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

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。

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

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 75 th 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 anthropometrie 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 sid students,with no significant change in serum inflammatory cytokines.