METHODS: A secondary analysis was conducted on 2626 adolescents aged 12-19 years in United States. Abnormal glucose metabolism was defined as fasting plasma glucose ≥ 5.6 mmol/L or oral glucose tolerance test 2-h plasma glucose ≥ 7.8 mmol/L or glycohemoglobin A1c ≥ 5.7% or a previous diagnosis of diabetes. The HW phenotype was defined as triglyceride(TG) concentrations ≥ 1.47 mmol/L and waist circumference (WC) ≥ 90th percentile. The HWHtR phenotype was defined as TG concentrations ≥ 1.47 mmol/L and waist-to-height ratio (WHtR) ≥ 0.5.
RESULTS: 621(23.6%) adolescents had abnormal glucose metabolism. The prevalences of abnormal glucose metabolism were 22.7% and 40.6% in adolescents without and with HW phenotype. The prevalences of abnormal glucose metabolism were 22.4% and 38.6% in adolescents without and with HWHtR phenotype. Adolescents with HWHtR phenotype were more likely to have abnormal glucose metabolism (OR = 1.548, P = 0.010). The levels of homeostasis model assessment insulin resistance and β cell fuction index were higher in adolescents with HWHtR phenotype than in adolescents without HWHtR phenotype (P < 0.001).
CONCLUSIONS: The study demonstrates that HWHtR phenotype was closely associated with an increased risk of abnormal glucose metabolism in adolescents. Adolescents with HWHtR phenotype had worsen insulin resistance and increased insulin secretion as a result of compensation.
UNASSIGNED: The study provided a simple method, HWHtR phenotype, for evaluating the status of glucose metabolism in adolescents.
方法:对美国2626名12-19岁青少年进行了二次分析。葡萄糖代谢异常定义为空腹血糖≥5.6mmol/L或口服葡萄糖耐量试验2小时血糖≥7.8mmol/L或糖化血红蛋白≥5.7%或先前诊断为糖尿病。HW表型定义为甘油三酯(TG)浓度≥1.47mmol/L,腰围(WC)≥90百分位数。HWHtR表型定义为TG浓度≥1.47mmol/L,腰高比(WHtR)≥0.5。
结果:621(23.6%)青少年糖代谢异常。无HW表型和有HW表型的青少年糖代谢异常的发生率分别为22.7%和40.6%。在没有和具有HWHtR表型的青少年中,葡萄糖代谢异常的患病率分别为22.4%和38.6%。具有HWHtR表型的青少年更容易发生糖代谢异常(OR=1.548,P=0.010)。稳态模型评估胰岛素抵抗和β细胞功能指数在具有HWHtR表型的青少年中的水平高于无HWHtR表型的青少年(P<0.001)。
结论:研究表明,HWHtR表型与青少年糖代谢异常风险增加密切相关。具有HWHtR表型的青少年由于补偿而胰岛素抵抗恶化,胰岛素分泌增加。
未经评估:该研究提供了一种简单的方法,HWHtR表型,用于评估青少年葡萄糖代谢状况。