Departamento de Nutrición, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Eur J Pediatr. 2011 Jan;170(1):35-43. doi: 10.1007/s00431-010-1260-1. Epub 2010 Jul 31.
The aim of the present work was to study the association between different anthropometric parameters and insulin resistance (IR) in Spanish schoolchildren without a previous diagnosis. A total of 443 Spanish schoolchildren (9-11 years of age) were studied in this cross-sectional study. The anthropometric measurements collected were weight, height, body circumferences and skinfolds. Body mass index (BMI), waist/hip ratio, percentage body fat and fat-free body mass were determined. Overnight-fasted blood lipids, insulin and glucose levels were analysed, and estimation of IR, taking into account the homeostasis model assessment (HOMA), was calculated. The children with IR had higher serum triglycerides and insulin levels, were heavier and taller, and had a higher BMI, a larger waist circumference, a larger hip circumference, a larger waist/hip ratio and thicker bicipital and tricipital skinfolds than those who did not have IR. Age, sex, BMI and waist circumference explained 32.0% of the variance in the HOMA values; only sex, triglycerides and waist circumference independently influenced this variable. A 1-cm increase in waist circumference was associated with approximately a 3.8% increase in the mean HOMA value. The children with a waist circumference of over the p90 for their age and sex were at greater risk of showing IR as measured by the HOMA: odds ratio = 6.94 (2.01-23.91; P < 0.001). In conclusion, according to these results, waist circumference is the best anthropometric parameter associated with IR in children, and those with a waist circumference of over the p90 for their age and sex would appear to be at particular risk.
本研究旨在探讨西班牙学龄儿童中不同人体测量参数与胰岛素抵抗(IR)之间的关系。本横断面研究共纳入 443 名西班牙学龄儿童(9-11 岁)。收集的人体测量指标包括体重、身高、体围和皮褶厚度。计算体重指数(BMI)、腰臀比、体脂肪百分比和去脂体重。分析空腹过夜的血脂、胰岛素和血糖水平,并采用稳态模型评估(HOMA)评估 IR。IR 组的血清三酰甘油和胰岛素水平较高,体重和身高较大,BMI、腰围、臀围、腰臀比和肱二头肌、肱三头肌皮褶厚度较大。年龄、性别、BMI 和腰围解释了 HOMA 值 32.0%的变异性;只有性别、三酰甘油和腰围独立影响该变量。腰围增加 1cm 与 HOMA 值平均增加约 3.8%相关。腰围超过同性别同年龄 p90 的儿童发生 IR 的风险更高(HOMA:比值比=6.94,2.01-23.91;P<0.001)。总之,根据这些结果,腰围是与儿童 IR 最相关的人体测量参数,腰围超过同性别同年龄 p90 的儿童似乎面临更大的风险。