8～10岁超重肥胖儿童HOMA-IR指数分布及与人体成分的相关性研究

Distribution of HOMA-IR Index and Its Relationship with Body Composition in Overweight/Obesity Children Aged 8 to 10 Years

目的:探讨8~10岁超重肥胖儿童稳态胰岛素评估模型胰岛素抵抗(HOMA-IR)指数的分布及与人体成分等测量指标的关系。方法:以2018年北京市某小学8~10岁超重肥胖儿童为研究对象,采集人体测量指标(体质量、身高、体质量指数、腰臀比)、人体成分指标(肌肉量、去脂体重量、体脂肪、体脂百分比、内脏脂肪面积、基础代谢率),检测血液空腹血糖、胰岛素水平,采用HOMA-IR指数评估胰岛素抵抗。结果:共收集149名儿童,其中超重57名、肥胖92名;肥胖者体质量指数、腰臀比、体脂肪、体脂百分比、空腹胰岛素、内脏脂肪面积、HOMA-IR指数均显著高于超重者,两者空腹血糖比较无显著差异(P=0.108)。男生(109例)在肌肉量、去脂体重、基础代谢率方面大于女生(40例)(P<0.05)。48例(32.2%)儿童存在胰岛素抵抗状态(IR>4),且各检测指标均显著升高(P<0.001)。体质量指数、腰臀比、体脂肪、体脂百分比、内脏脂肪面积均与HOMA-IR指数呈显著正相关(P<0.001),其中腰臀比相关性最大(r=0.472)。结论:超重肥胖儿童HOMA-IR指数普遍偏高。HOMA-IR指数大于4时,体重、BMI、体脂肪、体脂百分比、内脏脂肪面积等显著增加。人体成分分析可用于超重肥胖儿童体格评估。

Objective To investigate the distribution of homeostasis model assessment-insulin resistance(HOMA-IR)index and its relationship with body composition in overweight/obesity children aged 8 to 10 years.Method We selected overweight/obesity children aged 8 to 10 years in one primary school of Beijing city,including anthropometric parameters(height,body weight,body mass index,waist-hip ratio),body composition parameters(soft lean mass,fat free mass,body fat mass,percent body fat,visceral fat area,basal metabolic rate),fasting blood glucose,fasting insulin and insulin resistance was evaluated by HOMA-IR index.Result Totally 149 children(n=109 for boys and n=40 for girls)were collected.The body mass index,waist-hip ratio,body fat mass,percent body fat,visceral fat area,fasting insulin and HOMA-IR index of obesity group(n=92)were significant higher than overweight group(n=57),but there was no difference in fasting blood-glucose.Except soft lean mass,fat free mass and basal metabolic rate,the other parameters were no significant difference between boys and girls.48 cases(32.2%)were insulin resistance state(IR>4).When HOMA-IR index surpassed 4,all parameters were significantly increased(P<0.001).Body mass index,waist-hip ratio,body fat mass,percent body fat,visceral fat area were positively related to HOMA-IR index(P<0.001),especially waist-hip ratio.Conclusion The HOMA-IR index in overweight/obesity children were increased.When HOMA-IR index surpassed 4,all parameters were significantly increased.The measurement of body composition plays an important role in overweight/obesity children.