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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 analyze insulin resistance in mountain children and its related factors. Methods One middle school and two primary schools were selected in the mountainous area of Longquan city. Two hundred and seventy children aged 10-15 years from 47 classes were randomly selected to measure body weight, height, waist circumference, blood pressure and blood glucose (FBG), insulin (FINS) Triglyceride (TG), high-density lipoprotein (HDL-C) and total cholesterol (TC) were measured and insulin resistance (IR) was defined by the 75% quantiles of the calculated insulin resistance index (HOMA- . Multivariate analysis of IR-related influencing factors. Results HOMAIR 75th percentile was 2.59. Univariate analysis showed that the correlation coefficients of HDL-C, TG, non-HDL-C, BMI, WC, SBP, DBP, FPG and HOMA-IR were all statistically significant except for age and gender Logistic regression analysis showed that the indexes (OR, 95% CI) significantly influencing on insulin resistance were WC (1.07,1.06 ~ 1.09), FPG (2.29,1.78-2.94), HDL-C (0.34,0.21 ~ 0.56) and TG (1.43, 1.14-1.78). Conclusion WC, FPG and TG may be risk factors for insulin resistance in obese children in mountainous areas. HDL-C may be a protective factor.