Early testing of insulin resistance: a tale of two lipid ratios in a group of 5th graders screened by the Coronary Artery Risk Detection in Appalachian Communities Project (CARDIAC Project).
Early testing of insulin resistance: a tale of two lipid ratios in a group of 5th graders screened by the Coronary Artery Risk Detection in Appalachian Communities Project (CARDIAC Project).
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胰岛素抵抗的早期测试：阿巴拉契亚社区冠状动脉风险检测项目（CARDIAC 项目）筛查的一组五年级学生的两种脂质比率的故事。
DOI：
10.1007/s12519-018-00225-z
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Neal,William
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文献类型：
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作者：
Mosimah,CharlesItuka;Lilly,Christa;Forbin,Awung-Njia;Murray,PamelaJ;Pyles,Lee;Elliot,Elloise;Neal,William
在西弗吉尼亚州，47%的五年级儿童超重或肥胖。关于儿童胰岛素抵抗的定义没有明确的共识，直接测量人群水平的胰岛素是昂贵的。本研究中进一步检查的两个拟议指标包括甘油三酯（TRIG）/高密度脂蛋白胆固醇（HDL-C）比值和TRIG/低密度脂蛋白（LDL-C）比值。本研究的目的是检查TRIG/HDL-C比值，TRIG/LDL-C比值和胰岛素抵抗之间的关系在五年级与黑棘皮病（AN）。空腹血糖和胰岛素水平只收集了一个小组的学生谁是AN阳性，并用于确定胰岛素抵抗的稳态模型（HOMA-IR）方程。统计分析包括t检验和logistic回归与受试者工作特征curved.ResultsOf学生评估为AN，4.5%（n= 2360）检测阳性。在1030例HOMA-IR患者中，胰岛素抵抗的患病率为79%（n= 814），TRIG/HDL-C比值和TRIG/LDL-C比值与胰岛素抵抗显著相关（TRIG/HDL-C：Est. = 0.36，P < 0.0001，AUC = 0.68; TRIG/LDL-C：Est. = 0.87，P < 0.0001，AUC = 0.69）。多因素分析显示，体重指数增加（Est. = 0.05，P < 0.0001），性别（Est. = 0.49，p < 0.0001）和TRIG/HDL-C比值结论TRIG/HDL-C比TRIG/LDL-C更能反映AN阳性儿童的胰岛素抵抗;因此，在人群水平上，可以获得胆固醇而不是胰岛素，用于儿童早期胰岛素抵抗的初步测试。
BackgroundIn West Virginia (WV), 47% of fifth-grade children are either overweight or obese. There is no clear consensus regarding the definition of insulin resistance in children, and directly measuring insulin on the population level is costly. Two proposed measures examined further in this study include triglyceride (TRIG)/high-density lipoprotein cholesterol (HDL-C) ratio and TRIG/low-density lipoprotein (LDL-C) ratio. The purpose of this study is to examine the relationship between TRIG/HDL-C ratio, TRIG/LDL-C ratio and insulin resistance in fifth-graders with acanthosis nigricans (AN).MethodsBetween 2007 and 2016, 52,545 fifth-grade students in WV were assessed for AN. Fasting glucose and insulin levels were collected only for a sub-group of students who were AN-positive and was used to determine insulin resistance using the Homeostatic Model for Insulin Resistance (HOMA-IR) equation. Statistical analysis includedttests and logistic regression with receiver operating characteristic curves.ResultsOf the students assessed for AN, 4.5% (n= 2360) tested positive. The prevalence of insulin resistance was 79% (n= 814) among 1030 with AN and complete HOMA-IR. TRIG/HDL-C ratio and TRIG/LDL-C ratio were significantly associated with insulin resistance (TRIG/HDL-C:Est. = 0.36,P< 0.0001, AUC = 0.68; TRIG/LDL-C: Est. = 0.87,P< 0.0001, AUC = 0.69). Multivariate analysis showed that increased body mass index (Est. = 0.05,P< 0.0001), gender (Est. = 0.49,p< 0.0001) and TRIG/HDL-C ratio (Est. = 0.21,P< 0.0001) were significantly associated with insulin resistance.ConclusionsTRIG/HDL-C is a better surrogate marker of insulin resistance in AN-positive children compared to TRIG/LDL-C ratio; so, on a population-level, cholesterol rather than insulin may be obtained for preliminary testing of early insulin resistance in children.