Steinberger J, Moorehead C, Katch V, Rocchini A P
Division of Pediatric Cardiology, University of Minnesota, Minneapolis, USA.
J Pediatr. 1995 May;126(5 Pt 1):690-5. doi: 10.1016/s0022-3476(95)70394-2.
To determine whether the lipid abnormalities observed in obese adolescents are associated with insulin resistance.
We evaluated the relationship between lipid levels and insulin resistance in 82 obese adolescents. Insulin resistance was assessed by fasting insulin level and sum of the insulin values after an oral glucose tolerance test in all 82, and were compared with data from 40 nonobese adolescents. Whole-body glucose uptake during euglycemic hyperinsulinemia (M value) was performed in 19 of the obese adolescents and compared with that of 24 nonobese young adults.
The obese adolescents had significantly elevated low-density lipoprotein cholesterol (LDL-C) (3.09 +/- 0.73 mmol/L; 119 +/- 28.2 mg/dl) and triglycerides (1.22 +/- 0.62 mmol/L; 108 +/- 54.6 mg/dl) and low high-density lipoprotein cholesterol (HDL-C) levels (0.94 +/- 0.24 mmol/L; 36 +/- 9.1 mg/dl) when compared with values in the nonobese subjects. M values were significantly depressed in the obese compared with the nonobese subjects. Adiposity significantly correlated with low HDL-C and elevated triglyceride values. From the variables representing insulin resistance, the strongest correlation with the abnormal lipid profile was found for the M value. A stepwise multiple regression analysis revealed that the M value was the only step entered into the relationship for triglycerides and LDL-C, and both M value and fasting insulin were entered for HDL-C.
In obese adolescents the degree of insulin resistance explains a significant portion of the variance in the levels of triglycerides, LDL-C, and HDL-C.
确定肥胖青少年中观察到的脂质异常是否与胰岛素抵抗相关。
我们评估了82名肥胖青少年的脂质水平与胰岛素抵抗之间的关系。通过所有82名青少年的空腹胰岛素水平和口服葡萄糖耐量试验后的胰岛素值总和来评估胰岛素抵抗，并与40名非肥胖青少年的数据进行比较。对19名肥胖青少年进行了正常血糖高胰岛素血症期间的全身葡萄糖摄取（M值）测定，并与24名非肥胖青年成人进行比较。
与非肥胖受试者相比，肥胖青少年的低密度脂蛋白胆固醇（LDL-C）（3.09±0.73 mmol/L；119±28.2 mg/dl）和甘油三酯（1.22±0.62 mmol/L；108±54.6 mg/dl）显著升高，高密度脂蛋白胆固醇（HDL-C）水平（0.94±0.24 mmol/L；36±9.1 mg/dl）降低。与非肥胖受试者相比，肥胖者的M值显著降低。肥胖程度与低HDL-C和升高的甘油三酯值显著相关。在代表胰岛素抵抗的变量中，发现与异常脂质谱相关性最强的是M值。逐步多元回归分析显示，M值是进入甘油三酯和LDL-C关系的唯一因素，而M值和空腹胰岛素均进入HDL-C关系。
在肥胖青少年中，胰岛素抵抗程度解释了甘油三酯、LDL-C和HDL-C水平差异的很大一部分。
