Influence of Adiposity on Insulin Resistance and Glycemia Markers Among UK Children of South Asian, Black African-Caribbean, and White European Origin Child Heart and Health Study in England
Influence of Adiposity on Insulin Resistance and Glycemia Markers Among UK Children of South Asian, Black African-Caribbean, and White European Origin Child Heart and Health Study in England
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DOI：
10.2337/dc12-1726
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发表时间：
2013-06-01
期刊：
影响因子：
16.2
通讯作者：
Wells, Jonathan C. K.
中科院分区：
文献类型：
--
作者：
Nightingale, Claire M.;Sattar, Naveed;Wells, Jonathan C. K.
南亚人和白色欧洲人之间2型糖尿病风险的种族差异起源于成年前，并且不能完全解释为南亚人的肥胖水平较高。虽然不同种族对肥胖的代谢敏感性可能不同，但这在儿童时期的研究很少。因此，我们研究了肥胖，胰岛素抵抗，以及不同种族的儿童中胰岛素抵抗标志物之间的关系。研究设计和方法-对4，633名9至10岁儿童的横断面研究（应答率68%）主要为南亚人、非洲-加勒比黑人和白色欧洲人（分别为1，266、1，176和1，109例）进行了胰岛素抵抗（HOMA-IR）、糖化血红蛋白（HbA（1c）和空腹血糖）和肥胖的稳态模型评估。（BMI，腰围，皮肤厚度，在所有种族群体中，所有肥胖测量与HOMA-IR正相关，但与非洲-加勒比黑人和白色欧洲人相比，南亚人的相关性更强。对于脂肪质量百分比增加1-SD，HOMA-IR的百分比差异分别为37.5%（95%CI 33.3-41.7）、29.7%（25.8-33.8）和27.0%（22.9-31.2）（P相互作用< 0.001）。在南亚人和非洲-加勒比黑人中，所有的肥胖标志物都与HbAic呈正相关，但在白色欧洲人中没有;对于脂肪质量百分比增加1-SD，HbA（1c）的百分比差异为0.04%（95% CI 0.03-0.06）、0.04%（0.02-0.05）和0.02%（-0.00至0.04）（P相互作用< 0.001）。空腹血糖模式不太一致。结论南亚儿童对肥胖代谢更敏感。早期预防或治疗儿童肥胖可能对预防2型糖尿病至关重要，特别是在南亚人中。
OBJECTIVE-Ethnic differences in type 2 diabetes risk between South Asians and white Europeans originate before adult life and are not fully explained by higher adiposity levels in South Asians. Although metabolic sensitivity to adiposity may differ between ethnic groups, this has been little studied in childhood. We have therefore examined the associations among adiposity, insulin resistance, and glycemia markers in children of different ethnic origins.RESEARCH DESIGN AND METHODS-Cross-sectional study of 4,633 9- to 10-year-old children (response rate 68%) predominantly of South Asian, black African-Caribbean, and white European origin (n = 1,266, 1,176, and 1,109, respectively) who had homeostasis model assessments of insulin resistance (HOMA-IR), glycemia markers (HbA(1c) and fasting glucose), and adiposity (BMI, waist circumference, skmfold thicknesses, and bioimpedance [fat mass]).RESULTS-All adiposity measures were positively associated with HOMA-IR in all ethnic groups, but associations were stronger among South Asians compared to black African-Caribbeans and white Europeans. For a 1-SD increase in fat mass percentage, percentage differences in HOMA-IR were 37.5% (95% CI 33.3-41.7), 29.7% (25.8-33.8), and 27.0% (22.9-31.2), respectively (P interaction < 0.001). All adiposity markers were positively associated with HbAic in South Asians and black African-Caribbeans but not in white Europeans; for a 1-SD increase in fat mass percentage, percentage differences in HbA(1c) were 0.04% (95% CI 0.03-0.06), 0.04% (0.02-0.05), and 0.02% (-0.00 to 0.04), respectively (P interaction < 0.001). Patterns for fasting glucose were less consistent.CONCLUSIONS-South Asian children are more metabolically sensitive to adiposity. Early prevention or treatment of childhood obesity may be critical for type 2 diabetes prevention, especially in South Asians.