Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Department of Kinesiology, University of Georgia College of Education, Athens, USA.
Int J Obes (Lond). 2018 Oct;42(10):1762-1770. doi: 10.1038/s41366-018-0177-z. Epub 2018 Aug 17.
BACKGROUND/OBJECTIVES: Childhood body mass index (BMI) predicts adult glucose homeostasis measures and type 2 diabetes mellitus, but little is known about the predictive utility of other anthropometric measures in childhood. We aimed to identify the anthropometric measure in childhood that best predicts adult glucose homeostasis measures and examine if the combination of additional anthropometric measures further improves predictive utility.
A 20-year follow-up of children participating in the Childhood Determinants of Adult Health Study (n = 2345, aged 7-15 years at baseline). Baseline anthropometric measures were waist circumference (WC), WC adjusted for height, weight adjusted for height, hip circumference, waist-hip-ratio, waist-height-ratio, BMI, conicity index, abdominal volume index (AVI), body adiposity index, and a body shape index. Fasting glucose and insulin levels measured at follow-up were used to define insulin resistance (HOMA2-IR), low beta-cell function (HOMA2-β), high fasting insulin, and impaired fasting glucose (IFG).
All child anthropometric measures were significantly associated with HOMA2-IR, HOMA2-β, and high fasting insulin (relative risk = 1.12-1.55), but not IFG. AVI had the largest area under receiver-operating curve (AUC) in predicting adult HOMA2-IR (AUC, 95% confidence interval: 0.610, 0.584-0.637), HOMA2-β (0.615, 0.588-0.642) and high fasting insulin (0.613, 0.587-0.639). Combining each additional anthropometric measure with AVI did not appreciably increase predictive utility (an increase of 0.001-0.002 in AUC, p > 0.05 for all).
Anthropometric measures from a single time-point in childhood are associated with insulin-related outcomes 20-year later in adulthood. However, overall predictive utility was low and was not substantially enhanced by combining multiple different child anthropometric measures.
背景/目的：儿童时期的体重指数（BMI）可以预测成年后的葡萄糖稳态指标和 2 型糖尿病，但对于儿童时期其他人体测量指标的预测能力知之甚少。我们旨在确定儿童时期预测成人葡萄糖稳态指标的最佳人体测量指标，并探讨是否可以通过组合其他人体测量指标来进一步提高预测能力。
对参加儿童时期决定成人健康研究（Childhood Determinants of Adult Health Study，n=2345，基线时年龄为 7-15 岁）的儿童进行 20 年随访。基线时的人体测量指标包括腰围（WC）、WC 按身高校正、体重按身高校正、臀围、腰臀比、腰高比、BMI、凸度指数、腹部体积指数（AVI）、身体脂肪指数和体型指数。在随访时测量空腹血糖和胰岛素水平，用于定义胰岛素抵抗（HOMA2-IR）、低β细胞功能（HOMA2-β）、高空腹胰岛素和空腹血糖受损（IFG）。
所有儿童人体测量指标均与 HOMA2-IR、HOMA2-β 和高空腹胰岛素显著相关（相对风险=1.12-1.55），但与 IFG 无关。AVI 在预测成人 HOMA2-IR（AUC，95%置信区间：0.610，0.584-0.637）、HOMA2-β（0.615，0.588-0.642）和高空腹胰岛素（0.613，0.587-0.639）方面具有最大的受试者工作特征曲线下面积（AUC）。与 AVI 联合使用其他每一种人体测量指标均不能明显提高预测能力（AUC 仅增加 0.001-0.002，所有 P 值均>0.05）。
儿童时期单次人体测量指标与成年后 20 年的胰岛素相关结局相关。然而，总体预测能力较低，通过组合多种不同的儿童人体测量指标并不能显著提高预测能力。
