胰岛素抵抗对青少年腹部肥胖、肝脂肪浸润和体重指数的影响。

Effect of Insulin Resistance on Abdominal Obesity, Liver Fat Infiltration, and Body Mass Index in Youngsters.

机构信息

Multidisciplinary Academic Unit Reynosa Aztlán, Universidad Autónoma de Tamaulipas, Reynosa, Tamaulipas, Mexico.

Department of Graduate Studies, Universidad Nacional Autónoma de México, Mexico City, Mexico.

出版信息

Arch Med Res. 2023 Nov;54(7):102873. doi: 10.1016/j.arcmed.2023.102873. Epub 2023 Sep 1.

DOI:10.1016/j.arcmed.2023.102873

PMID:37660428

Abstract

AIM

Evaluate insulin resistance (IR) as a mediator of the effect of body fat distribution on liver fat infiltration and stiffness (LSt) in young adults using structural equation modeling (SEM).

METHODS

We invited 500 first year students from two universities and evaluated their family history to determine the risk for cardiometabolic disease. Of these, 174 students (age 19 ± 1 years) were assessed for total body fat percentage (BF%), LSt, fat infiltration (Coefficient attenuated parameter CAP), and serum biochemical analysis. We performed a mediation analysis using two different structural equation models to determine the relationship between BMI, BF%, abdominal obesity (AO), IR, LSt, and fat infiltration using standardized β coefficients. The symbol "->" means "explains/causes".

RESULTS

Model#1 supported that mediation analysis and had a better fit than the direct effect. AO->IR (b = 0.62, p = 0.005), AO->CAP (b = 0.63, p <0.001), and CAP->IR (b = 0.23, p = 0.007), with negligible effect of BMI on CAP and IR. Model#2 showed direct effect of BMI on LSt was a better fit than mediation. BMI->LSt (b = 0.17, p = 0.05) but no effect AO->LSt. Interestingly, LSt->IR (b = 0.18, p = 0.001), but bi-directional IR->LSt (b = 0.23, p = 0.001).

CONCLUSIONS

AO and BMI in young adults have differential phenotypic effects on liver CAP and LSt. Visceral fat had a direct effect on IR and CAP. Meanwhile, BMI was associated with LSt. Our findings shed light on the complex interplay of factors influencing liver stiffness, particularly in young individuals. Further research is needed to elucidate the precise mechanisms underlying these associations and their implications for liver health.

摘要

目的

利用结构方程模型（SEM）评估胰岛素抵抗（IR）作为体脂分布对年轻成年人肝脂肪浸润和硬度（LSt）影响的中介作用。

方法

我们邀请了两所大学的 500 名一年级学生，并评估了他们的家族病史，以确定患心血管代谢疾病的风险。其中，174 名学生（年龄 19±1 岁）评估了全身脂肪百分比（BF%）、LSt、脂肪浸润（衰减系数参数 CAP）和血清生化分析。我们使用标准化β系数，通过两种不同的结构方程模型进行中介分析，以确定 BMI、BF%、腹部肥胖（AO）、IR、LSt 和脂肪浸润之间的关系。符号“->”表示“解释/导致”。

结果

模型#1 支持中介分析，拟合度优于直接效应。AO->IR（b=0.62，p=0.005），AO->CAP（b=0.63，p<0.001），和 CAP->IR（b=0.23，p=0.007），BMI 对 CAP 和 IR 的影响可以忽略不计。模型#2 显示 BMI 对 LSt 的直接效应拟合度优于中介。BMI->LSt（b=0.17，p=0.05），但 AO->LSt 没有影响。有趣的是，LSt->IR（b=0.18，p=0.001），但 IR->LSt 是双向的（b=0.23，p=0.001）。