Zhang Huijie, Zhang Tao, Li Shengxu, Li Ying, Hussain Azad, Fernandez Camilo, Harville Emily, Bazzano Lydia A, He Jiang, Chen Wei
Department of Endocrinology and Diabetes, The First Affiliated Hospital, Xiamen University, Xiamen, China.
Tulane Center for Cardiovascular Health and Department of Epidemiology, Tulane University Health Sciences Center, New Orleans, LA.
Sci Rep. 2015 Dec 7;5:17885. doi: 10.1038/srep17885.
Childhood adiposity and insulin resistance are well-known risk factors for adult metabolic syndrome (MetS). This study aims to examine whether the association between childhood adiposity and adult MetS is modified by insulin resistance. The cohort consisted of 1,593 black and white subjects, aged 19-50 years at follow-up, who were examined 19 years apart on average as children and adults for MetS variables. The prevalence of adult MetS was compared between the insulin-sensitive obesity and insulin-resistant obesity groups in childhood. Adult MetS prevalence was higher in the insulin-resistant obesity group than in the insulin-sensitive obesity group (34.9% vs. 24.3%, p = 0.008). In multivariable logistic regression analyses adjusted for age, race, gender, and follow-up years, individuals with insulin-resistant obesity in childhood were 1.7 times (p = 0.011) more likely to have MetS 19 years later on average than those with insulin-sensitive obesity in childhood. Odds ratio did not differ significantly between blacks and whites (p = 0.724). ORs for the association of childhood BMI with adult MetS significantly increased with increasing tertiles of childhood HOMA (p < 0.001 for trend). These findings suggest that insulin resistance amplifies the association between childhood adiposity and adult MetS and underscore the importance of preventing both adiposity and insulin resistance in early life.
儿童肥胖和胰岛素抵抗是成人代谢综合征（MetS）众所周知的风险因素。本研究旨在探讨儿童肥胖与成人MetS之间的关联是否会因胰岛素抵抗而改变。该队列由1593名黑人和白人受试者组成，随访时年龄在19 - 50岁之间，他们在儿童期和成年期平均相隔19年接受了代谢综合征变量检查。比较了儿童期胰岛素敏感型肥胖组和胰岛素抵抗型肥胖组的成人MetS患病率。胰岛素抵抗型肥胖组的成人MetS患病率高于胰岛素敏感型肥胖组（34.9%对24.3%，p = 0.008）。在对年龄、种族、性别和随访年限进行调整的多变量逻辑回归分析中，儿童期患有胰岛素抵抗型肥胖的个体在19年后平均患MetS的可能性是儿童期患有胰岛素敏感型肥胖个体的1.7倍（p = 0.011）。黑人和白人之间的优势比没有显著差异（p = 0.724）。儿童BMI与成人MetS关联的优势比随着儿童期HOMA三分位数的增加而显著增加（趋势p < 0.001）。这些发现表明，胰岛素抵抗会放大儿童肥胖与成人MetS之间的关联，并强调在生命早期预防肥胖和胰岛素抵抗的重要性。
