Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea.
Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Front Endocrinol (Lausanne). 2022 May 23;13:872591. doi: 10.3389/fendo.2022.872591. eCollection 2022.
The objective of this study is to investigate whether body mass index (BMI) changes are associated with fasting glucose and insulin resistance (IR) in early childhood.
From the Environment and Development of Children (EDC) cohort, 334 children who visited at ages 2 and 4 were included in this study. Height and weight were measured at ages 2 and 4, and fasting glucose and insulin were assessed at age 4. Homeostatic model assessment of insulin resistance (HOMA-IR) was calculated as insulin (μIU/ml) × glucose (mg/dl)/405. The BMI Z-score [BMI (Z)] quartiles for each age group were defined as Q4, ≥75th percentile; Q2-3, 25th to 75th percentile; and Q1, <25th percentile. Glucose, insulin, and the HOMA-IR were compared between groups according to the change in BMI (Z) from age 2 to 4.
Children who stayed in Q4 at both ages had higher fasting glucose (92.2 vs. 88.0 and 87.1 mg/dl), insulin (3.2 vs. 2.5 and 2.3 μIU/ml), and HOMA-IR (0.68 vs. 0.54 and 0.52) than children who stayed in Q1 or Q2-3 (all P<0.01). Children in Q4 at both ages had higher fasting glucose than children whose BMI (Z) increased from Q1 or Q2-3 to Q4 (92.2 vs. 87.3, P<0.001). The BMI (Z) category at age 2 of children who were in Q2-3 at age 4 did not affect glucose or IR at 4 years.
The group of children within the highest BMI (Z) quartile at both 2 and 4 years of age had higher fasting glucose and IR at age 4 than any other BMI (Z) change group.
本研究旨在探讨儿童早期体重指数（BMI）变化与空腹血糖和胰岛素抵抗（IR）的关系。
本研究纳入了环境与儿童发展（EDC）队列中 334 名在 2 岁和 4 岁时就诊的儿童。在 2 岁和 4 岁时测量身高和体重，在 4 岁时检测空腹血糖和胰岛素。胰岛素抵抗的稳态模型评估（HOMA-IR）计算方法为胰岛素（μIU/ml）×血糖（mg/dl）/405。根据从 2 岁到 4 岁期间 BMI（Z）的变化，将每个年龄组的 BMI Z 评分（BMI（Z））四分位距定义为 Q4，≥第 75 百分位数；Q2-3，第 25 至 75 百分位数；和 Q1，<第 25 百分位数。根据 BMI（Z）从 2 岁到 4 岁的变化，比较各组之间的血糖、胰岛素和 HOMA-IR。
在两个年龄点均处于 Q4 的儿童的空腹血糖（92.2 比 88.0 和 87.1mg/dl）、胰岛素（3.2 比 2.5 和 2.3μIU/ml）和 HOMA-IR（0.68 比 0.54 和 0.52）高于 Q1 或 Q2-3 的儿童（均 P<0.01）。两个年龄点均处于 Q4 的儿童的空腹血糖高于 BMI（Z）从 Q1 或 Q2-3 增加到 Q4 的儿童（92.2 比 87.3，P<0.001）。4 岁时处于 Q2-3 的儿童，其 2 岁时的 BMI（Z）类别并不影响 4 岁时的血糖或 IR。
在 2 岁和 4 岁时均处于最高 BMI（Z）四分位距的儿童组在 4 岁时的空腹血糖和 IR 高于任何其他 BMI（Z）变化组。
