Insulin resistance determined by Homeostasis Model Assessment (HOMA) and associations with metabolic syndrome among Chinese children and teenagers.
Insulin resistance determined by Homeostasis Model Assessment (HOMA) and associations with metabolic syndrome among Chinese children and teenagers.
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DOI：
10.1186/1758-5996-5-71
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发表时间：
2013-11-15
影响因子：
4.8
通讯作者：
Mi J
中科院分区：
文献类型：
--
作者：
Yin J;Li M;Xu L;Wang Y;Cheng H;Zhao X;Mi J
本研究的目的是评估中国儿童和青少年胰岛素抵抗程度与代谢综合征不同组分之间的关系。此外，确定MS风险中胰岛素抵抗的稳态模型评估（HOMA-IR）的截止值。共招募了3203名6 ~ 18岁的中国儿童。测量人体测量和生化参数。代谢综合征（MS）通过修改的成人治疗组III（ATP III）定义确定。计算HOMA-IR指数并确定正常参考范围。采用受试者工作特征（ROC）分析，寻找HOMA-IR诊断MS的最佳截断值。随着胰岛素抵抗（HOMA-IR值的五分位数）的增加，MS或其相关组分的OR值显著增加。HOMA-IR最高五分位数的参与者被归类为代谢综合征的可能性是最低五分位数组的60倍。同样，胰岛素和HOMA-IR的平均值随着MS组分的数量而增加。目前的HOMA-IR截止点对应于我们的健康参考儿童的第95百分位数为3.0为整个参与者，2.6为儿童在青春期前阶段和3.2在青春期，分别。MS诊断的最佳点是2.3在总参与者中，1.7在青春期前的儿童和2.6在青春期的青少年，分别由ROC曲线，这产生了高灵敏度和中等特异性的筛选测试。根据HOMA-IR > 3.0，肥胖儿童和MS儿童胰岛素抵抗的患病率分别为44.3%和61.6%。我们的数据表明胰岛素抵抗在中国肥胖儿童和青少年中很常见，并且与MS风险密切相关，因此需要在生命早期考虑。作为胰岛素抵抗和MS风险评估的可靠指标，该队列中的最佳HOMA-IR截止点随青春期的变化而变化。HOMA-IR可用于早期评估儿童和青少年的胰岛素抵抗，并可用于预防和诊断治疗干预的长期获益。
The aim of this study is to assess the association between the degree of insulin resistance and the different components of the metabolic syndrome among Chinese children and adolescents. Moreover, to determine the cut-off values for homeostasis model assessment of insulin resistance (HOMA-IR) at MS risk. 3203 Chinese children aged 6 to 18 years were recruited. Anthropometric and biochemical parameters were measured. Metabolic syndrome (MS) was identified by a modified Adult Treatment Panel III (ATP III) definition. HOMA-IR index was calculated and the normal reference ranges were defined from the healthy participants. Receiver operating characteristic (ROC) analysis was used to find the optimal cutoff of HOMA-IR for diagnosis of MS. With the increase of insulin resistance (quintile of HOMA-IR value), the ORs of suffering MS or its related components were significantly increased. Participants in the highest quintile of HOMA-IR were about 60 times more likely to be classified with metabolic syndrome than those in the lowest quintile group. Similarly, the mean values of insulin and HOMA-IR increased with the number of MS components. The present HOMA-IR cutoff point corresponding to the 95th percentile of our healthy reference children was 3.0 for whole participants, 2.6 for children in prepubertal stage and 3.2 in pubertal period, respectively. The optimal point for diagnosis of MS was 2.3 in total participants, 1.7 in prepubertal children and 2.6 in pubertal adolescents, respectively, by ROC curve, which yielded high sensitivity and moderate specificity for a screening test. According to HOMA-IR > 3.0, the prevalence of insulin resistance in obese or MS children were 44.3% and 61.6% respectively. Our data indicates insulin resistance is common among Chinese obese children and adolescents, and is strongly related to MS risk, therefore requiring consideration early in life. As a reliable measure of insulin resistance and assessment of MS risk, the optimal HOMA-IR cut-off points in this cohort were developed with variation regarding puberty. HOMA-IR may be useful for early evaluating insulin resistance in children and teenagers and could have a long-term benefit of preventive and diagnostic therapeutic intervention.
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