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肥胖儿童和青少年骨骼成熟与肾上腺雄激素水平之间的关联。

The association between skeletal maturation and adrenal androgen levels in obese children and adolescents.

作者信息

Kim Sung Eun, Jang Joon Weon, Ahn Moon Bae, Kim Shin-Hee, Cho Won Kyoung, Cho Kyoung Soon, Park So Hyun, Jung Min Ho, Suh Byoung Kyu

机构信息

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Ann Pediatr Endocrinol Metab. 2017 Jun;22(2):108-114. doi: 10.6065/apem.2017.22.2.108. Epub 2017 Jun 28.

Abstract

PURPOSE

This study aimed to investigate the association between skeletal maturation and adrenal androgen levels in obese children and adolescents.

METHODS

Fifty-three children and adolescents (aged 7-15 years) diagnosed as obese or overweight were investigated. Anthropometric measurements, bone age (BA) determination, serum biochemical analyses, and hormonal measurements were performed. The difference between BA and chronological age (BA-CA, dBACA) was calculated and used to represent the degree of advanced skeletal maturation.

RESULTS

Thirty-one subjects were classified into the obese group and 22 subjects into the overweight group. Insulin resistance as calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) was significantly higher in the obese group than in the overweight group (4.03±2.20 vs. 2.86±1.11, =0.026). The skeletal maturation of the obese group was advanced, but the dBACA did not differ between the obese and overweight groups statistically (1.43±1.35 vs. 0.91±1.15, =0.141). Serum dehydroepiandrosterone sulfate (DHEA-S) levels were significantly higher in subjects with dBACA>1 compared to those with dBACA≤1 (104.3±62.2 vs. 59.6±61.0, =0.014). Correlation analyses demonstrated that dBACA was positively correlated with body mass index standard deviation scores (=0.35, =0.010), fasting insulin (=0.36, =0.009), HOMA-IR (=0.30, =0.031), and insulin-like growth factor-binding protein-3 (=0.331, =0.028). In multivariate linear regression analysis, HOMA-IR (=0.026) and serum DHEA-S (=0.032) were positively correlated with the degree of advanced skeletal maturation.

CONCLUSION

Advanced skeletal maturation is associated with increased insulin resistance and elevated DHEA-S levels in obese children and adolescents.

摘要

目的

本研究旨在调查肥胖儿童和青少年骨骼成熟与肾上腺雄激素水平之间的关联。

方法

对53名被诊断为肥胖或超重的儿童和青少年(7 - 15岁)进行了调查。进行了人体测量、骨龄(BA)测定、血清生化分析和激素测量。计算骨龄与实际年龄之差(BA - CA,dBACA),并用其代表骨骼成熟提前的程度。

结果

31名受试者被分为肥胖组,22名受试者被分为超重组。通过稳态模型评估胰岛素抵抗(HOMA - IR)计算得出的胰岛素抵抗在肥胖组显著高于超重组(4.03±2.20对2.86±1.11,P = 0.026)。肥胖组的骨骼成熟提前,但肥胖组和超重组之间的dBACA在统计学上无差异(1.43±1.35对0.91±1.15,P = 0.141)。与dBACA≤1的受试者相比,dBACA>1的受试者血清硫酸脱氢表雄酮(DHEA - S)水平显著更高(104.3±62.2对59.6±61.0,P = 0.014)。相关性分析表明,dBACA与体重指数标准差评分呈正相关(r = 约0.35,P = 0.010)、空腹胰岛素(r = 约0.36,P = 0.009)、HOMA - IR(r = 约0.30,P = 0.031)和胰岛素样生长因子结合蛋白 - 3(r = 约0.331,P = 0.028)。在多变量线性回归分析中,HOMA - IR(β = 0.026)和血清DHEA - S(β = 0.032)与骨骼成熟提前的程度呈正相关。

结论

肥胖儿童和青少年骨骼成熟提前与胰岛素抵抗增加和DHEA - S水平升高有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7408/5495976/a2cb3af36dff/apem-22-108-g001.jpg

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