Dietary risk factors for the development of insulin resistance in adolescent girls: a 3-year prospective study.
Dietary risk factors for the development of insulin resistance in adolescent girls: a 3-year prospective study.
复制标题
青春期女孩出现胰岛素抵抗的饮食危险因素：一项为期 3 年的前瞻性研究。
DOI：
10.1017/s1368980012004983
复制
发表时间：
2014
影响因子：
3.2
通讯作者：
Thompson,JaniceL
中科院分区：
文献类型：
--
作者：
White,James;Jago,Russell;Thompson,JaniceL
目的识别青春期胰岛素抵抗的危险因素，为早期预防提供有价值的信息。这项研究试图确定胰岛素抵抗和空腹血糖水平变化的危险因素。设计参加国家心肺血液研究所生长与健康研究的女孩前瞻性队列。背景：美国。受试者为青春期女孩(N 774)，年龄分别为16-17岁和18-19岁。在3年的时间里，测量空腹血糖、胰岛素和血清可替宁，并自我报告饮食摄入量(3d食物日记)、吸烟状况和体力活动水平。结果胰岛素抵抗(HOMA-IR)稳态模型评估的改善与从多不饱和脂肪(β=−3·33，95%CI−6·28，−0·39，P=0·03)和可溶纤维克(β=−5·20，95%CI−9·81，−0·59，P=0·03)摄取的能量百分比增加有关，胰岛素也有类似的发现。转化为肥胖与胰岛素(β=6·34，95%CI 2·78，9·91，P<；0·001)和HOMA-IR(β=28·77，95%CI 8·13，49·40，P=0.006)相关。16-17岁年龄段的血清可替宁浓度与空腹血糖浓度的大幅升高相关(β=15.43，95%可信区间6·09，24·77，P<；0.001)。结论增加来自多不饱和脂肪和纤维的能量百分比，避免过度体重增加和烟草暴露，可以显著降低青春期晚期胰岛素抵抗的风险。
Objective Identifying risk factors for insulin resistance in adolescence could provide valuable information for early prevention. The study sought to identify risk factors for changes in insulin resistance and fasting blood glucose levels. Design Prospective cohort of girls participating in the National Heart, Lung, and Blood Institute Growth and Health Study. Setting USA. Subjects Adolescent girls (n 774) assessed at the ages of 16–17 and 18–19 years. Over a 3-year period, measurements of fasting blood glucose and insulin and serum cotinine were taken, and dietary intake (3 d food diary), smoking status and physical activity levels were self-reported. Results Improvements in homeostasis model assessment of insulin resistance (HOMA-IR) were associated with increases in the percentage of energy intake from polyunsaturated fats (β = −3·33, 95 % CI −6·28, −0·39, P = 0·03) and grams of soluble fibre (β = −5·20, 95 % CI −9·81, −0·59, P = 0·03) between the ages of 16–17 and 18–19 years; with similar findings for insulin. Transitioning into obesity was associated with an increase in insulin (β = 6·34, 95 % CI 2·78, 9·91, P < 0·001) and HOMA-IR (β = 28·77, 95 % CI 8·13, 49·40, P = 0·006). Serum cotinine concentrations at 16–17 years, indicating exposure to tobacco, were associated with large increases (β = 15·43, 95 % CI 6·09, 24·77, P < 0·001) in fasting blood glucose concentrations. Conclusions Increases in the percentage of energy from polyunsaturated fat and fibre, and avoidance of excess weight gain and tobacco exposure, could substantially reduce the risk of insulin resistance in late adolescence.