Centre for Clinical Trials and Population Studies, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.
Newcastle University Medical School, Newcastle, UK.
Pediatr Diabetes. 2018 Mar;19(2):223-230. doi: 10.1111/pedi.12571. Epub 2017 Aug 29.
The risk of type 2 diabetes is increasing in teenage girls, and is associated with their greater insulin resistance (IR).
We hypothesized that the adverse metabolic profile of girls (compared with boys) would persist from childhood through adolescence.
Community-based longitudinal cohort of 292 children (147 boys) studied annually from 9 to 16 years.
IR (homeostasis-model-assessment-2), high-density lipoprotein-cholesterol (HDL-C), triglycerides, % body-fat (dual-energy x-ray absorptiometry), pubertal stage (age at peak height velocity), physical activity (accelerometry). Multi-level modelling established the age-related trends in IR and lipids and the influence of covariates.
Each year from 9 to 15 years, girls had 21% to 63% higher IR than boys (girls mean IR 0.73-1.33, boys 0.51-0.89, P < .005). At 16 years the gender difference was not significant (girls IR 0.60, boys 0.56, P = .45). Girls had lower HDL-C from 9 to 12 years, higher triglycerides from 9 to 14 years, greater adiposity throughout, and earlier puberty, but boys were more active than girls (all P < .05). After adjustment for %-fat, puberty and activity, the gender difference in IR between girls and boys aged 9 to 15 years became non-significant (IR girls 0.66-1.01, boys 0.65-1.04, P > .07). However, after adjustment at 16 years, girls' IR was 25% lower than boys' (girls 0.44, boys 0.63, P = .001), and they had 22% higher HDL-C (P < .001) and 20% lower triglycerides (P = .003).
The higher IR of prepubertal and early pubertal girls diminishes during late puberty, and boys begin to exhibit greater metabolic risk. Despite being leaner and more active, boys at 16 years have higher IR than girls, suggesting future higher risk for diabetes, thus we reject our hypothesis.
2 型糖尿病的风险在少女中逐渐增加，且与她们更高的胰岛素抵抗（IR）有关。
我们假设女孩（与男孩相比）的不良代谢特征将从儿童期持续到青春期。
对 292 名儿童（147 名男孩）进行了基于社区的纵向队列研究，每年进行一次，研究时间从 9 岁到 16 岁。
胰岛素抵抗（稳态模型评估-2）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯、体脂肪百分比（双能 X 射线吸收法）、青春期阶段（身高突增高峰年龄）、身体活动（加速度计）。多水平模型确定了 IR 和脂质的年龄相关趋势以及协变量的影响。
从 9 岁到 15 岁，女孩的 IR 比男孩高 21%至 63%（女孩的 IR 平均值为 0.73-1.33，男孩为 0.51-0.89，P<.005）。在 16 岁时，性别差异不显著（女孩的 IR 为 0.60，男孩为 0.56，P=0.45）。从 9 岁到 12 岁，女孩的 HDL-C 较低，从 9 岁到 14 岁，女孩的甘油三酯较高，整个青春期期间，女孩的体脂率较高，青春期开始较早，而男孩的身体活动量比女孩多（所有 P<.05）。在调整体脂百分比、青春期和活动度后，9 至 15 岁女孩和男孩的 IR 之间的性别差异变得无统计学意义（女孩的 IR 为 0.66-1.01，男孩的 IR 为 0.65-1.04，P>.07）。然而，在 16 岁时进行调整后，女孩的 IR 比男孩低 25%（女孩为 0.44，男孩为 0.63，P=0.001），HDL-C 高 22%（P<.001），甘油三酯低 20%（P=0.003）。
青春期前和早期青春期女孩的较高 IR 在青春期后期会降低，而男孩开始表现出更大的代谢风险。尽管男孩更瘦、更活跃，但 16 岁时的 IR 高于女孩，这表明未来患糖尿病的风险更高，因此我们拒绝我们的假设。
