Lu Na, Cheng Gang, Ma Chun-Ming, Liu Xiao-Li
Department of Endocrinology, The First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao 066000, Hebei Province, China.
Department of Endocrinology, Qinhuangdao Hospital of Traditional Chinese Medicine, No.1 Changjiang East Road, Qinhuangdao 066000, Hebei Province, China.
Diabetes Res Clin Pract. 2023 Apr;198:110622. doi: 10.1016/j.diabres.2023.110622. Epub 2023 Mar 15.
The purpose of this study was to evaluate the relationship between hypertriglyceridemic waist (HW) phenotype,hypertriglyceridemic waist-to-height ratio (HWHtR) phenotype and abnormal glucose metabolism in adolescents.
A secondary analysis was conducted on 2626 adolescents aged 12-19 years in United States. Abnormal glucose metabolism was defined as fasting plasma glucose ≥ 5.6 mmol/L or oral glucose tolerance test 2-h plasma glucose ≥ 7.8 mmol/L or glycohemoglobin A1c ≥ 5.7% or a previous diagnosis of diabetes. The HW phenotype was defined as triglyceride(TG) concentrations ≥ 1.47 mmol/L and waist circumference (WC) ≥ 90th percentile. The HWHtR phenotype was defined as TG concentrations ≥ 1.47 mmol/L and waist-to-height ratio (WHtR) ≥ 0.5.
621(23.6%) adolescents had abnormal glucose metabolism. The prevalences of abnormal glucose metabolism were 22.7% and 40.6% in adolescents without and with HW phenotype. The prevalences of abnormal glucose metabolism were 22.4% and 38.6% in adolescents without and with HWHtR phenotype. Adolescents with HWHtR phenotype were more likely to have abnormal glucose metabolism (OR = 1.548, P = 0.010). The levels of homeostasis model assessment insulin resistance and β cell fuction index were higher in adolescents with HWHtR phenotype than in adolescents without HWHtR phenotype (P < 0.001).
The study demonstrates that HWHtR phenotype was closely associated with an increased risk of abnormal glucose metabolism in adolescents. Adolescents with HWHtR phenotype had worsen insulin resistance and increased insulin secretion as a result of compensation.
The study provided a simple method, HWHtR phenotype, for evaluating the status of glucose metabolism in adolescents.
本研究旨在评估青少年中高甘油三酯腰围(HW)表型、高甘油三酯腰高比(HWHtR)表型与糖代谢异常之间的关系。
对美国2626名12至19岁青少年进行了二次分析。糖代谢异常定义为空腹血糖≥5.6 mmol/L或口服葡萄糖耐量试验2小时血糖≥7.8 mmol/L或糖化血红蛋白A1c≥5.7%或既往有糖尿病诊断。HW表型定义为甘油三酯(TG)浓度≥1.47 mmol/L且腰围(WC)≥第90百分位数。HWHtR表型定义为TG浓度≥1.47 mmol/L且腰高比(WHtR)≥0.5。
621名(23.6%)青少年存在糖代谢异常。无HW表型和有HW表型的青少年中糖代谢异常的患病率分别为22.7%和40.6%。无HWHtR表型和有HWHtR表型的青少年中糖代谢异常的患病率分别为22.4%和38.6%。有HWHtR表型的青少年更有可能出现糖代谢异常(OR = 1.548,P = 0.010)。有HWHtR表型的青少年的稳态模型评估胰岛素抵抗和β细胞功能指数水平高于无HWHtR表型的青少年(P < 0.001)。
该研究表明,HWHtR表型与青少年糖代谢异常风险增加密切相关。有HWHtR表型的青少年胰岛素抵抗加重,作为代偿胰岛素分泌增加。
该研究提供了一种评估青少年糖代谢状态的简单方法,即HWHtR表型。