Nightingale Claire M, Rudnicka Alicja R, Donin Angela S, Sattar Naveed, Cook Derek G, Whincup Peter H, Owen Christopher G
Population Health Research Institute, St George's, University of London, London, UK.
Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK.
Arch Dis Child. 2017 Jul;102(7):612-616. doi: 10.1136/archdischild-2016-312016. Epub 2017 Mar 13.
Higher screen time is associated with type 2 diabetes (T2D) risk in adults, but the association with T2D risk markers in children is unclear. We examined associations between self-reported screen time and T2D risk markers in children.
Survey of 4495 children aged 9-10 years who had fasting cardiometabolic risk marker assessments, anthropometry measurements and reported daily screen time; objective physical activity was measured in a subset of 2031 children.
Compared with an hour or less screen time daily, those reporting screen time over 3 hours had higher ponderal index (1.9%, 95% CI 0.5% to 3.4%), skinfold thickness (4.5%, 0.2% to 8.8%), fat mass index (3.3%, 0.0% to 6.7%), leptin (9.2%, 1.1% to 18.0%) and insulin resistance (10.5%, 4.9% to 16.4%); associations with glucose, HbA, physical activity and cardiovascular risk markers were weak or absent. Associations with insulin resistance remained after adjustment for adiposity, socioeconomic markers and physical activity.
Strong graded associations between screen time, adiposity and insulin resistance suggest that reducing screen time could facilitate early T2D prevention. While these observations are of considerable public health interest, evidence from randomised controlled trials is needed to suggest causality.
在成年人中，较长的屏幕使用时间与2型糖尿病（T2D）风险相关，但与儿童T2D风险标志物之间的关联尚不清楚。我们研究了儿童自我报告的屏幕使用时间与T2D风险标志物之间的关联。
对4495名9至10岁的儿童进行调查，这些儿童进行了空腹心脏代谢风险标志物评估、人体测量并报告了每日屏幕使用时间；对2031名儿童的一个子集测量了客观身体活动。
与每天屏幕使用时间1小时或更少相比，报告屏幕使用时间超过3小时的儿童有更高的 ponderal指数（1.9%，95%可信区间0.5%至3.4%）、皮褶厚度（4.5%，0.2%至8.8%）、脂肪量指数（3.3%，0.0%至6.7%）、瘦素（9.2%，1.1%至18.0%）和胰岛素抵抗（10.5%，4.9%至16.4%）；与血糖、糖化血红蛋白、身体活动和心血管风险标志物的关联较弱或不存在。在调整肥胖、社会经济标志物和身体活动后，与胰岛素抵抗的关联仍然存在。
屏幕使用时间、肥胖和胰岛素抵抗之间的强分级关联表明，减少屏幕使用时间可能有助于早期预防T2D。虽然这些观察结果具有相当大的公共卫生意义，但需要随机对照试验的证据来表明因果关系。
