Development of insulin resistance and its relation to diet in the obese child
Development of insulin resistance and its relation to diet in the obese child
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DOI：
10.1007/s00394-007-0648-9
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发表时间：
2007-06-01
影响因子：
5
通讯作者：
Gil, Angel
中科院分区：
文献类型：
--
作者：
Canete, Ramon;Gil-Campos, Mercedes;Gil, Angel
在世界范围内，青少年肥胖症的发病率持续增加，约30%的肥胖儿童表现出胰岛素抵抗（IR）和其他代谢异常。本文综述了肥胖儿童IR的发生机制以及IR与儿童期和青春期饮食因素之间的可能联系。虽然血浆游离脂肪酸（FFA）及其在细胞内水平的对应物长链酰基辅酶A（LC酰基辅酶A）的浓度增加与儿童肥胖IR的早期发作有关，但一种新的内分泌范式表明脂肪组织分泌多种激素和细胞因子调节脂质能量代谢。这些激素变化先于代谢物如FFA和葡萄糖的任何变化，似乎与儿童早期IR有关。过量的热量摄入会增加儿童的IR;相反，通过低热量饮食实现的超重的大幅减少会降低IR。动物蛋白质的摄入量增加，特别是在生命早期，以及富含饱和脂肪酸、反式脂肪酸和n-6多不饱和脂肪酸的饮食，以及高碳水化合物/脂肪比的饮食，除了高血脂和低纤维饮食外，似乎也会加剧肥胖和IR。
The incidence rate of obesity in youth has continued to increase worldwide and about 30% of obese children display insulin resistance (IR) and other metabolic abnormalities. The present study reviews the mechanisms for development of IR in the obese child and possible links between IR and dietary factors in childhood and adolescence. Although increased concentrations of plasma free fatty acids (FFA) and their counter part at intracellular level, long-chain acyl-coenzyme A (LC acyl-CoA), have been related to the early onset of IR in childhood obesity, a new endocrine paradigm states that adipose tissue secretes a wide variety of hormones and cytokines that regulate lipid energy metabolism. These hormonal changes precede any changes in metabolites such as FFA and glucose and appear to be associated with early IR in childhood. Excessive caloric intake increases IR in children; opposite, substantial reduction of overweight achieved by a hypocaloric diet decreases it. Elevated consumption of animal protein, particularly in early life, as well as diets rich in saturated, trans, and n-6 polyunsaturated fatty acids, and diets with a high carbohydrate to fat ratio, besides a high glycaemic and low-fiber diet also appear to exacerbate adiposity and IR.