Changes in insulin resistance and cardiovascular risk during adolescence: Establishment of differential risk in males and females
Changes in insulin resistance and cardiovascular risk during adolescence: Establishment of differential risk in males and females
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DOI：
10.1161/circulationaha.107.704569
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发表时间：
2008-05-06
期刊：
影响因子：
37.8
通讯作者：
Sinaiko, Alan R.
中科院分区：
文献类型：
--
作者：
Moran, Antoinette;Jacobs, David R., Jr.;Sinaiko, Alan R.
背景-在11至19岁的青少年中研究了胰岛素抵抗和心血管风险的发展变化。方法和结果-在明尼阿波利斯，明尼苏达州，学龄儿童的血压筛查后随机选择一个队列。对该队列进行了3次研究，对其兄弟姐妹进行了1次研究（对来自363个家庭的507名个体进行了996次观察）。正葡萄糖钳夹法测定胰岛素敏感性。从11岁到19岁，男女的体重指数和腰围增加相似。体脂含量男性降低，女性升高（P < 0.001）。男性的瘦体重以更快的速度增加（P < 0.0001）。男性在11岁时胰岛素抵抗较低，但稳定增加至19岁（P = 0.003）;相反，女性没有增加。因此，尽管在11岁时胰岛素抵抗较低，青春期肥胖减少，但到19岁时，男性比女性更具胰岛素抵抗性。男性的甘油三酯增加，高密度脂蛋白胆固醇降低，而女性的模式相反，这导致19岁时男性的甘油三酯较高，高密度脂蛋白胆固醇较低。低密度脂蛋白和总胆固醇没有性别差异.在两种性别中，收缩压均增加，但男孩的增加率更高（P = 0.03）。结论--在从童年晚期到青春期的过渡期，男性的胰岛素抵抗增加与甘油三酯增加和高密度脂蛋白胆固醇降低有关，尽管同时减少了体脂，而女性则相反。这些与性别相关的胰岛素抵抗的发育变化与肥胖、总胆固醇和低密度脂蛋白胆固醇的变化无关，与胰岛素抵抗在男性心血管风险增加中的早期作用一致。
Background - Developmental changes in insulin resistance and cardiovascular risk were studied in youths 11 to 19 years of age.Methods and Results - A cohort was randomly selected after blood pressure screening of Minneapolis, Minn, school children. Studies were done 3 times on this cohort and once on their siblings ( 996 observations on 507 individuals from 363 families). Insulin sensitivity was determined by euglycemic clamp. Body mass index and waist circumference increased similarly in both sexes from ages 11 to 19 years. Body fat decreased in males and increased in females ( P < 0.001). Lean body mass increased at a steeper rate in males ( P < 0.0001). Insulin resistance was lower in males at 11 years but increased steadily to 19 years ( P = 0.003); in contrast, it did not increase in females. Thus, despite being less insulin resistant at 11 years and decreasing in fatness during puberty, males became more insulin resistant than females by 19 years of age. Triglycerides increased in males and high- density lipoprotein cholesterol decreased, whereas the opposite pattern was seen in females, which resulted in higher triglycerides and lower high- density lipoprotein cholesterol in males at 19 years. No gender difference in low- density lipoprotein or total cholesterol was seen. Systolic blood pressure increased in both sexes but at a greater rate in boys ( P = 0.03).Conclusions - During the transition from late childhood through adolescence, insulin resistance in males increased in association with increased triglycerides and decreased high- density lipoprotein cholesterol, despite a concurrent reduction in body fatness, whereas the opposite occurred in females. These gender- related developmental changes in insulin resistance, which were independent from changes in fatness, total cholesterol, and low- density lipoprotein cholesterol, are consistent with an early role for insulin resistance in the increased cardiovascular risk found in males.