Cazeau Rachel-Marie, Rauch Lindsey, Huang Hong, Bauer John A, Hoffman Robert P
1 Section of Endocrinology, Metabolism and Diabetes, Nationwide Children's Hospital , Columbus, Ohio.
2 Division of Pediatric Endocrinology, Metabolism and Diabetes, Department of Pediatrics, the Clinical Research Center of The Ohio State University College of Medicine and Public Health , Columbus, Ohio.
Metab Syndr Relat Disord. 2016 Sep;14(7):340-6. doi: 10.1089/met.2015.0122. Epub 2016 Jul 15.
Black adolescents are at increased risk of cardiometabolic disease but have lower fasting triglyceride, which is usually associated with decreased risk. No one has studied racial differences in triglycerides or free fatty acids (FFAs) after a high-fat meal.
Oral glucose tolerance testing was used to assess insulin secretion, sensitivity, and disposition index (DI). Endothelial function, triglycerides, FFA, c-reactive protein, interleukin 6 (IL6), and adiponectin were measured both pre- and 3 hr postprandially (McDonald's Big Breakfast(®) and 12 ounce Sprite(®)) in obese adolescents (10-13 years, 9 black and 7 white). Endothelial function was assessed using reactive hyperemic changes in forearm vascular resistance (FVR).
Oral glucose tolerance test (OGTT) showed no difference in insulin sensitivity, but blacks tended to have (P = 0.08) higher insulin secretion and had increased DI (P = 0.003). After a high-fat meal, triglycerides increased in both groups (P < 0.001), tended to be lower in blacks compared with whites preprandially (64 ± 33 mg/dL vs 110 ± 80, P = 0.064), and was lower postprandially (112 ± 63 vs 188 ± 112, P = 0.039). Pre- and postprandial FFA (Black: 0.58 ± 0.15 and 0.39 ± 0.18 vs. white: 0.44 ± 0.14 and 0.26 ± 0.06, P = 0.020) and adiponectin (P = 0.002) were increased in blacks. FFA decreased in both groups postprandially (P = 0.002). IL6 increased after the meal (P = 0.022). Endothelial function decreased postprandially (P < 0.02), but this was due to a decrease in preocclusion FVR.
These results indicate that differences in fat metabolism are present in both black and white obese adolescents. How these differences explain higher rates of cardiometabolic disease in blacks is unclear.
黑人青少年患心脏代谢疾病的风险增加，但空腹甘油三酯水平较低，而空腹甘油三酯通常与风险降低相关。此前没有人研究过高脂餐后甘油三酯或游离脂肪酸（FFA）的种族差异。
采用口服葡萄糖耐量试验评估胰岛素分泌、敏感性和处置指数（DI）。在肥胖青少年（10 - 13岁，9名黑人，7名白人）中，于餐前及餐后3小时测量内皮功能、甘油三酯、FFA、C反应蛋白、白细胞介素6（IL6）和脂联素（食用麦当劳大早餐（®）和12盎司雪碧（®）后）。使用前臂血管阻力（FVR）的反应性充血变化评估内皮功能。
口服葡萄糖耐量试验（OGTT）显示胰岛素敏感性无差异，但黑人的胰岛素分泌往往较高（P = 0.08），且处置指数增加（P = 0.003）。高脂餐后，两组的甘油三酯均升高（P < 0.001），黑人餐前甘油三酯水平与白人相比往往较低（64 ± 33mg/dL对110 ± 80，P = 0.064），餐后也较低（112 ± 63对188 ± 112，P = 0.039）。黑人餐前和餐后的FFA（黑人：0.58 ± 0.15和0.39 ± 0.18，白人：0.44 ± 0.14和0.26 ± 0.06，P = 0.020）及脂联素（P = 0.002）均升高。两组餐后FFA均降低（P = 0.002）。餐后IL6升高（P = 0.022）。餐后内皮功能降低（P < 0.02），但这是由于闭塞前FVR降低所致。
这些结果表明，黑人与白人肥胖青少年在脂肪代谢方面存在差异。尚不清楚这些差异如何解释黑人较高的心脏代谢疾病发病率。
