上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (1): 16-.

• 专题报道（营养学研究） • 上一篇    下一篇

7～14岁学生HOMA-IR指数分布及与代谢综合征和炎症因子的关系

万燕萍1, 徐仁应1, 沈婉蓉1, 张晓敏1, 曹 丹1, 罗开莉1, 蔡 威2   

  1. 上海交通大学 医学院 1. 仁济医院临床营养科, 上海 200001；2. 新华医院临床营养中心, 上海 200092
  • 出版日期:2010-01-26 发布日期:2010-01-26
  • 作者简介:万燕萍（1960—）, 女, 主任医师, 教授, 硕士生导师；电子信箱: wanyp204@yahoo.com.cn。
  • 基金资助:

    上海市卫生局青年科研基金（2006Y28）；上海市科委科技攻关计划（064119518）

Distribution of HOMA-IR index and its relationship with metabolic syndrome and inflammatory cytokines in students aged 7 to 14 years

WAN Yan-ping1, XU Ren-ying1, SHEN Wan-rong1, ZHANG Xiao-min1, CAO Dan1, LUO Kai-li1, CAI Wei2   

  1. 1. Department of Clinical Nutrition, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China；2. Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
  • Online:2010-01-26 Published:2010-01-26
  • Supported by:

    Shanghai Municipal Health Bureau Foundation, 2006Y28；Shanghai Science and Technology Committee Foundation, 064119518

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摘要：

目的 探讨7～14岁学生稳态胰岛素评估模型胰岛素抵抗（HOMA-IR）指数的分布及与代谢综合征和炎症因子的关系。方法 采集366名7～14岁学生（男生163名，女生203名）的人体测量指标（体质量、身高、体质量指数、腰围、臀围、腰臀比）、血压、总体脂肪质量、脂肪比例、空腹血脂、空腹血糖和空腹血胰岛素等数据，检测血清肿瘤坏死因子（TNF-α）、C反应蛋白（CRP）和白介素-6（IL-6）等炎症因子水平，采用HOMA-IR指数评估胰岛素抵抗。结果 男、女学生的HOMA-IR指数第75百分位值分别为3.62和2.88。体质量、身高、体质量指数、腰围、臀围、总体脂肪质量和脂肪比例均与HOMA-IR指数呈显著正相关（P<0.01）。HOMA-IR指数超过第75百分位值，男、女学生的年龄、人体测量指标、总体脂肪质量、脂肪比例和收缩压显著增加（P<0.05），舒张压无显著变化；男生的血清TNF-α和IL-6水平显著增加（P<0.05），CRP水平无显著变化；但女生的血清TNF-α、IL-6和CRP水平均无显著变化。结论 HOMA-IR指数增高，男生的人体测量指标、总体脂肪质量、脂肪比例、血清TNF-α和IL-6水平等显著增加，女生仅表现为人体测量指标、总体脂肪质量和脂肪比例等增加，而血清炎症因子水平无显著变化。

关键词: 胰岛素抵抗, HOMA-IR指数, 炎症因子, 儿童青少年

Abstract:

Objective To investigate the distribution of homeostasis model assessment-insulin resistance (HOMA-IR) index and its relationship with metabolic syndrome and inflammatory cytokines in students aged 7 to 14 years. Methods The data of 366 students (n=163 for boys and n=203 for girls) aged 7 to 14 years were collected, including anthropometric parameters (height, body weight, body mass index, waist circumference, hip circumference and waist-hip ratio), blood pressure, total fat mass, fat proportion, fasting blood lipid, fasting blood glucose, fasting insulin and serum levels of inflammatory cytokines such as tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6), and insulin resistance was evaluated by HOMA-IR index. Results The 75th percentile of HOMA-IR index for boys and girls was 3.62 and 2.88, respectively. Body weight, height, body mass index, waist circumference, hip circumference, total fat mass and fat proportion were positively related to HOMA-IR index (P<0.01). When HOMA-IR index surpassed 75th percentile, age, anthropometric parameters, total fat mass, fat proportion and systolic blood pressure significantly increased in boy and girl students (P<0.05), no significant change occurred in diastolic blood pressure in boy and girl students, the levels of serum TNF-α and IL-6 significantly increased in boy students (P<0.05), while there was no significant change in level of CRP in boy students and levels of CRP, TNF-α and IL-6 in girl students. Conclusion The increase of HOMA-IR index leads to a dramatic increase of anthropometric parameters, total fat mass, fat proportion and serum TNF-α and IL-6 in boy students, while that results in the increase of anthropometric parameters, total fat mass and fat proportion in girl students, with no significant change in serum inflammatory cytokines.

Key words: insulin resistance, HOMA-IR index, inflammatory cytokines, children