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新冠大流行时期的不良“彩虹”:肥胖和超重儿童及青少年的葡萄糖代谢变化。

The bad rainbow of COVID-19 time: effects on glucose metabolism in children and adolescents with obesity and overweight.

机构信息

Department of Pediatrics, University of Chieti, Chieti, Italy.

Clinical Research Center, "G. d'Annunzio" Foundation, University of Chieti, Chieti, Italy.

出版信息

Int J Obes (Lond). 2022 Sep;46(9):1694-1702. doi: 10.1038/s41366-022-01164-6. Epub 2022 Jul 1.

Abstract

BACKGROUND

COVID-19 restriction measurements have enhanced the obesity status in the pediatric population which might further contribute to obesity-related glucose-insulin metabolism alterations. Therefore, we retrospectively compared anthropometric and OGTT data on children with obesity during the 13 years before and during the COVID-19 pandemic.

SUBJECTS/METHODS: Data from 741 children with obesity and overweight were retrieved and clustered into seven groups starting from year 2008-2009 until 2020-2021. Differences in anthropometric measurements and glucose/insulin metabolism were evaluated between the different groups.

RESULTS

Children with overweight and obesity in the COVID-19 restriction group did not present increased values of SDS-Body Mass Index (BMI). Significantly higher values for Waist Circumference (WC), SDS-WC, Waist/Height ratio (WHtR), and body mass fat were detected in these children (all P < 0.01). Fasting glycaemia, glucose, and insulin excursions were significantly higher compared to pre- pandemic children (all P < 0.01). Insulin resistance was higher while insulin secretion was lower (all P < 0.01) determining a significantly higher percentage of impaired glucose tolerance in the COVID-19 restriction group (P < 0.002). Furthermore, High-Density Lipoprotein (HDL) cholesterol was significantly lower (P < 0.01) and SDS for systolic and diastolic blood pressure values were significantly higher (P = 0.03 and P = 0.02, respectively).

CONCLUSIONS

COVID-19 restriction measurements determined profound alterations in glucose and insulin metabolism in children with obesity and overweight. Urgent strategies are needed in order to reverse COVID-19 restriction measures' effects on glucose and insulin metabolism.

摘要

背景

新冠疫情限制措施加剧了儿科人群的肥胖状况,这可能进一步导致肥胖相关的葡萄糖-胰岛素代谢改变。因此,我们回顾性比较了新冠疫情前后 13 年间肥胖儿童的人体测量学和 OGTT 数据。

对象/方法:从 2008-2009 年到 2020-2021 年,共检索了 741 名肥胖和超重儿童的数据,并将其分为七个组。评估了不同组之间的人体测量学测量和葡萄糖/胰岛素代谢的差异。

结果

在新冠疫情限制组中,超重和肥胖儿童的 SDS-体重指数(BMI)值没有增加。这些儿童的腰围(WC)、SDS-WC、腰高比(WHtR)和体脂肪质量显著升高(均 P<0.01)。空腹血糖、血糖和胰岛素水平明显高于疫情前儿童(均 P<0.01)。胰岛素抵抗更高,而胰岛素分泌更低(均 P<0.01),这导致新冠疫情限制组的糖耐量受损百分比显著升高(P<0.002)。此外,高密度脂蛋白(HDL)胆固醇明显降低(P<0.01),收缩压和舒张压的 SDS 值明显升高(分别为 P=0.03 和 P=0.02)。

结论

新冠疫情限制措施导致肥胖和超重儿童的葡萄糖和胰岛素代谢发生深刻改变。需要采取紧急策略来逆转新冠疫情限制措施对葡萄糖和胰岛素代谢的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9eb/9263072/815cd5b5a404/41366_2022_1164_Fig1_HTML.jpg

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