Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, 55454.
Am J Hum Biol. 2013 Sep-Oct;25(5):581-5. doi: 10.1002/ajhb.22416. Epub 2013 Jul 30.
There is biological crosstalk between insulin signaling and bone remodeling pathways, and wrist circumference and bone area were recently found to associate with insulin resistance independent of body mass index (BMI) in overweight/obese children. We aimed to expand on this work by using more specific measures of adiposity for adjustment and examining children with broader range of BMI.
We used serial data (1,051 total measures) on 313 non-Hispanic white youth (ages 8-18 y) from the Fels Longitudinal Study with homeostasis model assessment of insulin resistance (HOMA-IR) as the outcome. Internal standard deviation score (SDS) for wrist breadth was evaluated as a predictor of HOMA-IR (log-transformed) before and after adjusting for internal-sample SDSs for BMI, waist circumference (WC), and total body fat (TBF) from dual energy X-ray absorptiometry, in addition to age, sex, Tanner stage, and birth year, using generalized estimating equations.
Before additional adiposity adjustment, we found a significant positive association between wrist breadth SDS and log-transformed HOMA-IR (β = 0.13; 95%CI: 0.09-0.17), which remained significant after adjusting for TBF SDS (β = 0.09; 95%CI: 0.05-0.13; P < 0.001), BMI SDS (β = 0.06; 95%CI: 0.02-0.10; P = 0.007), and WC SDS (β = 0.06; 95%CI: 0.02-0.09; P = 0.005).
Further work is needed to determine whether simple frame size measures such as wrist breadth may be useful markers of metabolic risk.
胰岛素信号转导和骨重塑途径之间存在生物学相互作用，最近发现在超重/肥胖儿童中，腕围和骨面积与胰岛素抵抗相关，且与体重指数（BMI）无关。我们旨在通过使用更具体的肥胖指标进行调整，并检查 BMI 范围更广的儿童，来进一步研究这一问题。
我们使用 Fels 纵向研究中的 313 名非西班牙裔白人青少年（年龄 8-18 岁）的系列数据（共 1051 项测量值），以稳态模型评估的胰岛素抵抗（HOMA-IR）作为结局。在调整了来自双能 X 射线吸收仪的 BMI、腰围（WC）和全身脂肪（TBF）的内部样本 SDS 后，评估手腕宽度 SDS 作为 HOMA-IR（对数转换）的预测因子，此外还调整了年龄、性别、Tanner 分期和出生年份，使用广义估计方程。
在进行额外的肥胖调整之前，我们发现手腕宽度 SDS 与 HOMA-IR 对数转换值之间存在显著正相关（β=0.13；95%CI：0.09-0.17），在调整 TBF SDS 后（β=0.09；95%CI：0.05-0.13；P<0.001）、BMI SDS（β=0.06；95%CI：0.02-0.10；P=0.007）和 WC SDS（β=0.06；95%CI：0.02-0.09；P=0.005）后仍具有显著意义。
需要进一步研究以确定简单的框架尺寸测量值（如手腕宽度）是否可能是代谢风险的有用标志物。
