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性别差异决定了性激素结合球蛋白在肥胖儿童短期减重计划中的作用。

Sex difference determined the role of sex hormone-binding globulin in obese children during short-term weight reduction program.

作者信息

Wang Fu-Min, Lin Chien-Ming, Lien Shao-Hung, Wu Li-Wei, Huang Ching-Feng, Chu Der-Ming

机构信息

Department of Pediatrics, Tri-Service General Hospital Graduate Institute of Medical Sciences Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Medicine (Baltimore). 2017 May;96(19):e6834. doi: 10.1097/MD.0000000000006834.

Abstract

The relationship between hyperinsulinemia and decreased sex hormone-binding globulin (SHBG) levels has been observed in obese adults and children. Weight reduction not only increased insulin sensitivity but also elevated serum SHBG levels in obese adults and children. However, the correlation between the changes in insulin resistance indices and serum SHBG concentration during weight reduction program (WRP) is not fully understood, particularly in obese children. This study is to evaluate whether SHBG level is a potential biomarker that can be used to assess insulin resistance in obese children during a short-term WRP. Forty-eight obese Taiwanese children (11.7 ± 2.2 years; 25 boys and 23 girls) participating in 8-week WRP were studied. Anthropometric measurements, lipid profiles, insulin resistance indices, and serum SHBG concentration were recorded at baseline and at the end of the WRP. The results showed body weight (BW), body mass index (BMI), body fat percentage (BF%), body fat weight (BFW), and insulin resistance indices such as fasting insulin, fasting insulin to glucose ratio, homeostasis model assessment (HOMA) of insulin resistance, log (HOMA) all significantly decreased after the 8-week WRP. With respect to lipid profiles, only high-density lipoprotein cholesterol (HDL-C) levels increased in both sexes. At baseline, insulin resistance indices were inversely correlated with SHBG concentrations in girls, but not in boys. The difference in SHBG after WRP was 2.58 nmol/L (95% confidence interval [CI]: -3.51, 8.66) in boys and 0.58 nmol/L (95% CI: -5.23, 6.39) in girls. There was a trend toward increased serum SHBG levels in boys (P = .39) and girls (P = .84) after weight loss, but a significantly negative correlation between the change in SHBG and in each of the insulin resistance indices only in the girls after adjusting age and ΔBFW during WRP.In conclusion, short-term WRP has the potential effects of decreased BW, BMI, BF%, and BFW, as well as increased serum HDL-C levels and insulin sensitivity in obese Taiwanese children. Although serum SHBG levels moderately increased in both sexes during short-term WRP, measuring the change in SHBG concentrations might be a potential biomarker to evaluate improvement in insulin resistance in girls only, and not in boys.

摘要

在肥胖的成人和儿童中,已观察到高胰岛素血症与性激素结合球蛋白(SHBG)水平降低之间的关系。体重减轻不仅增加了肥胖成人和儿童的胰岛素敏感性,还提高了血清SHBG水平。然而,在减肥计划(WRP)期间,胰岛素抵抗指数变化与血清SHBG浓度之间的相关性尚未完全明确,尤其是在肥胖儿童中。本研究旨在评估SHBG水平是否是一种潜在的生物标志物,可用于评估肥胖儿童在短期WRP期间的胰岛素抵抗。对48名参加8周WRP的台湾肥胖儿童(11.7±2.2岁;25名男孩和23名女孩)进行了研究。在基线和WRP结束时记录人体测量指标、血脂谱、胰岛素抵抗指数和血清SHBG浓度。结果显示,经过8周的WRP后,体重(BW)、体重指数(BMI)、体脂百分比(BF%)、体脂重量(BFW)以及胰岛素抵抗指数如空腹胰岛素、空腹胰岛素与葡萄糖比值、胰岛素抵抗的稳态模型评估(HOMA)、log(HOMA)均显著降低。关于血脂谱,只有高密度脂蛋白胆固醇(HDL-C)水平在两性中均升高。在基线时,女孩的胰岛素抵抗指数与SHBG浓度呈负相关,而男孩则不然。WRP后男孩的SHBG差异为2.58 nmol/L(95%置信区间[CI]:-3.51,8.66),女孩为0.58 nmol/L(95%CI:-5.23,6.39)。减肥后男孩(P = 0.39)和女孩(P = 0.84)的血清SHBG水平有升高趋势,但在调整WRP期间的年龄和ΔBFW后,仅在女孩中SHBG变化与各胰岛素抵抗指数之间存在显著负相关。总之,短期WRP对台湾肥胖儿童具有降低BW、BMI、BF%和BFW的潜在作用,同时还能提高血清HDL-C水平和胰岛素敏感性。虽然在短期WRP期间两性的血清SHBG水平均有适度升高,但测量SHBG浓度变化可能只是评估女孩而非男孩胰岛素抵抗改善情况的潜在生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d946/5428600/367cab7daf8d/medi-96-e6834-g001.jpg

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