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目的了解福建省漳州市和广东省中山市儿童青少年中胰岛素抵抗指数(HOMA-IR)的分布情况。方法从福建省漳州市区和广东省中山市区分层随机抽取6~18周岁儿童青少年3102名[男孩1574名(50.74%),女孩1528名(49.26%)]进行横断面研究,分别测量其身高、体重、空腹血糖和空腹胰岛素并计算BMI和HOMA-IR。结果空腹血糖、空腹胰岛素水平在6~18周岁阶段随着年龄的增加逐渐增加,但性别差异无统计学意义;BMI随年龄增加而增加,12~15岁女孩的BMI高于同年龄段的男孩(P<0.05),16岁之后男孩的BMI高于女孩(P<0.05);HOMA-IR在6~12岁之间都随年龄的增加而增加,12岁之后,HOMA-IR指数处于高位,男女差异无统计学意义。结论空腹血糖、空腹胰岛素、HOMA-IR随年龄变化而变化,评价儿童胰岛素抵抗应基于不同年龄段该HOMA-IR的某一百分位数,而不是由单一切割值来确定。
Objective To investigate the distribution of insulin resistance index (HOMA-IR) among children and adolescents in Zhangzhou City, Fujian Province and Zhongshan City, Guangdong Province. Methods A total of 3102 adolescents aged 6-18 years (1574 boys (50.74%) and 1528 girls (49.26%) were randomly selected from the urban areas of Zhangzhou City and Zhongshan City of Guangdong Province] Height, weight, fasting blood glucose and fasting insulin and calculated BMI and HOMA-IR. Results Fasting plasma glucose and fasting insulin levels increased gradually with the increase of age at 6-18 years old, but there was no significant difference in gender. BMI increased with age, but BMI in 12-15 years old girls was higher than that in boys of same age (P <0.05). After 16 years of age, boys had higher BMI than girls (P <0.05). HOMA-IR increased with age between 6 and 12 years old. HOMA-IR index was high after 12 years old, No significant difference between men and women. Conclusion The fasting blood glucose, fasting insulin and HOMA-IR change with age. The assessment of children’s insulin resistance should be based on a certain percentile of HOMA-IR in different age groups rather than a single cut value.