Araújo J, Severo M, Santos S, Ramos E
EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
Nutr Metab Cardiovasc Dis. 2017 Apr;27(4):360-365. doi: 10.1016/j.numecd.2016.12.007. Epub 2016 Dec 24.
We aimed to study whether the effect of adolescent adiposity on adult blood pressure and insulin resistance was mediated by adult adiposity.
Data from the EPITeen cohort at 13, 17 and 21 years was used (n = 2211). Sex- and age-specific body mass index z-scores (BMIz) and waist-to-hip ratio (WHR) were used as indicators of total and central adiposity, respectively. Systolic blood pressure (SBP), glucose and insulin were assessed at 21 years and the homeostasis model assessment (HOMA-IR) was used as a marker of insulin resistance. Path analysis was applied to evaluate direct and indirect effects of adiposity (13, 17 and 21y) on adult SBP and HOMA-IR, separately for total and central adiposity and for each outcome. Results are presented as standardized regression coefficients [β (95%CI)]. The total effect of BMIz at 13 years on SBP at 21 years was 0.211 (0.178; 0.244), totally mediated by adult BMIz. Total effect of BMIz 13y on HOMA-IR was 0.248 (0.196; 0.299). Although this effect was mostly mediated by BMIz 21y, an additional direct effect from BMIz 17y was found [β = -0.240 (-0.315; -0.164)]. Central adiposity was also positively associated with SBP and HOMA-IR at 21 years, and the effect of adolescent WHR was totally mediated by adult WHR for both outcomes.
The effect of adolescent adiposity on adult SBP and HOMA-IR was mostly mediated by adult adiposity. However, for HOMA-IR an additional direct effect from total adiposity at 17 years was found.
我们旨在研究青少年肥胖对成人血压和胰岛素抵抗的影响是否由成人肥胖介导。
使用了EPITeen队列在13岁、17岁和21岁时的数据（n = 2211）。分别使用按性别和年龄划分的体重指数z评分（BMIz）和腰臀比（WHR）作为总体肥胖和中心性肥胖的指标。在21岁时评估收缩压（SBP）、血糖和胰岛素，并使用稳态模型评估（HOMA-IR）作为胰岛素抵抗的标志物。应用路径分析分别评估总体肥胖和中心性肥胖以及每种结局下肥胖（13岁、17岁和21岁）对成人SBP和HOMA-IR的直接和间接影响。结果以标准化回归系数[β（95%CI）]表示。13岁时BMIz对21岁时SBP的总效应为0.211（0.178；0.244），完全由成人BMIz介导。13岁时BMIz对HOMA-IR的总效应为0.248（0.196；0.299）。尽管这种效应大多由21岁时的BMIz介导，但发现17岁时的BMIz还有额外的直接效应[β = -0.240（-0.315；-0.164）]。中心性肥胖在21岁时也与SBP和HOMA-IR呈正相关，青少年WHR对这两种结局的影响完全由成人WHR介导。
青少年肥胖对成人SBP和HOMA-IR的影响大多由成人肥胖介导。然而，对于HOMA-IR，发现17岁时总体肥胖还有额外的直接效应。
