Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
Am J Hum Biol. 2012 Nov-Dec;24(6):806-11. doi: 10.1002/ajhb.22321. Epub 2012 Sep 25.
We compared adiposity from triceps and subscapular skinfold thickness (SF) with total body fat from dual energy X-ray absorptiometry (DXA) in their associations with HOMA insulin resistance for a large sample of US adolescents.
We analyzed cross-sectional data from 1496 adolescents, ages 12.0-17.99 year examined as part of the US national health and nutrition examination survey (NHANES) cycles 2001-04. Data collected included skinfold thicknesses, DXA-based total body fat (DXF), serum insulin and fasting glucose for homeostasis model assessment of insulin resistance (HOMA-IR). Regression models adjusting for complex survey design effects and correspondence analyses were used to study associations with HOMA-IR and concordance between the two measures of adiposity.
SF and DXA models had identical precisions for estimating continuous HOMA-IR, based on bootstrap estimations. For boys, RMSEs = 0.53 (95% CI: 0.49-0.58) and 0.53 (95% CI: 0.48-0.57) for SF and DXA models respectively; and for girls RMSEs were SF = 0.45 (95% CI: 0.41-0.48) and DXA = 0.46 (95% CI: 0.42-0.48). Both adiposity models identified high proportions of the same individuals (positive percent agreement: 80-81%) with exact agreements exceeding 92% for identifying adolescents at elevated risk of IR in both sexes.
Triceps and subscapular skinfold thicknesses estimate HOMA-IR and identify those at highest risk for insulin resistance as well as total body fat from DXA. Skinfold thickness provides an inexpensive and widely applicable measure of fatness that is appropriate for studies of insulin resistance and perhaps other metabolic variables in adolescents.
我们比较了肱三头肌和肩胛下角皮褶厚度（SF）与双能 X 射线吸收法（DXA）测定的全身脂肪量与 HOMA 胰岛素抵抗的相关性，该研究纳入了大量美国青少年。
我们分析了美国国家健康和营养检查调查（NHANES）2001-04 周期中 1496 名 12.0-17.99 岁青少年的横断面数据。收集的数据包括皮褶厚度、基于 DXA 的全身脂肪量（DXF）、血清胰岛素和空腹血糖，用于 HOMA 胰岛素抵抗评估。采用调整复杂调查设计效果的回归模型和对应分析，研究与 HOMA-IR 的相关性以及两种肥胖测量方法的一致性。
基于 Bootstrap 估计，SF 和 DXA 模型在估计连续 HOMA-IR 方面具有相同的精度。对于男孩，SF 和 DXA 模型的 RMSE 分别为 0.53（95%CI：0.49-0.58）和 0.53（95%CI：0.48-0.57）；对于女孩，SF 的 RMSE 为 0.45（95%CI：0.41-0.48），DXA 的 RMSE 为 0.46（95%CI：0.42-0.48）。两种肥胖模型均识别出大量相同个体（阳性百分比一致率：80-81%），且对于识别两性中处于胰岛素抵抗高风险的个体，两者的完全一致率均超过 92%。
肱三头肌和肩胛下角皮褶厚度可估计 HOMA-IR，并识别出胰岛素抵抗风险最高的个体以及 DXA 测定的全身脂肪量。皮褶厚度是一种经济实惠且广泛适用的肥胖测量方法，适用于研究青少年的胰岛素抵抗和其他代谢变量。
