Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey.
Horm Res Paediatr. 2010;73(3):166-74. doi: 10.1159/000284357. Epub 2010 Mar 3.
Cardiovascular risk starts early in life; therefore, it is of interest to clarify the relation between puberty, sex hormones, insulin resistance and lipid levels in children. This is a cross sectional study of 365 school students (8-18 years of age). We analyzed the associations of sex hormones (testosterone, free androgen index, estradiol, free estradiol index) and sex hormone-binding globulin (SHBG) with insulin resistance and lipid levels. Analyses were performed in prepubertal versus adolescent girls and boys. Among prepubertal boys, estradiol was significantly associated with increased log homeostasis model assessment-estimated insulin resistance (HOMA-IR; B = 0.9, model R(2) = 0.62, p < 0.001) and insulin levels (B = 0.8, model R(2) = 0.58, p < 0.001). Testosterone was associated with increased high-density lipoprotein cholesterol (HDL-C) levels among prepubertal boys (B = 10, model R(2) = 0.42, p = 0.04). Among adolescent girls, SHBG was significantly associated with decreased HOMA-IR (B = -0.8, model R(2) = 0.34, p = 0.01) and insulin levels (B = -0.7, model R(2) = 0.34, p = 0.01). SHBG was also related to increased HDL-C levels among prepubertal (B = 24, model R(2) = 0.42, p = 0.047) and adolescent girls (B = 21, model R(2) = 0.44, p = 0.002). In conclusion, sex hormone levels and SHBG have important effects on HDL-C and insulin resistance among children and adolescents.
心血管风险始于生命早期；因此，阐明青春期、性激素、胰岛素抵抗和儿童脂质水平之间的关系很有意义。这是一项对 365 名在校学生（8-18 岁）的横断面研究。我们分析了性激素（睾酮、游离雄激素指数、雌二醇、游离雌二醇指数）和性激素结合球蛋白（SHBG）与胰岛素抵抗和脂质水平的关系。在青春期前和青春期的女孩和男孩中进行了分析。在青春期前的男孩中，雌二醇与升高的稳态模型评估-估计的胰岛素抵抗（HOMA-IR；B = 0.9，模型 R²= 0.62，p < 0.001）和胰岛素水平（B = 0.8，模型 R²= 0.58，p < 0.001）显著相关。睾酮与青春期前男孩的高密度脂蛋白胆固醇（HDL-C）水平升高相关（B = 10，模型 R²= 0.42，p = 0.04）。在青春期女孩中，SHBG 与 HOMA-IR（B = -0.8，模型 R²= 0.34，p = 0.01）和胰岛素水平（B = -0.7，模型 R²= 0.34，p = 0.01）的降低显著相关。SHBG 还与青春期前（B = 24，模型 R²= 0.42，p = 0.047）和青春期女孩（B = 21，模型 R²= 0.44，p = 0.002）的 HDL-C 水平升高有关。总之，性激素水平和 SHBG 对儿童和青少年的 HDL-C 和胰岛素抵抗有重要影响。
