Batey L S, Goff D C, Tortolero S R, Nichaman M Z, Chan W, Chan F A, Grunbaum J, Hanis C L, Labarthe D R
Southwest Center for Prevention Research, and School of Public Health, University of Texas Houston Health Science Center, 77030, USA.
Circulation. 1997 Dec 16;96(12):4319-25. doi: 10.1161/01.cir.96.12.4319.
Mexican-American (MA) adults are known to have a greater burden of diabetes and insulin resistance than non-Hispanic white (NHW) people. In this report, we examined data obtained from MA and NHW third-grade children for evidence of a pattern consistent with the insulin resistance syndrome. In addition, we developed two summary measures characterizing insulin resistance syndrome to compare measures of this syndrome among our population.
Data regarding fasting insulin, triglycerides, HDL cholesterol, systolic blood pressure, and body mass index (BMI) were available for 403 third-grade children. Median levels of insulin and glucose were significantly higher in MA boys and girls than in NHW boys and girls. Risk factors characterizing insulin resistance, including levels of insulin, triglycerides, systolic blood pressure, HDL cholesterol, and BMI were categorized as above or below the total population median. MA children were more likely than NHW children to have three or more adverse risk factors (55% versus 37%). When risk factors were converted to Z scores, and the five Z scores were summed for each individual, MA boys and girls had higher mean scores than NHW boys and girls (means for boys, 0.65 versus -0.97, P<.0001; girls, 0.52 versus -0.30, P<.04). Principal components analysis was used to create a summary score or index representing the insulin resistance syndrome. This summary score was significantly higher among MA boys and girls than NHW boys and girls (means for boys, 0.34 versus -0.72, P<.0001; girls, 0.35 versus -0.04, P=.056).
Our results support the hypothesis that MA children exhibit a greater degree of the insulin resistance syndrome than NHW children, especially among boys. We conclude that some of the factors responsible for the increased risk of NIDDM seen among MA adults are demonstrable in childhood.
已知墨西哥裔美国（MA）成年人比非西班牙裔白人（NHW）患糖尿病和胰岛素抵抗的负担更重。在本报告中，我们检查了从MA和NHW三年级儿童获得的数据，以寻找与胰岛素抵抗综合征一致的模式证据。此外，我们制定了两种表征胰岛素抵抗综合征的综合指标，以比较我们研究人群中该综合征的各项指标。
403名三年级儿童提供了空腹胰岛素、甘油三酯、高密度脂蛋白胆固醇、收缩压和体重指数（BMI）的数据。MA男孩和女孩的胰岛素和葡萄糖中位数水平显著高于NHW男孩和女孩。表征胰岛素抵抗的危险因素，包括胰岛素水平、甘油三酯、收缩压、高密度脂蛋白胆固醇和BMI，被分类为高于或低于总体人群中位数。MA儿童比NHW儿童更有可能有三个或更多不良危险因素（55%对37%）。当危险因素转换为Z分数，并将每个个体的五个Z分数相加时，MA男孩和女孩的平均分数高于NHW男孩和女孩（男孩的平均值，0.65对-0.97，P<0.0001；女孩，0.52对-0.30，P<0.04）。主成分分析用于创建一个代表胰岛素抵抗综合征的综合分数或指数。该综合分数在MA男孩和女孩中显著高于NHW男孩和女孩（男孩的平均值，0.34对-0.72，P<0.0001；女孩，0.35对-0.04，P=0.056）。
我们的结果支持这样的假设，即MA儿童比NHW儿童表现出更高程度的胰岛素抵抗综合征，尤其是在男孩中。我们得出结论，MA成年人中2型糖尿病风险增加的一些因素在儿童期就已显现。
