Changes in risk variables of metabolic syndrome since childhood in pre-diabetic and type 2 diabetic subjects: the Bogalusa Heart Study.
Changes in risk variables of metabolic syndrome since childhood in pre-diabetic and type 2 diabetic subjects: the Bogalusa Heart Study.
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糖尿病前和2型糖尿病患者以来代谢综合征的风险变量的变化：Bogalusa心脏研究。
DOI：
10.2337/dc08-0898
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发表时间：
2008-10
期刊：
影响因子：
16.2
通讯作者：
Berenson, Gerald S.
中科院分区：
文献类型：
--
作者：
Nguyen, Quoc Manh;Srinivasan, Sathanur R.;Xu, Ji-Hua;Chen, Wei;Berenson, Gerald S.
目的——众所周知，2 型糖尿病与代谢综合征有关。然而，关于代谢综合征变量在 2 型糖尿病从儿童期到成年期发展过程中的长期不利变化的信息尚缺乏。研究设计和方法——对血糖正常（n = 1,838）、糖尿病前期（n = 90）和2型糖尿病（n = 60）受试者的社区队列进行回顾性观察，对儿童期（4-11岁）、青春期（12-18岁）和成年期（19-44岁）的心血管危险因素进行连续随访。结果：与血糖正常的受试者相比，糖尿病受试者的肩胛下皮褶、BMI、甘油三酯、葡萄糖、胰岛素和胰岛素抵抗的稳态模型评估水平显着较高，从儿童时期开始，HDL 胆固醇水平较低，而青春期和成年期的平均动脉压 (MAP) 水平较高。在包括BMI、MAP、HDL胆固醇、LDL胆固醇、甘油三酯、葡萄糖和胰岛素的多变量模型中，根据年龄、年龄2、种族、性别和种族×性别相互作用进行调整后，葡萄糖和LDL胆固醇的不良变化与糖尿病前期受试者独立相关，而BMI、葡萄糖和HDL胆固醇的不良变化与糖尿病前期受试者独立相关。 糖尿病受试者。作为年轻人，糖尿病前期和糖尿病组的肥胖、高血压、血脂异常、高胰岛素血症和代谢综合征的患病率显着较高。结论——这些研究结果表明，代谢综合征、肥胖和自儿童期以来加速的葡萄糖稳态测量等风险变量的不利水平是2型糖尿病早期自然史的特征，并强调了从儿童期开始对危险因素进行早期预防和干预的重要性。
OBJECTIVE—That type 2 diabetes is associated with the metabolic syndrome is known. However, information is lacking regarding the long-term and adverse changes of metabolic syndrome variables in the development of type 2 diabetes from childhood to adulthood. RESEARCH DESIGN AND METHODS—Observations were examined, retrospectively, in a community-based cohort of normoglycemic (n = 1,838), pre-diabetic (n = 90), and type 2 diabetic (n = 60) subjects followed serially for cardiovascular risk factors during childhood (4–11 years), adolescence (12–18 years), and adulthood (19–44 years). RESULTS—Diabetic subjects versus normoglycemic subjects had significantly higher levels of subscapular skinfold, BMI, triglycerides, glucose, insulin, and homeostasis model assessment of insulin resistance and lower levels of HDL cholesterol beginning in childhood and higher levels of mean arterial pressure (MAP) in adolescence and adulthood. In a multivariate model including BMI, MAP, HDL cholesterol, LDL cholesterol, triglycerides, glucose, and insulin, adjusted for age, age2, race, sex, and race × sex interaction, adverse changes in glucose and LDL cholesterol were independently associated with pre-diabetic subjects, whereas adverse changes in BMI, glucose, and HDL cholesterol were associated with diabetic subjects. As young adults, pre-diabetic and diabetic groups displayed a significantly higher prevalence of obesity, hypertension, dyslipidemia, hyperinsulinemia, and metabolic syndrome. CONCLUSIONS—These findings indicate that adverse levels of risk variables of metabolic syndrome, adiposity, and measures of glucose homeostasis accelerating since childhood characterize the early natural history of type 2 diabetes and underscore the importance of early prevention and intervention on risk factors beginning in childhood.
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