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肥胖儿童和青少年的胰岛素抵抗与心脏代谢危险因素:一种分层方法。

Insulin resistance and cardiometabolic risk factors in obese children and adolescents: a hierarchical approach.

作者信息

Sakou Irine-Ikbale, Psaltopoulou Theodora, Sergentanis Theodoros N, Karavanaki Kyriaki, Karachaliou Feneli, Ntanasis-Stathopoulos Ioannis, Tzanninis Stamatios, Sdogou Triantafyllia, Greydanus Donald, Tsitsika Artemis

出版信息

J Pediatr Endocrinol Metab. 2015 May;28(5-6):589-96. doi: 10.1515/jpem-2014-0431.

Abstract

BACKGROUND

This study aims to globally assess the network of insulin resistance (IR)-related factors in a sample of overweight and obese Greek youths.

METHODS

A total of 185 subjects were examined, and IR was quantified by homeostasis model assessment (HOMA-IR). Multivariate hierarchical approach was performed, and five distinct levels were recognized, namely, immutable demographic features and early life parameters, current anthropometric measures, IR, unfavorable clinical conditions, and social parameters. Two analyses were performed based on HOMA-IR cut-off values (3.16 and, as an alternative, 3.99).

RESULTS

Obesity was associated with IR (adjusted OR=3.19, 95% CI: 1.12-9.09). IR steadily predicted low HDL (adjusted OR=5.75, 95% CI: 1.58-20.87), hypertriglyceridemia (adjusted OR=10.28, 95% CI: 1.18-89.55), and systolic hypertension. At the alternative analysis, IR was also associated with older age, older age at menarche, hyperuricemia, and low school grades.

CONCLUSION

Emerging on the grounds of obesity, IR confers risks for dyslipidemia and hypertension at a relatively early age. Along with weight loss, interventions targeted at IR are required to prevent cardiometabolic risk in adolescence.

摘要

背景

本研究旨在全面评估希腊超重和肥胖青少年样本中胰岛素抵抗(IR)相关因素的网络。

方法

共检查了185名受试者,通过稳态模型评估(HOMA-IR)对IR进行量化。采用多变量分层方法,识别出五个不同层次,即不变的人口统计学特征和早期生活参数、当前人体测量指标、IR、不良临床状况和社会参数。基于HOMA-IR临界值(3.16以及作为替代的3.99)进行了两项分析。

结果

肥胖与IR相关(调整后的OR=3.19,95%CI:1.12-9.09)。IR能稳定预测低高密度脂蛋白(HDL)(调整后的OR=5.75,95%CI:1.58-20.87)、高甘油三酯血症(调整后的OR=10.28,95%CI:1.18-89.55)和收缩期高血压。在替代分析中,IR还与年龄较大、初潮年龄较大、高尿酸血症和低学业成绩相关。

结论

基于肥胖出现的IR在相对较早的年龄就会带来血脂异常和高血压风险。除了减重外,还需要针对IR的干预措施来预防青少年的心脏代谢风险。

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