Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 42559, USA.
Metabolism. 2010 May;59(5):718-27. doi: 10.1016/j.metabol.2009.09.016. Epub 2009 Nov 14.
We evaluated the associations of teenage insulin and adolescent diet with 10-year weight gain in an analysis sample of black and white girls matched for pubertal stage, body mass index (BMI) (or fat mass), and insulin at ages 9 to 10 years. We hypothesized that preteen insulin and insulin resistance would interact with dietary factors to positively predict increases in BMI. Furthermore, we hypothesized that increased insulin and insulin resistance, interacting with higher caloric intake during adolescence, would lead to greater increments in BMI in black girls than in white girls. Prospective 10-year follow-up was performed on 215 pairs of black and white schoolgirls matched at baseline by BMI (or fat mass), insulin, and pubertal stage, with repeated measures of body habitus, insulin, and dietary intake. When matched for BMI, black girls had higher fat-free mass and white girls had higher fat mass at ages 9 to 10 years. Black-white differences in caloric intake were not significant at ages 9 to 10 years, but black girls consumed more calories at age 19 years. Black girls consumed a greater percentage of calories from fat throughout. At age 19 years, black girls had higher BMI, fat mass index, and insulin. When matched at ages 9 to 10 years for fat mass, black girls were heavier, had higher BMI, and had greater fat-free mass. By ages 18 to 19 years, black girls continued to have higher BMI, but had accrued higher fat mass and a higher percentage of body fat. By stepwise multiple regression, 10-year increases in BMI were predicted by ages 9 to 10 years BMI, 10-year change in insulin, and a 3-way interaction between ages 9 to 10 years insulin, adolescent caloric intake, and race (higher in black girls) (all Ps < .0001). Insulin at ages 9 to 10 years interacts with caloric intake to increase BMI by age 19 years. There appear to be intrinsic black-white metabolic differences that lead to greater gains in fat during adolescence in black girls. Evaluating BMI and insulin at ages 9 to 10 years could identify girls (particularly black) who would optimally benefit from dietary and exercise interventions to avoid obesity.
我们评估了青少年胰岛素和青少年饮食与黑人及白人女孩 10 年体重增加的关联，这些女孩在 9 至 10 岁时根据青春期阶段、体重指数（BMI）（或体脂肪）和胰岛素进行匹配。我们假设，青春期前胰岛素和胰岛素抵抗会与饮食因素相互作用，积极预测 BMI 的增加。此外，我们假设，在青春期期间，胰岛素和胰岛素抵抗的增加与较高的热量摄入相结合，将导致黑人女孩 BMI 的增加幅度大于白人女孩。对 215 对黑人及白人女学生进行了前瞻性 10 年随访，这些女学生在基线时根据 BMI（或体脂肪）、胰岛素和青春期阶段进行匹配，并且对身体形态、胰岛素和饮食摄入进行了重复测量。在 9 至 10 岁时，与白人女孩相比，黑人女孩的去脂体重更高，而白人女孩的体脂肪量更高。9 至 10 岁时，黑人和白人女孩的热量摄入差异并不显著，但黑人女孩在 19 岁时摄入的热量更多。黑人女孩一直摄入更多的脂肪热量。在 19 岁时，黑人女孩的 BMI、体脂肪指数和胰岛素水平更高。在 9 至 10 岁时根据体脂肪进行匹配时，黑人女孩更重，BMI 更高，去脂体重更大。到 18 至 19 岁时，黑人女孩的 BMI 继续升高，但体脂肪量和体脂肪百分比增加更高。通过逐步多元回归分析，10 年 BMI 的增加由 9 至 10 岁时的 BMI、10 年内胰岛素的变化以及 9 至 10 岁时胰岛素、青少年热量摄入和种族之间的 3 向相互作用（黑人女孩中更高）（均 P<.0001）预测。9 至 10 岁时的胰岛素与热量摄入相互作用，导致 19 岁时 BMI 增加。似乎存在内在的黑白人种代谢差异，导致黑人女孩在青春期期间体脂肪增加更多。在 9 至 10 岁时评估 BMI 和胰岛素可以识别出（特别是黑人）女孩，她们将从饮食和运动干预中获益最大，以避免肥胖。
