPG（r = - 0.339）、TI（r = - 0.237）和HOMA - IR（r = - 0.269）呈负相关（p<0.01）。在多元线性回归分析中，WHtR（β = 4.925，p = 0.000）和FHD（β = 0.492，p = 0.000）是HOMA - IR的显著独立预测因素。FHD（β = - 289.856，p = 0.000）和FPG（β = - 228.203，p = 0.001）是胃饥饿素的显著独立预测因素。
本研究表明，易患糖尿病的有FHD和肥胖症的受试者在青少年阶段存在胰岛素抵抗。有FHD的受试者胃饥饿素水平较低可能是FPG升高的结果。
