山区儿童胰岛素抵抗及相关因素分析

An analysis on the influencing factors of insulin resistance among children in the mountainous area

目的分析山区儿童胰岛素抵抗及其相关因素。方法在龙泉市山区选择1所中学和2所小学,随机抽取47个班级的10~15岁儿童2 125人,测量体重、身高、腰围、血压以及血糖（FBG）、血清胰岛素（FINS）、甘油三酯（TG）、高密度脂蛋白（HDL-C）和总胆固醇（TC）等指标,并用计算所得的胰岛素抵抗指数（HOMA-IR）的75%分位数定义有无胰岛素抵抗（IR）。用多因素分析与IR有关的影响因素。结果 HOMAIR第75百分位为2.59。单因素分析,除年龄、性别外,HDL-C、TG、non HDL-C、BMI、WC、SBP、DBP、FPG与HOMA-IR的相关系数均有统计学意义（P〈0.05）;多因素Logistic回归分析对胰岛素抵抗（IR）具有显著影响的指标（OR值,95%CI）依次有WC（1.07,1.06~1.09）、FPG（2.29,1.78~2.94）、HDL-C（0.34,0.21~0.56）和TG（1.43,1.14~1.78）。结论 WC、FPG和TG可能是山区肥胖儿童胰岛素抵抗的危险因素,HDL-C可能为保护因素。

Objective To explore the influencing factors of insulin resistance among children in the mountainous area.Methods One middle school and 2 primary schools in Longquan city were randomly selected,47 classes of schoolchildren aged 10- 15 years were selected. Weight,height,waist circumstance（ WC）,blood pressure,blood glucose（ FBG）,serum insulin（ FINS）,triglycerides（ TG）,high- density lipoprotein（ HDL- C） and total cholesterol（ TC） were determined. Influencing factors of insulin resistance were analyzed by univariate and multiple logistic regression analysis.Results A total of 2 125 students were enrolled in this study. The 75 th percentile of HOMA- IR was 2. 59 respectively.The univariate analysis showed that HOMA- IR was significantly associated with HDL- C,TG,non HDL- C,BMI,WC,SBP,DBP and FPG（ P〈0. 05）. The multiple logistic regression analysis showed that WC（ OR = 1. 07,95% CI = 1. 06-1. 09）,FPG（ OR = 2. 29,95% CI = 1. 78- 2. 94）,HDL- C（ OR = 0. 34,95% CI = 0. 21- 0. 56） and TG（ OR = 1. 43,95% CI = 1. 14- 1. 78） were the risk factors of insulin resistance. Conclusion WC,FPG,TG may be the risk factors of insulin resistance among children in the mountainous area,while HDL- C is the protective factor.