Mo-Suwan L, McNeil E, Sangsupawanich P, Chittchang U, Choprapawon C
Department of Paediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Acta Paediatr. 2017 Jan;106(1):128-134. doi: 10.1111/apa.13639.
The association between adiposity rebound and insulin resistance in middle childhood has seldom been studied. We examined the effect of body mass index (BMI) velocity and early adiposity rebound on the insulin resistance of prepubertal children.
BMI data from a longitudinal follow-up of a birth cohort in Thailand were used. The homoeostatic model assessment of insulin resistance (HOMA-IR) was calculated from 12-hour fasting plasma glucose and serum insulin at eight-and-a-half years of age. BMI velocity was calculated from four periods: zero to one, one to three, three to six and six to eight-and-a-half years of age. A multiple linear regression model was used to assess the association of BMI velocity during these four periods and insulin resistance at the age of eight-and-a-half years.
In 814 children - 76.7% of the initial cohort - BMI velocities between years one to three, three to six and six to eight-and-a-half years were positively associated with HOMA-IR levels after adjusting for demographic, behavioural and socio-economic factors. Children who had BMI gains between three and six years had mean HOMA-IR values that were 43% higher than those who did not.
BMI velocity during early and middle childhood, and early adiposity rebound between three and six years, was associated with a higher insulin resistance risk at eight-and-a-half years.
儿童中期肥胖反弹与胰岛素抵抗之间的关联鲜有研究。我们研究了体重指数(BMI)变化速度和早期肥胖反弹对青春期前儿童胰岛素抵抗的影响。
使用泰国一个出生队列纵向随访的BMI数据。根据8.5岁时12小时空腹血糖和血清胰岛素计算胰岛素抵抗的稳态模型评估值(HOMA-IR)。BMI变化速度根据四个时期计算:0至1岁、1至3岁、3至6岁和6至8.5岁。采用多元线性回归模型评估这四个时期的BMI变化速度与8.5岁时胰岛素抵抗之间的关联。
在814名儿童(占初始队列的76.7%)中,在调整人口统计学、行为和社会经济因素后,1至3岁、3至6岁和6至8.5岁期间的BMI变化速度与HOMA-IR水平呈正相关。3至6岁期间BMI增加的儿童,其平均HOMA-IR值比未增加的儿童高43%。
儿童早期和中期的BMI变化速度,以及3至6岁时的早期肥胖反弹,与8.5岁时较高的胰岛素抵抗风险相关。