Ashraf Ambika P, Alvarez Jessica, Huisingh Carrie, Casazza Krista, Gower Barbara
Department of Pediatrics/Division of Pediatric Endocrinology and Metabolism, The Children's Hospital, University of Alabama Birmingham, Birmingham, USA.
Division of Endocrinology, Emory University School of Medicine, Atlanta, USA.
Br J Med Med Res. 2013 Oct;3(4):1050-1061. doi: 10.9734/BJMMR/2013/2720#sthash.xsm9PVK7.dpuf.
Puberty is a developmental stage of increased insulin resistance that also is a critical period for bone mass accrual. Historically, African Americans (AA) have lesser risk for osteoporotic fractures compared to European Americans (EA). AA also have higher incidence of insulin resistance. The possibility that bone health and insulin secretion or concentrations are linked has not been investigated.
We aimed to examine the associations of bone mineral density (BMD) and bone mineral apparent density (BMAD) with insulin sensitivity and secretion in healthy adolescent girls and healthy female adults and to evaluate ethnic differences in these associations.
Observational cohort design.
University of Alabama at Birmingham, between January 2010 and September 2011.
Healthy, female, non-smoking adolescents and young adults (14-55 years) were enrolled in this observational cohort study.
Adolescents had significantly higher fasting insulin (=0.0002), insulin area under the curve [AUC] (= 0.0004) and lower insulin sensitivity (=0.0005) compared to adults. Among adolescents, AA race was significantly associated with BMD (β=0.086, P=0.01) and BMAD (β=0.0075, P=0.002); however, adjusting for insulin AUC explained this difference. Insulin AUC (β=0.0006, P=0.029) and fasting insulin (β=0.0005, P=0.01) were positively associated with BMAD only in AA adolescents. Insulin AUC and fasting insulin were not significant predictors of BMD for adults.
The higher insulin concentration among AA adolescents is associated with increased BMD and higher BMAD.
青春期是胰岛素抵抗增加的发育阶段，也是骨量积累的关键时期。从历史上看，与欧裔美国人（EA）相比，非裔美国人（AA）发生骨质疏松性骨折的风险较低。AA的胰岛素抵抗发生率也较高。骨骼健康与胰岛素分泌或浓度之间是否存在关联尚未得到研究。
我们旨在研究健康青春期女孩和健康成年女性的骨矿物质密度（BMD）和骨矿物质表观密度（BMAD）与胰岛素敏感性和分泌之间的关联，并评估这些关联中的种族差异。
观察性队列研究。
2010年1月至2011年9月在阿拉巴马大学伯明翰分校。
健康、非吸烟的女性青少年和年轻人（14 - 55岁）参加了这项观察性队列研究。
与成年人相比，青少年的空腹胰岛素水平显著更高（P = 0.0002）、胰岛素曲线下面积（AUC）显著更高（P = 0.0004），而胰岛素敏感性显著更低（P = 0.0005）。在青少年中，AA种族与BMD（β = 0.086，P = 0.01）和BMAD（β = 0.0075，P = 0.002）显著相关；然而，对胰岛素AUC进行校正后，这种差异得到了解释。仅在AA青少年中，胰岛素AUC（β = 0.0006，P = 0.029）和空腹胰岛素（β = 0.0005，P = 0.01）与BMAD呈正相关。胰岛素AUC和空腹胰岛素对成年人的BMD不是显著的预测指标。
AA青少年中较高的胰岛素浓度与BMD增加和较高的BMAD相关。
