Insulin resistance syndrome in a representative sample of children and adolescents from Quebec, Canada
Insulin resistance syndrome in a representative sample of children and adolescents from Quebec, Canada
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DOI：
10.1038/sj.ijo.0802694
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发表时间：
2004-07-01
影响因子：
4.9
通讯作者：
Levy, E
中科院分区：
文献类型：
--
作者：
Lambert, M;Paradis, G;Levy, E
目的：估计胰岛素抵抗综合征（IRS）在青年代表性样本中的患病率。测试胰岛素抵抗（IR）和肥胖对代谢危险因素聚集的独立贡献。确定IRS的基本组成部分。研究肥胖和空腹血浆游离脂肪酸（FFA）水平之间的关系：方法：在1999年，我们进行了一项以学校为基础的调查，在加拿大魁北克的青年年龄为9，13和16岁的代表性样本。2244名受试者获得了特定的调查问卷数据、标准化临床测量结果和空腹血液样本。结果：在所有年龄性别组中，随着胰岛素四分位数的增加，肥胖指数、血压（BP）、血糖和甘油三酯（TG）显著升高，而高密度脂蛋白胆固醇（HDL-C）显著降低。IRS的总体患病率为11.5%（95%CI：10.2 - 12.9），IRS定义为高胰岛素血症合并两种或两种以上的危险因素，包括超重、高收缩压、空腹血糖受损、高TG和低HDL-C。IRS的患病率在不同年龄或性别之间没有显著差异。肥胖对危险因素聚集的独立贡献强于空腹胰岛素（或HOMA-IR）。因素分析显示，三个因素（BMI/胰岛素/脂质、BMI/胰岛素/葡萄糖和舒张压/收缩压）在不同年龄段一致，表明IRS的基础病理生理过程不止一种。虽然FFA的升高可能是肥胖与IR之间的因果关系，但我们没有检测到肥胖和空腹血浆FFA.CONCLUSION：IRS在青年中非常普遍，甚至在9岁的儿童中也是如此。因子分析确定了IRS内的三个生理领域，对IR和肥胖标志物具有统一作用。
OBJECTIVES: To estimate the prevalence of insulin resistance syndrome (IRS) in a representative sample of youth. To test for the independent contribution of insulin resistance (IR) and adiposity to clustering of metabolic risk factors. To identify the underlying components of IRS. To examine the relationship between adiposity and fasting plasma levels of free fatty acids (FFA).METHODS: In 1999, we conducted a school-based survey of a representative sample of youth aged 9, 13 and 16 y in Quebec, Canada. Age-specific questionnaire data, standardized clinical measurements and a fasting blood sample were available for 2244 subjects. Fasting insulin and HOMA were used as surrogate measures of IR.RESULTS: In all age - sex groups, adiposity indices, blood pressure ( BP), plasma glucose and triglycerides (TG) increased significantly with increasing insulin quartiles while HDL cholesterol (HDL-C) decreased. The overall prevalence of IRS defined as hyperinsulinaemia combined with two or more risk factors including overweight, high systolic BP, impaired fasting glucose, high TG and low HDL-C, was 11.5% (95% CI: 10.2 - 12.9). There were no significant differences in the prevalence of IRS across ages or between sexes. The independent contribution of adiposity to clustering of risk factors was stronger than that of fasting insulin ( or HOMA-IR). Factor analysis revealed three factors (BMI/insulin/lipids, BMI/insulin/ glucose and diastolic/systolic BP) consistent across ages suggesting that more than one pathophysiologic process underlies IRS. Although elevation of FFA might be in the causal pathway linking obesity to IR, we did not detect any consistent association between measures of fatness and fasting plasma FFA.CONCLUSION: IRS is highly prevalent in youth, even among children as young as age 9 y. Factor analysis identifies three physiologic domains within IRS with a unifying role for markers of IR and adiposity.