Visceral fat, insulin sensitivity, and lipids in prepubertal children
Visceral fat, insulin sensitivity, and lipids in prepubertal children
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DOI：
10.2337/diabetes.48.8.1515
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发表时间：
1999-08-01
期刊：
影响因子：
7.7
通讯作者：
Goran, MI
中科院分区：
文献类型：
--
作者：
Gower, BA;Nagy, TR;Goran, MI
在成人中，内脏脂肪堆积与胰岛素抵抗和血脂异常有关。这些关系的因果性质尚不清楚。本研究的目的是确定在青春期前儿童中是否存在类似的关系。具体而言，我们确定内脏脂肪是否与空腹胰岛素，胰岛素敏感性（Si），血清甘油三酯（TG）浓度，或血清高密度脂蛋白胆固醇（HDL-C）浓度;内脏脂肪或Si是否独立地与脂质相关;以及种族是否影响内脏脂肪和危险因素之间的关系。受试者是61名青春期前的非洲裔美国人和白人儿童。通过双能X线吸收法测定全身脂肪，通过计算机断层扫描测定内脏脂肪，通过甲苯磺丁脲改良的、频繁采样的静脉葡萄糖耐量试验（最小建模）测定胰岛素敏感性。在多元线性回归分析中（调整总脂肪、性别和种族），内脏脂肪与TG（P < 0.05）和空腹胰岛素（P < 0.001）独立相关，但与S-i无关（P = 0.425）。总体脂与Si独立相关（P < 0.001）。Si与空腹胰岛素独立相关（P < 0.001），而与TG和HDL-C无关（P分别为0.941和0.201）。非裔美国人的S-i比白种人低42%（0.50 +/- 0.05 vs.0.86 +/- 0.11 x 10（-5）min（-1）.pmol（-1）.l，校正总脂肪后的平均值+/- SE，P < 0.001）。尽管如此，种族与TG或HDL-C均无独立相关性（校正总脂肪、内脏脂肪和性别后，P值分别为0.075和0.619）。总脂肪和内脏脂肪与危险因素之间的关系的斜率并不因种族而异。总之，内脏脂肪似乎代谢独特的儿童，独立与TG和胰岛素升高，但不是Si。肥胖儿童和非裔美国儿童的胰岛素抵抗程度更高，与内脏脂肪堆积无关。低硅与高，更快的胰岛素，但不血脂异常。因此，儿童的肥胖、内脏脂肪堆积和种族可能会带来负面但独立的健康风险。
In adults, visceral fat accumulation is associated with insulin resistance and dyslipidemia. The cause-and-effect nature of these relationships is not clear. The objective of the present study was to determine if similar relationships exist in prepubertal children. Specifically, we determined whether visceral fat was associated with fasting insulin, insulin sensitivity (Si), serum triglyceride (TG) concentration, or serum HDL cholesterol (HDL-C) concentration; whether visceral fat or Si was independently related to lipids; and whether ethnicity influenced the relationship between visceral fat and risk factors. Subjects were 61 prepubertal African-American and Caucasian children. Total body fat was determined by dual-energy X-ray absorptiometry, visceral fat by computed tomography, and insulin sensitivity by the tolbutamide-modified, frequently sampled intravenous glucose tolerance test with minimal modeling. In multiple linear regression analysis (adjusting for total fat, sex, and ethnicity), visceral fat was independently related to TG (P < 0.05) and fasting insulin (P < 0.001), but not S-i (P = 0.425). Total body fat was independently related to Si (P < 0.001). Si was independently related to fasting insulin (P < 0.001) but not to TG or HDL-C (P = 0.941 and 0.201, respectively). S-i in African-Americans was 42% lower than in Caucasians (0.50 +/- 0.05 vs. 0.86 +/- 0.11 x 10(-5) min(-1).pmol(-1).l, mean +/- SE after adjusting for total fat, P < 0.001). Nonetheless, ethnicity was not independently related to either TG or HDL-C (P = 0.075 and 0.619, respectively, after adjusting for total and visceral fat and sex). The slopes of the relationships of total and visceral fat with risk factors did not differ with ethnicity. In conclusion, visceral fat appears metabolically unique in children, being independently associated with elevated TG and insulin but not Si. Obese children and African-American children were more insulin resistant, independent of visceral fat accumulation. Lower Si was associated with higher, faster insulin, but not dyslipidemia. Thus, obesity, visceral fat accumulation, and ethnicity in children may confer negative, but independent, health risks.