Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Australia;
Research Centre of Applied and Preventive Cardiovascular Medicine, and Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia;
Pediatrics. 2015 Jan;135(1):e144-51. doi: 10.1542/peds.2014-1534. Epub 2014 Dec 22.
Fasting insulin concentrations are increasingly being used as a surrogate for insulin resistance and risk for type 2 diabetes (T2DM), although associations with adult outcomes are unclear. Our objective was to determine whether fasting insulin concentrations in childhood associate with later T2DM.
Fasting insulin values were available from 2478 participants in the longitudinal Cardiovascular Risk in Young Finns Study at baseline age 3 to 18 years, along with data on adult T2DM (N = 84, mean age = 39.6 years).
Among 3- to 6-year-olds, a 1-SD increase in fasting insulin was associated with a relative risk (RR) of 2.04 (95% confidence interval [CI], 1.54-2.70) for later T2DM, which remained significant after we adjusted for BMI and parental history of T2DM. For those aged 9 to 18 years, a 1-SD increase in insulin was associated with an RR of 1.32 (95% CI, 1.06-1.65) for T2DM, but this became nonsignificant after we adjusted for BMI and parental history of T2DM. In the latter age group, a 1-SD increase in BMI was associated with an RR of 1.45 (95% CI, 1.21-1.73) for T2DM, with adjustment for insulin and parental history of T2DM not improving this association. BMI in younger children was not associated with later T2DM. In life course analyses, those with T2DM had higher fasting insulin levels in early childhood and later adulthood but not in peripubertal years.
Elevated fasting insulin concentrations in early childhood, but not adolescence, are independently associated with an elevated risk of T2DM in adulthood.
空腹胰岛素浓度越来越多地被用作胰岛素抵抗和 2 型糖尿病（T2DM）风险的替代指标，尽管其与成人结局的关联尚不清楚。我们的目的是确定儿童时期的空腹胰岛素浓度是否与以后的 T2DM 有关。
在纵向心血管风险在年轻的芬兰人研究中，2478 名参与者在基线时年龄为 3 至 18 岁，同时还有成年 T2DM（N=84，平均年龄为 39.6 岁）的数据。
在 3 至 6 岁的儿童中，空腹胰岛素增加 1-SD 与以后发生 T2DM 的相对风险（RR）为 2.04（95%置信区间[CI]，1.54-2.70），这一结果在我们调整 BMI 和 T2DM 家族史后仍然显著。对于 9 至 18 岁的儿童，胰岛素增加 1-SD 与 T2DM 的 RR 为 1.32（95%CI，1.06-1.65），但在我们调整 BMI 和 T2DM 家族史后，这一结果变得不显著。在后一组中，BMI 增加 1-SD 与 T2DM 的 RR 为 1.45（95%CI，1.21-1.73），调整胰岛素和 T2DM 家族史并不能改善这种关联。在年幼的儿童中，BMI 与以后的 T2DM 无关。在生命历程分析中，那些患有 T2DM 的人在儿童早期和成年后期的空腹胰岛素水平较高，但在青春期时则没有。
儿童早期而非青春期时升高的空腹胰岛素浓度与成年后患 T2DM 的风险增加独立相关。
