胎球蛋白 A 作为青春期前儿童胰岛素抵抗和心血管风险的替代标志物。
Fetuin-A as an Alternative Marker for Insulin Resistance and Cardiovascular Risk in Prepubertal Children.
机构信息
Department of Pediatrics, Hallym University, College of Medicine.
出版信息
J Atheroscler Thromb. 2017 Oct 1;24(10):1031-1038. doi: 10.5551/jat.38323. Epub 2017 Feb 1.
AIM
Fetuin-A plays a role in insulin resistance and cardiovascular disease. This study aims to determine the relationship between fetuin-A levels and cardiometabolic risk factors, as well as to investigate the effect of serum fetuin-A on insulin resistance indices to determine whether fetuin-A is an additional marker for insulin resistance in prepubertal children.
METHODS
A total of 99 prepubertal Korean children (59 males) aged from 6.0 to 10.0 years was included in this study. Subjects were divided into underweight/normal-weight and overweight/obese groups. Serum fetuin-A levels were measured using an enzyme-linked immunosorbent assay and were natural logarithm (ln)-transformed.
RESULTS
Serum fetuin-A concentrations were significantly elevated in overweight/obese children as compared with underweight/normal-weight children (P=0.029). Ln serum fetuin-A was significantly positively correlated with body mass index (BMI) standard deviation scores (SDSs) (r=0.239, P=0.017), triglyceride levels (r=0.285, P=0.004), ln insulin (r=0.377, P＜0.001), systolic blood pressure (BP) (r=0.274, P=0.006), and diastolic BP (r=0.304, P=0.006) and was significantly inversely correlated with high-density lipoprotein cholesterol (HDL-C) levels (r=-0.236, P=0.019). In univariate linear regression analysis, ln fetuin-A was significantly positively associated with the homeostasis model assessment of insulin resistance (HOMA-IR) (r=0.356, P＜0.001) and significantly inversely associated with the quantitative insulin sensitivity check index (QUICKI) (r=-0.309, P=0.002). Following adjustment for age, gender, BMI, and lipid profiles in multivariate linear regression analysis, fetuin-A was significantly positively associated with HOMA-IR (P=0.048) and marginally inversely associated with QUICKI (P=0.054).
CONCLUSIONS
Our results suggest that fetuin-A can be an alternative marker for insulin resistance and cardiovascular risk in prepubertal children.
目的
胎球蛋白-A 在胰岛素抵抗和心血管疾病中发挥作用。本研究旨在确定胎球蛋白-A 水平与心血管代谢危险因素之间的关系，并探讨血清胎球蛋白-A 对胰岛素抵抗指数的影响，以确定胎球蛋白-A 是否是青春期前儿童胰岛素抵抗的附加标志物。
方法
本研究共纳入 99 名 6.0-10.0 岁的青春期前韩国儿童（男 59 名）。受试者分为体重不足/正常体重和超重/肥胖组。采用酶联免疫吸附试验法测定血清胎球蛋白-A 水平，并进行自然对数（ln）转换。
结果
与体重不足/正常体重儿童相比，超重/肥胖儿童的血清胎球蛋白-A 浓度显著升高（P=0.029）。ln 血清胎球蛋白-A 与体质指数（BMI）标准差评分（SDS）（r=0.239，P=0.017）、甘油三酯水平（r=0.285，P=0.004）、ln 胰岛素（r=0.377，P＜0.001）、收缩压（r=0.274，P=0.006）和舒张压（r=0.304，P=0.006）呈显著正相关，与高密度脂蛋白胆固醇（HDL-C）水平（r=-0.236，P=0.019）呈显著负相关。在单因素线性回归分析中，ln 胎球蛋白-A 与稳态模型评估的胰岛素抵抗（HOMA-IR）显著正相关（r=0.356，P＜0.001），与定量胰岛素敏感性检查指数（QUICKI）显著负相关（r=-0.309，P=0.002）。在多元线性回归分析中，校正年龄、性别、BMI 和血脂谱后，胎球蛋白-A 与 HOMA-IR 显著正相关（P=0.048），与 QUICKI 显著负相关（P=0.054）。
结论
我们的结果表明，胎球蛋白-A 可能是青春期前儿童胰岛素抵抗和心血管风险的替代标志物。
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