Skoczen S, Wojcik M, Fijorek K, Siedlar M, Starzyk J B
Department of Clinical Immunology, Chair of Clinical Immunology and Transplantology, Jagiellonian University Medical College, Krakow, Poland.
Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Polish-American Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland.
Exp Clin Endocrinol Diabetes. 2015 Apr;123(4):252-9. doi: 10.1055/s-0034-1398503. Epub 2015 Apr 13.
The assessment of the health consequences associated with obesity in young children is challenging. The aims of this study were: (1) to compare insulin resistance indices derived from OGTT in obese patients and healthy control (2) to analyze central obesity and Type 2 Diabetes genes expression in obese children, with special attention to the youngest group (< 10 years old).
The study included 49 children with obesity (median age 13.5 years old), and 25 healthy peers. Biochemical blood tests and expression of 11 central obesity and 33 Type 2 Diabetes genes was assessed.
A significant difference in insulin resistance between obese and non-obese adolescents was observed in all studied indices (mean values of the insulin levels: 24.9 vs. 9.71 mIU/L in T0, 128 vs. 54.7 mIU/L in T60 and 98.7 vs. 41.1 mIU/L in T120 respectively; AUC: 217 vs. 77.2 ng/mlh, mean values of B% (state beta cell function), S% (insulin sensitivity), and IR were 255 (±97) vs. 135 (±37.8), 46.6 (±37.3) vs. 84.2 (±29.6) and 3 (±1.55) vs. 1.36 (±0,56); HIS, WBIS and ISIBel median 3.89, 44.7, 0.73 vs. 8.57, 110, 2.25. All comparisons differed significantly p<0.001). Moreover, insulin sensitivity was significantly better in the older obese group (>10 years old): median AUC 239 vs. 104 ng/mlh, and HIS, WBIS and ISIBel 3.57, 38, 0.67 vs. 6.23, 75.6, 1.87 respectively in the obese older compared to the obese younger subgroup, p<0.05. The expression of 64% of the central obesity genes and 70% of Type 2 Diabetes genes was higher in the obese compared to control groups. The differences were more pronounced in the younger obese group.
Insulin resistance may develop in early stage of childhood obesity and in very young children may be associated with higher expression of the central obesity and Type 2 Diabetes genes.
评估幼儿肥胖相关的健康后果具有挑战性。本研究的目的是:(1)比较肥胖患者和健康对照者口服葡萄糖耐量试验(OGTT)得出的胰岛素抵抗指数;(2)分析肥胖儿童的中心性肥胖和2型糖尿病基因表达,特别关注最年幼组(<10岁)。
本研究纳入49名肥胖儿童(中位年龄13.5岁)和25名健康同龄人。评估了血液生化指标以及11种中心性肥胖基因和33种2型糖尿病基因的表达。
在所有研究指标中,肥胖和非肥胖青少年的胰岛素抵抗存在显著差异(胰岛素水平平均值:T0时分别为24.9 vs. 9.71 mIU/L,T60时为128 vs. 54.7 mIU/L,T120时为98.7 vs. 41.1 mIU/L;曲线下面积(AUC):217 vs. 77.2 ng/mlh,B%(β细胞功能状态)、S%(胰岛素敏感性)和胰岛素抵抗(IR)的平均值分别为255(±97)vs. 135(±37.8)、46.6(±37.3)vs. 84.2(±29.6)和3(±1.55)vs. 1.36(±0.56);高胰岛素正葡萄糖钳夹试验(HIS)、稳态模型评估的胰岛素敏感性(WBIS)和胰岛素敏感性指数(ISIBel)中位数分别为3.89、44.7、0.73 vs. 8.57、110、2.25。所有比较均有显著差异,p<0.001)。此外,年龄较大的肥胖组(>10岁)胰岛素敏感性明显更好:肥胖年长亚组与肥胖年幼亚组相比,AUC中位数分别为239 vs. 104 ng/mlh,HIS、WBIS和ISIBel分别为3.57、38、0.67 vs. 6.23、75.6、1.87,p<0.05。与对照组相比,肥胖组中64%的中心性肥胖基因和70%的2型糖尿病基因表达更高。这些差异在年幼肥胖组中更为明显。
胰岛素抵抗可能在儿童肥胖的早期阶段就会出现,在幼儿中可能与中心性肥胖和2型糖尿病基因的高表达有关。