Insulin resistance during puberty - Results from clamp studies in 357 children
Insulin resistance during puberty - Results from clamp studies in 357 children
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DOI：
10.2337/diabetes.48.10.2039
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发表时间：
1999-10-01
期刊：
影响因子：
7.7
通讯作者：
Sinaiko, AR
中科院分区：
文献类型：
--
作者：
Moran, A;Jacobs, DR;Sinaiko, AR
胰岛素抵抗可能是成年人心血管危险因素的一个重要原因，这种综合征的发病可能发生在儿童时期。然而，儿童通常在青春期经历短暂的胰岛素抵抗。有357名10-14岁的正常儿童（159名女孩，198名男孩）接受了正葡萄糖钳夹研究，以评估坦纳分期（T）、性别、种族和BMI对胰岛素抵抗的影响。胰岛素抵抗在青春期开始时（T2）立即增加，但在青春期结束时（T5）恢复到接近青春期前的水平。其峰值出现在T3在两种性别，和女孩比男孩在所有的T阶段的胰岛素抵抗。白色男孩似乎比黑人男孩更胰岛素抵抗;白色女孩和黑人女孩之间没有差异。胰岛素抵抗与BMI、三头肌皮褶厚度和腰围密切相关，这种关系与坦纳分期或性别无关。然而，BMI和肥胖的差异并不能完全解释青春期的胰岛素抵抗。这些结果表明：1）男孩和女孩之间存在胰岛素抵抗的显著差异; 2）胰岛素抵抗在T2、T3和T4显著增加，但在T5降低至接近青春期前水平; 3）虽然胰岛素抵抗与BMI和肥胖的人体测量指标有关，但这些因素不能完全解释青春期坦纳阶段发生的胰岛素抵抗。
Insulin resistance may be an important cause of a constellation of cardiovascular risk factors in adults, and onset of this syndrome may occur in childhood. However, children normally experience transient insulin resistance at puberty. There were 357 normal children (159 girls, 198 boys) age 10-14 years who underwent euglycemic clamp studies to assess the effects of Tanner stage (T), sex, ethnicity, and BMI on insulin resistance. Insulin resistance increased immediately at the onset of puberty (T2), but returned to near prepubertal levels by the end of puberty (T5). Its peak occurred at T3 in both sexes, and girls were more insulin resistant than boys at all T stages. White boys appeared to be more insulin resistant than black boys; no difference was seen between white and black girls. Insulin resistance was strongly related to BMI, triceps skinfold thickness, and waist circumference, and this relationship was independent of Tanner stage or sex. Differences in BMI and adiposity did not, however, entirely explain the insulin resistance of puberty. These results demonstrate that I) significant differences in insulin resistance are present between boys and girls; 2) insulin resistance increases significantly at T2, T3, and T4, but decreases to near prepubertal levels at T5; and 3) while insulin resistance is related to BMI and anthropometric measures of fatness, these factors do not completely explain the insulin resistance that occurs during the Tanner stages of puberty.