韩国健康青少年肥胖指数与胰岛素抵抗之间的关联：JS高中研究
Association between Obesity Indices and Insulin Resistance among Healthy Korean Adolescents: The JS High School Study.
作者信息
Lim Sun Min, Choi Dong Phil, Rhee Yumie, Kim Hyeon Chang
机构信息
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea; Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.
出版信息
PLoS One. 2015 May 13;10(5):e0125238. doi: 10.1371/journal.pone.0125238. eCollection 2015.
OBJECTIVE
To investigate whether indices of obesity are associated with insulin resistance in Korean adolescents.
METHODS
This study was conducted as a cross-sectional analysis of 817 healthy adolescents aged 15-16 years without diabetes. Percentiles group of weight-for-height, body mass index (BMI)-for-age, waist circumference (WC)-for-age, and skin fold thickness (SFT)-for-age were based on the 2007 Korean National Growth Charts. Percentiles of waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and percent body fat were calculated for the study population. Insulin resistance was estimated by homeostatic model assessment (HOMA-IR). Logistic regression models were used to estimate odds ratio for insulin resistance according to seven obesity indices. Generalized linear models were used to assess the associations between obesity indices and continuous HOMA-IR levels.
RESULTS
Sex and age-adjusted odds ratios (95% confidence interval) for insulin resistance, defined as HOMA-IR>2.50, of the 75-94th and ≥95th percentiles of weight-for-height were 3.87 (2.38-6.30) and 11.37 (5.87-22.02), compared to the <50th percentile. Corresponding odds ratios were 3.27 (2.02-5.28) and 11.72 (6.05-22.73) for BMI-for-age, 4.72 (2.82-7.88) and 13.22 (6.42-27.23) for WC-for-age, 3.67 (2.27-5.94) and 13.58 (6.71-27.48) for WHR, 4.78 (2.99-7.67) and 12.84 (6.23-26.46) for WHtR, 2.62 (1.61-4.26) and 6.68 (3.46-12.90) for SFT-for-age, and 2.29 (1.33-4.26) and 10.06 (4.39-23.06) for body fat. These associations were more prominent when insulin resistance was defined as HOMA-IR>3.16 and were stronger in males than in females. Continuous measure of HOMA-IR was significantly associated with body weight, BMI, WC, WHR, WHtR, and SFT in both sexes (p<0.001), and with percent body fat in males only (p<0.001).
CONCLUSION
Our findings suggest that obesity indices are positively associated with insulin resistance in apparently healthy adolescents.
目的
探讨肥胖指标是否与韩国青少年的胰岛素抵抗相关。
方法
本研究对817名15 - 16岁无糖尿病的健康青少年进行横断面分析。身高体重百分位数组、年龄别体重指数（BMI）、年龄别腰围（WC）和年龄别皮褶厚度（SFT）基于2007年韩国国家生长图表。计算研究人群的腰臀比（WHR）、腰高比（WHtR）和体脂百分比的百分位数。通过稳态模型评估（HOMA - IR）估算胰岛素抵抗。使用逻辑回归模型根据七个肥胖指标估算胰岛素抵抗的比值比。使用广义线性模型评估肥胖指标与连续HOMA - IR水平之间的关联。
结果
以HOMA - IR>2.50定义胰岛素抵抗，身高体重第75 - 94百分位数和≥95百分位数的性别和年龄调整后的比值比（95%置信区间）分别为3.87（2.38 - 6.30）和11.37（5.87 - 22.02），低于第50百分位数。年龄别BMI的相应比值比分别为3.27（2.02 - 5.28）和11.72（6.05 - 22.73），年龄别WC的为4.72（2.82 - 7.88）和13.22（6.42 - 27.23），WHR的为3.67（2.27 - 5.94）和13.58（6.71 - 27.48），WHtR的为4.78（2.99 - 7.67）和12.84（6.23 - 26.46），年龄别SFT的为2.62（1.61 - 4.26）和6.68（3.46 - 12.90），体脂的为2.29（1.33 - 4.26）和10.06（4.39 - 23.06）。当胰岛素抵抗定义为HOMA - IR>3.16时，这些关联更显著，且在男性中比女性更强。两性中HOMA - IR的连续测量值与体重、BMI、WC、WHR、WHtR和SFT均显著相关（p<0.001），仅在男性中与体脂百分比显著相关（p<0.001）。
结论
我们的研究结果表明，在看似健康的青少年中，肥胖指标与胰岛素抵抗呈正相关。
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