Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Instituto de Nutrición y Tecnología de Alimentos, Universidad de Chile, Santiago, Chile.
Arch Endocrinol Metab. 2024 Jan 29;68:e220353. doi: 10.20945/2359-4292-2022-0353.
To assess the association between leptin/adiponectin ratio (LAR) and insulin resistance surrogates in prepubertal children.
Study based on data from the Growth and Obesity Chilean Cohort Study (GOCS) involving 968 Chilean prepubertal children. Plasma insulin, leptin, and adiponectin were determined by immunoassays. Several common insulin resistance surrogates were calculated, including the homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride/HDL cholesterol index, triglyceride-glucose (TyG) index, and the TyG index corrected for body mass index (BMI; TyG-BMI) and waist circumference (WC; TyG-WC). Associations among variables were assessed using multiple linear and logistic regression analysis.
There was a significant direct association between plasma leptin and LAR with BMI z-score but no association between plasma adiponectin and adiposity. After adjustments for sex and age, LAR was significantly associated with all insulin resistance surrogates (which were categorized using the 75th percentile as the cutoff point), with the TyG-WC index emerging as the surrogate with the highest magnitude of association (odds ratio [OR] 2.44, 95% confidence interval [CI] 2.05-2.9). After additional adjustment for BMI z-score, only the association between LAR and TyG-WC remained significant (OR 1.64, 95% CI 1.27-2.12).
Plasma leptin and LAR were strongly associated with several common insulin resistance surrogates in prepubertal children, most notably with the TyG-WC index. Associations between LAR and insulin resistance indexes were mainly driven by the effect of plasma leptin, which is also directly associated with increased adiposity.
评估瘦素/脂联素比值(LAR)与青春期前儿童胰岛素抵抗替代指标的相关性。
本研究基于智利生长和肥胖队列研究(GOCS)的数据,共纳入 968 名智利青春期前儿童。通过免疫测定法测定血浆胰岛素、瘦素和脂联素。计算了几种常见的胰岛素抵抗替代指标,包括稳态模型评估的胰岛素抵抗(HOMA-IR)、甘油三酯/高密度脂蛋白胆固醇指数、甘油三酯-葡萄糖(TyG)指数以及经体重指数(BMI)和腰围(WC)校正的 TyG 指数(TyG-BMI 和 TyG-WC)。使用多元线性和逻辑回归分析评估变量之间的相关性。
血浆瘦素和 LAR 与 BMI z 评分呈显著正相关,但与体脂无相关性。在校正性别和年龄后,LAR 与所有胰岛素抵抗替代指标均呈显著相关(以第 75 百分位数作为截断点进行分类),其中 TyG-WC 指数与胰岛素抵抗的相关性最强(比值比 [OR] 2.44,95%置信区间 [CI] 2.05-2.9)。在校正 BMI z 评分后,仅 LAR 与 TyG-WC 之间的相关性仍具有统计学意义(OR 1.64,95%CI 1.27-2.12)。
在青春期前儿童中,血浆瘦素和 LAR 与几种常见的胰岛素抵抗替代指标密切相关,与 TyG-WC 指数相关性最强。LAR 与胰岛素抵抗指标之间的相关性主要归因于血浆瘦素的作用,而瘦素与体脂增加也直接相关。