Prevalence and determinants of insulin resistance among US adolescents - A population-based study
Prevalence and determinants of insulin resistance among US adolescents - A population-based study
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DOI：
10.2337/dc06-0709
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发表时间：
2006-11-01
期刊：
影响因子：
16.2
通讯作者：
Gurney, James G.
中科院分区：
文献类型：
--
作者：
Lee, Joyce M.;Okumura, Megumi J.;Gurney, James G.
目的-我们试图研究胰岛素的分布和胰岛素抵抗的稳态模型评估（HOMA-IR）以及HOMA-IR与性别、种族/民族、年龄和体重状况（通过BMI测量）在美国青少年中的相关性。902名12-19岁的青少年参加了1999-2002年的国家健康和营养检查调查，对全国代表性的1，802名无糖尿病的青少年，他们进行了空腹实验室测量。主要结果测量是HOMA-IR，计算从空腹胰岛素和葡萄糖和对数转换为多元线性回归analysis.Results -在调整回归模型，包括年龄和体重状态，女孩有较高的HOMA-IR比男孩和墨西哥裔美国儿童有较高的HOMA-IR水平比白色儿童。黑人和白色儿童之间校正后的HOMA-IR无显著差异。在校正比较中，肥胖儿童（BMI >=第95百分位数）的HOMA-IR水平显著高于正常体重儿童（BMI <第85百分位数）（平均HOMA-IR分别为4.93 [95%CI 4.56-5.35] vs. 2.30 [2.21-2.39]）。到目前为止，体重状况是胰岛素抵抗的最重要的决定因素，占HOMA-IR. The患病率的29.1%的变异胰岛素抵抗的肥胖青少年是52.1%（95%CI 44.5-59.8）结论-肥胖在美国青少年胰岛素抵抗的最重要的危险因素，独立于性别，年龄，或种族/民族。肥胖儿童胰岛素抵抗的流行预示着美国2型糖尿病负担的令人担忧的趋势。
OBJECTIVE - We sought to examine the distribution of insulin and homeostasis model assessment of insulin resistance (HOMA-IR) and associations of HOMA-IR with sex, race/ethnicity, age, and weight status, as measured by BMI, among U.S. adolescents.RESEARCH DESIGN AND METHODS - Of 4,902 adolescents aged 12-19 years who participated in the National Health and Nutrition Examination Survey 1999-2002, analysis was performed for a nationally representative subsample of 1,802 adolescents without diabetes who had fasting laboratory measurements. The main outcome measure was HOMA-IR, calculated from fasting insulin and glucose and log transformed for multiple linear regression analyses.RESULTS - in adjusted regression models that included age and weight status, girls had higher HOMA-IR than boys and Mexican-American children had higher HOMA-IR levels than white children. There were no significant differences in adjusted HOMA-IR between black and white children. Obese children (BMI >= 95th percentile) had significantly higher levels of HOMA-IR compared with children of normal weight (BMI < 85th percentile) in adjusted comparisons (mean HOMA-IR 4.93 [95% CI 4.56-5.35] vs. 2.30 [2.21-2.39], respectively). Weight status was by far the most important determinant of insulin resistance, accounting for 29.1% of the variance in HOMA-IR. The prevalence of insulin resistance in obese adolescents was 52.1% (95% CI 44.5-59.8).CONCLUSIONS - Obesity in U.S. adolescents represents the most important risk factor for insulin resistance, independent of sex, age, or race/ethnicity. The prevalence of insulin resistance in obese children foreshadows a worrisome trend for the burden of type 2 diabetes in the U.S.