Clinical Nutrition and Risk Factor Modification Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario.
Can J Cardiol. 2010 Mar;26(3):e128-32. doi: 10.1016/s0828-282x(10)70360-3.
The prevalence of the metabolic syndrome (MetS) is increasing worldwide and prevention represents a major challenge. Usually identified in middle age, the MetS has pediatric roots and there are variable incidence rates between ethnic groups. Due to the difficulty of diagnosis, it remains largely undetected in adolescents.
To assess the presence of the MetS features in healthy, normal-weight, multiethnic adolescents and to determine whether fasting blood glucose (FBG) could function as a simple indicator of its presence.
A convenience sample of secondary school students was used in a cross-sectional study. General linear model ANCOVA adjusted for multiple pairwise comparisons by the post hoc Tukey-Kramer test was used to assess differences among the tertiles of FBG.
A total of 182 adolescents from 62 Greater Toronto Area secondary schools in Ontario were recruited (44% Caucasian, 34% South Asian and 22% Chinese), with a mean (+/- SD) age of 17.4+/-0.9 years, a mean body mass index of 22.1+/-3.4 kg/m2 and a mean FBG of 4.92+/-0.4 mmol/L. Analysis with general linear model ANCOVA across the tertiles of FBG (3.83 mmol/L to 4.78 mmol/L, 4.79 mmol/L to 5.08 mmol/L, and 5.09 mmol/L to 6.45 mmol/L) showed significant linear increases of body mass index (P<0.005), waist circumference (P<0.001), systolic blood pressure (P<0.001) and diastolic blood pressure (P<0.05) with increasing FBG. Stepwise multiple regression analysis indicated systolic blood pressure (beta=0.0078, partial R2=0.039, P=0.007) and waist circumference (beta=0.0081, partial R2=0.025, P=0.035) were independent predictors of the increased FBG level.
MetS markers were present in a sample of healthy multiethnic adolescents in the Greater Toronto Area. FBG could be used as a simple indicator of the MetS to allow for early detection of the presence of the MetS and the introduction of preventive lifestyle measures. Further studies with larger sample sizes should address the accuracy of FBG for diagnosing the MetS.
代谢综合征（MetS）的患病率在全球范围内呈上升趋势，预防是一项重大挑战。代谢综合征通常在中年时被发现，但它在儿童时期就有了根源，而且不同种族的发病率也不同。由于诊断困难，青少年中代谢综合征的检出率仍然很高。
评估健康、正常体重的多种族青少年代谢综合征特征的存在，并确定空腹血糖（FBG）是否可以作为其存在的简单指标。
采用横断面研究便利样本，采用事后 Tukey-Kramer 检验调整的多对比较广义线性模型 ANCOVA 来评估 FBG 三分位组之间的差异。
共招募了安大略省大多伦多地区 62 所中学的 182 名青少年（44%为白种人，34%为南亚裔，22%为华裔），平均年龄为 17.4+/-0.9 岁，平均体重指数为 22.1+/-3.4kg/m2，平均 FBG 为 4.92+/-0.4mmol/L。通过一般线性模型 ANCOVA 对 FBG 的三分位组（3.83mmol/L 至 4.78mmol/L、4.79mmol/L 至 5.08mmol/L 和 5.09mmol/L 至 6.45mmol/L）进行分析，结果显示体重指数（P<0.005）、腰围（P<0.001）、收缩压（P<0.001）和舒张压（P<0.05）随着 FBG 的升高呈显著线性增加。逐步多元回归分析表明，收缩压（beta=0.0078，部分 R2=0.039，P=0.007）和腰围（beta=0.0081，部分 R2=0.025，P=0.035）是 FBG 升高的独立预测因素。
在大多伦多地区的健康多种族青少年样本中存在代谢综合征标志物。FBG 可作为代谢综合征的简单指标，用于早期发现代谢综合征的存在，并引入预防性生活方式措施。进一步的研究应该使用更大的样本量来解决 FBG 诊断代谢综合征的准确性问题。
