The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.
The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.
Pediatr Diabetes. 2019 Aug;20(5):538-548. doi: 10.1111/pedi.12859. Epub 2019 May 9.
Alterations in glucose metabolism that lead to the development of metabolic and cardiovascular disease may begin already in childhood.
This study aims to generate pediatric age and sex-specific reference values for fasting concentrations of glucose, hemoglobin A1c (HbA1c), insulin, C-peptide, and homeostasis model assessment: insulin resistance (HOMA-IR) in Danish/North-European white children and adolescents from a population-based cohort and to compare values from children and adolescents with overweight/obesity with this reference.
The population- and obesity clinic-based cohorts consisted of 2451 and 1935 children and adolescents between 6 and 18 years of age. Anthropometric measurements and blood samples were obtained and percentile curves were calculated.
In the population-based cohort, glucose, insulin, and HOMA-IR values increased before the expected onset of puberty (P < .05). Thereafter, all variables decreased in girls (P < .05) and HbA1c decreased in boys (P < .05). Concentrations of all measured markers of glucose metabolism were higher in the obesity clinic-based cohort than the population-based cohort (both sexes P < .001). Specifically, insulin and HOMA-IR continued to increase to 18 years in the clinic-based cohort, particularly among boys.
Fasting glucose, insulin, and HOMA-IR change during childhood, making pediatric reference values essential for timely identification of derangements in glucose metabolism. Children and adolescents with obesity exhibit increased concentrations of these biomarkers.
导致代谢和心血管疾病发展的葡萄糖代谢改变可能早在儿童期就已经开始。
本研究旨在为丹麦/北欧白种儿童和青少年生成基于人群的队列中空腹血糖、糖化血红蛋白（HbA1c）、胰岛素、C 肽和稳态模型评估：胰岛素抵抗（HOMA-IR）的年龄和性别特异性参考值，并将超重/肥胖儿童和青少年的这些值与参考值进行比较。
基于人群和肥胖诊所的队列包括 2451 名和 1935 名年龄在 6 至 18 岁之间的儿童和青少年。获取了人体测量学测量值和血液样本，并计算了百分位数曲线。
在基于人群的队列中，葡萄糖、胰岛素和 HOMA-IR 值在青春期前（P<.05）之前增加。此后，所有变量在女孩中（P<.05）下降，男孩中 HbA1c 下降（P<.05）。在肥胖诊所队列中，所有测量的葡萄糖代谢标志物的浓度均高于基于人群的队列（两性均 P<.001）。具体而言，胰岛素和 HOMA-IR 在诊所队列中持续增加到 18 岁，尤其是在男孩中。
空腹血糖、胰岛素和 HOMA-IR 在儿童期发生变化，因此儿科参考值对于及时识别葡萄糖代谢紊乱至关重要。肥胖的儿童和青少年表现出这些生物标志物浓度增加。
