Kong Alberta S, Vanderbloemen Laura, Skipper Betty, Leggott John, Sebesta Emilie, Glew Robert, Burge Mark R
Department of Pediatrics, University of New Mexico School of Medicine, MSC 10 5590, Albuquerque, NM 87131-0001, USA.
J Pediatr Endocrinol Metab. 2012;25(11-12):1095-102. doi: 10.1515/jpem-2012-0117.
Acanthosis nigricans (AN) is a dermatologic condition associated with hyperinsulinemia, a marker of insulin resistance that is the principal abnormality in metabolic syndrome (MetS). We examined the association of AN with the clustering of MetS components.
A cross-sectional study was conducted in an urban school-based health center in New Mexico. Students without diabetes were evaluated for AN, a family history of type 2 diabetes, body mass index (BMI), and MetS components. The clustering of MetS components by BMI category and AN status was assessed by comparing the group means of summed average z-scores of fasting insulin, triglycerides, high-density lipoprotein-cholesterol, and systolic blood pressure among the students. A multivariate model with BMI category and AN status controlling for Tanner stage was performed to identify the variables associated with the clustering of MetS components.
Complete data were available for 90 children (age, 9.7±1.4 years; 94% Hispanic; 60% female). In multivariate modeling of MetS cluster z-score, significant differences were found between the students with BMI <85th percentile [-0.27; 95% confidence interval (95% CI)=-0.42 to -0.11] and (a) the students with BMI 85th-94.9th percentile with AN (0.74; 95% CI=0.17-1.31) and (b) the students with BMI ≥95th percentile with AN (0.86; 95% CI=0.54-1.18). No significant differences in the MetS cluster z-score were seen between the students with BMI <85th percentile and those with BMI 85th-94.9th percentile without AN (0.24; 95% CI=-0.33 to 0.81) or those with BMI ≥95th percentile without AN (0.31; 95% CI=-0.13 to 0.75).
Overweight/obese Hispanic elementary school-aged children with AN exhibit clustering of MetS components and could benefit from early intervention.
黑棘皮病(AN)是一种与高胰岛素血症相关的皮肤病,高胰岛素血症是胰岛素抵抗的一个指标,而胰岛素抵抗是代谢综合征(MetS)的主要异常表现。我们研究了AN与MetS各组分聚集情况之间的关联。
在新墨西哥州一所城市学校的健康中心开展了一项横断面研究。对无糖尿病的学生进行了黑棘皮病、2型糖尿病家族史、体重指数(BMI)及MetS各组分的评估。通过比较学生中空腹胰岛素、甘油三酯、高密度脂蛋白胆固醇及收缩压的总和平均z评分的组均值,评估按BMI类别和AN状态划分的MetS各组分的聚集情况。采用一个控制了坦纳分期的包含BMI类别和AN状态的多变量模型,以确定与MetS各组分聚集相关的变量。
90名儿童(年龄9.7±1.4岁;94%为西班牙裔;60%为女性)有完整数据。在MetS聚集z评分的多变量建模中,BMI低于第85百分位数的学生[-0.27;95%置信区间(95%CI)=-0.42至-0.11]与(a)BMI在第85至94.9百分位数且患有AN的学生(0.74;95%CI=0.17 - 1.31)以及(b)BMI≥第95百分位数且患有AN的学生(0.86;95%CI=0.54 - 1.18)之间存在显著差异。BMI低于第85百分位数的学生与BMI在第85至94.9百分位数且无AN的学生(0.24;95%CI=-0.33至0.81)或BMI≥第95百分位数且无AN的学生(0.31;95%CI=-0.13至0.75)之间,在MetS聚集z评分上未见显著差异。
患有AN的超重/肥胖西班牙裔小学适龄儿童表现出MetS各组分的聚集,可能会从早期干预中获益。