Onal Zehra Esra, Atasayan Vildan, Gürbüz Tamay, Hepkaya Evrim, Nuhoğlu Cağatay
Haydarpaşa Numune Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey.
Afr Health Sci. 2014 Sep;14(3):533-8. doi: 10.4314/ahs.v14i3.6.
We investigated the relationship between insulin resistance reflected by homeostasis model assessment (HOMA-IR) index and serum HbA1c levels of obese children.
This study included 70 obese and 60 normal weight healthy children between the ages of 3 and 15. Anthropometric measures and biochemical tests (fasting glucose, fasting insulin, HbA1c) were performed on all subjects. Plasma glucose levels were measured by the glucose oxidase method. Plasma insulin concentrations were measured by radioimmunoassay (RIA). HOMA-IR index was used to estimate insulin resistance. A cut-off HOMA-IR level of ≥2.5 was accepted. The HbA1c analysis was performed using high-pressure liquid chromatography. The statistical analysis was performed using SPSS 5. Student's unpaired t-test and the Mann-Whitney U test were used to determine statistical significance.
Gender distribution did not reveal significant difference among the obese (F: 48.6%, M: 51.4%) and the non-obese (F: 46.7%, M: 53.3%) groups. The mean age value was significantly higher in the obese group (10.09 ± 3.09) (p > 0.005) than the non-obese group (8.31 ± 3.14) (p < 0.05). The mean value of body mass index (BMI) was 25.55 ± 4.3 in the obese group and 16.63 ± 2.3 in the non-obese group. The mean HOMA-IR values of obese group (2.84 ± 1.77) was significantly higher than the non-obese group (1.50 ± 0.95) (p < 0.005). Insulin resistance was significantly higher in the obese group. Subjects with HOMA-IR ≥2.5 levels in the obese group had significantly higher HbA1c values than those with HOMA-IR <2.5 levels.
High HbA1c levels in obese children can be used as a screening tool to detect insulin sensitivity and resistance at an early stage.
我们研究了稳态模型评估（HOMA-IR）指数所反映的胰岛素抵抗与肥胖儿童血清糖化血红蛋白（HbA1c）水平之间的关系。
本研究纳入了70名3至15岁的肥胖儿童和60名体重正常的健康儿童。对所有受试者进行人体测量和生化检测（空腹血糖、空腹胰岛素、HbA1c）。采用葡萄糖氧化酶法测定血浆葡萄糖水平。采用放射免疫分析法（RIA）测定血浆胰岛素浓度。使用HOMA-IR指数评估胰岛素抵抗。接受的HOMA-IR临界值为≥2.5。采用高压液相色谱法进行HbA1c分析。使用SPSS 5进行统计分析。采用学生独立样本t检验和曼-惠特尼U检验确定统计学意义。
肥胖组（女性：48.6%，男性：51.4%）和非肥胖组（女性：46.7%，男性：53.3%）的性别分布无显著差异。肥胖组的平均年龄值（10.09±3.09）显著高于非肥胖组（8.31±3.14）（p<0.05）。肥胖组的体重指数（BMI）平均值为25.55±4.3，非肥胖组为16.63±2.3。肥胖组的平均HOMA-IR值（2.84±1.77）显著高于非肥胖组（1.50±0.95）（p<0.005）。肥胖组的胰岛素抵抗显著更高。肥胖组中HOMA-IR≥2.5水平的受试者的HbA1c值显著高于HOMA-IR<2.5水平的受试者。
肥胖儿童的高HbA1c水平可作为早期检测胰岛素敏感性和抵抗的筛查工具。
