Cree-Green Melanie, Cai Ninghe, Pyle Laura, Ringham Brandy, Brown Mark S, Newcomer Bradley R, Nadeau Kristen J, Dabelea Dana
Pediatric Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado 80045.
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado 80045.
J Clin Endocrinol Metab. 2017 May 1;102(5):1652-1660. doi: 10.1210/jc.2016-3912.
Obesity, insulin resistance (IR), and diabetes are increasing in youth, especially in girls. IR is associated with muscle mitochondrial dysfunction in youth and adults with diabetes. However, it is unknown whether this relationship is present in youth prior to development of diabetes.
Assess IR and mitochondrial function, including sex differences, in nondiabetic youth.
Cross-sectional study of youth in the Exploring Perinatal Outcomes among Children, Resistance to InSulin in Type 1 And Type 2 diabetes, and Androgens and Insulin Resistance Study cohorts.
Academic medical university.
Two hundred seventy-five youth, 13 to 19 years old [43% males: 17.1 (16.52, 17.63) years, body mass index z-score (BMI-Z) 0.36, 64.7% Tanner 5; 57% females: 17.2 (16.43, 17.67) years, BMI-Z 0.72, 78.9% Tanner 5].
Fasting laboratories, oral glucose tolerance test, and 31P magnetic resonance spectroscopy.
IR [triglyceride:high-density lipoprotein (HDL) ratio, Matsuda index, and homeostasis model for insulin resistance (HOMA-IR)] and muscle mitochondrial function (adenosine 5'-diphosphate time constant and oxidative phosphorylation rate).
Compared with males, females were more insulin resistant, with higher triglyceride:HDL ratio [1.95 (1.30, 2.79) vs 1.69 (1.21, 2.23), P = 0.042], HOMA-IR [3.18 (2.42, 4.39) vs 2.76 (2.02, 4.08), P = 0.035], and fasting free fatty acids (FFAs) and lower Matsuda score [3.98 (2.71, 5.96) vs 5.39 (3.43, 7.57), P < 0.001]. After adjustment for the higher BMI and Tanner stage and lower physical activity levels seen in females, there were no sex differences in mitochondrial function nor in any IR measure except FFAs. We did not find an association between measures of IR and mitochondrial function.
The greater IR seen in adolescent girls vs boys is mostly explained by differences in BMI and physical activity. Mitochondrial function does not appear to be related to IR in a large cohort of nondiabetic youth.
肥胖、胰岛素抵抗（IR）和糖尿病在青少年中呈上升趋势，尤其是在女孩中。IR与青少年及成年糖尿病患者的肌肉线粒体功能障碍有关。然而，在糖尿病发生之前的青少年中这种关系是否存在尚不清楚。
评估非糖尿病青少年的IR和线粒体功能，包括性别差异。
对“儿童围产期结局探索、1型和2型糖尿病中的胰岛素抵抗以及雄激素与胰岛素抵抗研究”队列中的青少年进行横断面研究。
学术性医科大学。
275名13至19岁的青少年[43%为男性：年龄17.1（16.52，17.63）岁，体重指数z评分（BMI-Z）为0.36，64.7%处于坦纳5期；57%为女性：年龄17.2（16.43，17.67）岁，BMI-Z为0.72，78.9%处于坦纳5期]。
空腹实验室检查、口服葡萄糖耐量试验和31P磁共振波谱分析。
IR[甘油三酯：高密度脂蛋白（HDL）比值、松田指数和胰岛素抵抗稳态模型（HOMA-IR）]以及肌肉线粒体功能（腺苷5'-二磷酸时间常数和氧化磷酸化率）。
与男性相比，女性的胰岛素抵抗更强，甘油三酯：HDL比值更高[1.95（1.30，2.79）对1.69（1.21，2.23），P = 0.042]，HOMA-IR更高[3.18（2.42，4.39）对2.76（2.02，4.08），P = 0.035]，空腹游离脂肪酸（FFA）更高，而松田评分更低[3.98（2.71，5.96）对5.39（3.43，7.57），P < 0.001]。在对女性中较高的BMI、坦纳分期以及较低的身体活动水平进行校正后，除FFA外，线粒体功能和任何IR指标均无性别差异。我们未发现IR指标与线粒体功能之间存在关联。
