Aleman Mariano Nicolás, Luciardi María Constanza, Albornoz Emilce Romina, Bazán María Cristina, Abregú Adela Victoria
Departamento de Bioquímica Aplicada, Facultad de Bioquímica, Químicay Farmacia, Universidad Nacional de Tucumán, San Miguel de Tucumán, Argentina.
Departamento de Endocrinología, Hospital del Niño Jesús de Tucumán, San Miguel de Tucumán, Argentina.
Clin Exp Pediatr. 2024 Jan;67(1):37-45. doi: 10.3345/cep.2022.01382. Epub 2023 Dec 21.
Excess weight, inflammation, and insulin resistance (IR) are associated, but the prevalence of and biomarkers for IR in Latin children are unknown.
This study aimed to determine the prevalence of IR in prepubertal and pubertal Latin children with excess weight and explore the usefulness of different biomarkers of low-grade inflammation for identifying IR status.
Sixty-eight children (31 boys, 37 girls; approximately 11 years of age) with excess weight (overweight and obese) and 20 healthy normal-weight children (12 boys, 8 girls; approximately 12 years of age) were included. Anthropometric parameters, insulin, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, tumor necrosis factor- α (TNF-α), interleukin (IL)-6, monocyte chemoattractant protein-1 (MCP-1), soluble CD40 ligand (sCD40L), high-sensitivity C-reactive protein (hs-CRP), and myeloperoxidase were assessed and IR was determined by homeostasis model assessment index (cutoff points: 2.67 and 2.22 in prepubertal boys and girls and 5.55 and 3.82 in pubertal boys and girls, respectively). Intergroup differences were compared, correlations were investigated using Pearson correlation coefficient, and stepwise multiple linear regression analyses were performed to estimate the relationship between inflammatory biomarkers and IR.
The prevalence of IR among overweight children was 62%. IL-6 levels differed between overweight and obese boys, while erythrocyte sedimentation rate, MCP-1, TNF-α, IL-6, hs-CRP, and sCD40L differed between obese and normal-weight boys. In contrast, sCD40L levels were increased in overweight versus normal-weight girls, while MCP-1, TNF-α, IL-6, and sCD40L differed between obese and normal-weight girls. Furthermore, MCP-1 and sCD40L levels and erythrocyte sedimentation rate were positively correlated with IR; however, a stepwise regression analysis that adjusted for the body mass index (BMI) z score, sex, and age showed that none were good predictors of IR status.
The prevalence of IR is high among Latin children with excess weight. Although some inflammatory biomarkers differed among groups, none robustly predicted IR.
超重、炎症与胰岛素抵抗(IR)相关,但拉丁裔儿童中IR的患病率及生物标志物尚不清楚。
本研究旨在确定超重的青春期前和青春期拉丁裔儿童中IR的患病率,并探讨不同低度炎症生物标志物对识别IR状态的有用性。
纳入68名超重(超重和肥胖)儿童(31名男孩,37名女孩;约11岁)和20名健康体重正常儿童(12名男孩,8名女孩;约12岁)。评估人体测量参数、胰岛素、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、单核细胞趋化蛋白-1(MCP-1)、可溶性CD40配体(sCD40L)、高敏C反应蛋白(hs-CRP)和髓过氧化物酶,并通过稳态模型评估指数确定IR(切点:青春期前男孩和女孩分别为2.67和2.22,青春期男孩和女孩分别为5.55和3.82)。比较组间差异,使用Pearson相关系数研究相关性,并进行逐步多元线性回归分析以估计炎症生物标志物与IR之间的关系。
超重儿童中IR的患病率为62%。超重和肥胖男孩的IL-6水平不同,而肥胖和体重正常男孩的红细胞沉降率、MCP-1、TNF-α、IL-6、hs-CRP和sCD40L不同。相比之下,超重女孩与体重正常女孩相比,sCD40L水平升高,而肥胖和体重正常女孩的MCP-1、TNF-α、IL-6和sCD40L不同。此外,MCP-1和sCD40L水平以及红细胞沉降率与IR呈正相关;然而,在调整了体重指数(BMI)z评分、性别和年龄的逐步回归分析中,没有一个是IR状态的良好预测指标。
超重的拉丁裔儿童中IR的患病率很高。尽管一些炎症生物标志物在组间存在差异,但没有一个能有力地预测IR。