Blasetti A, Franchini S, Castorani V, Comegna L, Fornari E, Daniele F, Prezioso G, Piona C, Federico V, Zona D, Bresadola I, Chiarelli F, Maffeis C
Department of Pediatrics, "G. d'Annunzio" University-Chieti, Pescara, Italy.
Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy.
Int J Endocrinol. 2020 Oct 10;2020:1849274. doi: 10.1155/2020/1849274. eCollection 2020.
Skipping breakfast has been associated with a higher risk of obesity and cardiovascular (CV) risk factors. However, it is not known if skipping breakfast is also correlated with CV risk factors independently from obesity. The mechanisms explaining the role of skipping breakfast on promoting fat accumulation as well as CV risk are not known. Hormones, in particular, insulin-like growth factor-1 (IGF-1), may potentially play a role in the metabolic profile of breakfast skippers.
This cross-sectional study aims to test, in a sample of overweight/obese children, the hypotheses that skipping breakfast is associated with a worse metabolic profile and that IGF-1 levels are associated with this unfavorable metabolic profile.
We enrolled 112 overweight/obese prepubertal children (3-12 years). Anthropometric characteristics (height SDS, weight SDS, and body mass index (BMI) -score) were measured. Blood samples were collected to evaluate glucose and lipid metabolisms and hormone profile (growth hormone (GH), IGF-1, insulin, and cortisol). The triglycerides/high-density lipoprotein (HDL) cholesterol ratio was calculated as a predictor of cardiovascular risk. Children were divided into two groups according to breakfast habits: consumers (≥5 weekly; = 76) and skippers (≤4 weekly; = 36). Glycaemia, total and low-density lipoprotein (LDL) cholesterol, triglycerides ( < 0.05), and triglycerides/HDL cholesterol ratio ( < 0.001) were higher, while HDL cholesterol was lower ( < 0.01) in skippers as compared to consumers. IGF-1 concentrations were inversely correlated with LDL cholesterol ( = -0.279, =0.013) and directly correlated with HDL cholesterol ( = 0.226, =0.047). IGF-1 correlated positively with HDL cholesterol ( = 0.266, =0.045) in consumers and correlated negatively with LDL cholesterol ( = -0.442, =0.024) in skippers. Breakfast consumption among prepubertal overweight/obese children showed a better lipid profile in comparison with those who skipped breakfast [OR: 0.165 (95% CI: 0.053-0.518), =0.001]; these latter odds of the increased triglycerides/HDL cholesterol ratio was 6.1-fold higher.
Breakfast skippers show a worse lipid profile when compared to breakfast consumers. IGF-1 might play a role as an independent modulator of lipid metabolism.
不吃早餐与肥胖及心血管（CV）危险因素风险较高有关。然而，尚不清楚不吃早餐是否也独立于肥胖与CV危险因素相关。解释不吃早餐在促进脂肪堆积以及CV风险方面作用的机制尚不清楚。激素，尤其是胰岛素样生长因子-1（IGF-1），可能在不吃早餐者的代谢特征中发挥作用。
这项横断面研究旨在对超重/肥胖儿童样本进行测试，验证不吃早餐与较差的代谢特征相关以及IGF-1水平与这种不利的代谢特征相关的假设。
我们纳入了112名超重/肥胖的青春期前儿童（3至12岁）。测量了人体测量学特征（身高标准差评分、体重标准差评分和体重指数（BMI）评分）。采集血样以评估葡萄糖和脂质代谢以及激素谱（生长激素（GH）、IGF-1、胰岛素和皮质醇）。计算甘油三酯/高密度脂蛋白（HDL）胆固醇比值作为心血管风险的预测指标。根据早餐习惯将儿童分为两组：吃早餐者（每周≥5次；n = 76）和不吃早餐者（每周≤4次；n = 36）。与吃早餐者相比，不吃早餐者的血糖、总胆固醇和低密度脂蛋白（LDL）胆固醇、甘油三酯（P < 0.05）以及甘油三酯/HDL胆固醇比值（P < 0.001）更高，而HDL胆固醇更低（P < 0.01）。IGF-1浓度与LDL胆固醇呈负相关（r = -0.279，P = 0.013），与HDL胆固醇呈正相关（r = 0.226，P = 0.047）。在吃早餐者中，IGF-1与HDL胆固醇呈正相关（r = 0.266，P = 0.045），在不吃早餐者中与LDL胆固醇呈负相关（r = -0.442，P = 0.024）。青春期前超重/肥胖儿童中，吃早餐者与不吃早餐者相比，脂质谱更佳[比值比：0.165（95%置信区间：0.053 - 0.518），P = 0.001]；后者甘油三酯/HDL胆固醇比值升高的几率高6.1倍。
与吃早餐者相比，不吃早餐者的脂质谱更差。IGF-1可能作为脂质代谢的独立调节因子发挥作用。
