Reaven P, Nader P R, Berry C, Hoy T
Department of Medicine/Endocrinology, University of California, San Diego, La Jolla, CA 92093-0927, USA.
Pediatrics. 1998 Apr;101(4):E12. doi: 10.1542/peds.101.4.e12.
To evaluate the relationship between insulin levels and cardiovascular risk factors in children and determine whether it varies among ethnic groups.
Cardiovascular risk factors and insulin levels were compared in 144 Mexican-American and Anglo-American mother-child pairs, when the children were 11 years of age.
Although mean age did not differ between ethnicities, Mexican-American mothers and children both had a greater body mass index (mothers: 29.2 +/- 6.2 vs 27.2 +/- 7.9; children: 21.7 +/- 4.7 vs 19.7 +/- 4.6) and sum of skinfolds than did Anglo-Americans. Triglycerides, very low-density lipoprotein cholesterol, fasting insulin, and cholesterol/high-density lipoprotein ratio were higher, while high-density lipoprotein cholesterol was lower in both Mexican-American adults and children compared with Anglo-Americans. After adjusting for measures of obesity, only high-density lipoprotein cholesterol levels remained significantly lower in Mexican-Americans. For both adults and children, higher quartiles of insulin levels were associated with significantly higher triglycerides, blood pressure and lower high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol/apolipoprotein B levels (estimate of dense low-density lipoprotein size). A summary variable representing cardiovascular risk factors present in adult syndrome X patients was higher in both Mexican-American adults and children than in Anglo-Americans.
Mexican-American children and adults have higher levels of many cardiovascular risk factors, and this appears related to higher insulin levels and overweight. Appropriate nutrition, weight control, and exercise at early ages could be important in slowing the development of atherosclerosis.
评估儿童胰岛素水平与心血管危险因素之间的关系，并确定其在不同种族群体中是否存在差异。
在144对墨西哥裔美国人和英裔美国人的母婴中，当孩子11岁时，比较心血管危险因素和胰岛素水平。
尽管不同种族之间的平均年龄没有差异，但墨西哥裔美国母亲和孩子的体重指数（母亲：29.2±6.2 vs 27.2±7.9；孩子：21.7±4.7 vs 19.7±4.6）和皮褶厚度总和均高于英裔美国人。与英裔美国人相比，墨西哥裔美国成年人和儿童的甘油三酯、极低密度脂蛋白胆固醇、空腹胰岛素以及胆固醇/高密度脂蛋白比值更高，而高密度脂蛋白胆固醇更低。在对肥胖指标进行调整后，只有墨西哥裔美国人的高密度脂蛋白胆固醇水平仍显著较低。对于成年人和儿童而言，胰岛素水平较高的四分位数与甘油三酯、血压显著升高以及高密度脂蛋白胆固醇和低密度脂蛋白胆固醇/载脂蛋白B水平（致密低密度脂蛋白大小的估计值）降低相关。代表成人X综合征患者存在的心血管危险因素的汇总变量在墨西哥裔美国成年人和儿童中均高于英裔美国人。
墨西哥裔美国儿童和成年人有更高水平的多种心血管危险因素，这似乎与更高的胰岛素水平和超重有关。早期适当的营养、体重控制和运动对于减缓动脉粥样硬化的发展可能很重要。
