【摘要】 目的分析超重、肥胖儿童青少年黑棘皮症(AN)与胰岛素抵抗的关系,为诊断胰岛素抵抗提供临床线索。方法以2004年北京市儿童青少年代谢综合征调研中筛查出的1877例6～18岁超重和肥胖儿童青少年作为研究对象。测量体重指数、腰围,并检测空腹血糖、胰岛素和血脂水平,采用稳态模式评估(HOMA-IR)法,评价个体胰岛素抵抗状况。结果超重、肥胖儿童中黑棘皮症检出率分别为12·7%和26·3%;合并AN者的腰围、胰岛素、甘酰甘油(甘油三酯)、血压均分别显著高于单纯超重、肥胖者,肥胖合并AN者的高密度脂蛋白-胆固醇水平显著低于单纯肥胖者;超重、肥胖组中AN阳性者的HOMA-IR指数几何均值(P25～P75)分别为2·81(2·13～4·12)mU/L和3·69(2·53～5·34)mU/L,分别显著高于两组AN阴性者[2·03(1·45～3·01)mU/L;2·45(1·72～3·61)mU/L](P<0·001)。结论超过1/4的肥胖儿童罹患黑棘皮症;具有黑棘皮症表型特征的超重、肥胖儿童更容易出现代谢异常指标的改变,以及胰岛素抵抗程度的加重;黑棘皮症可以作为筛查胰岛素抵抗患儿的临床表型特征。更多还原

【Abstract】 Objective To explore the relationship between acanthosis nigricans(AN) and insulin resistance among overweight and obese children and adolescents with aim to supply clinical materials for diagnosis of insulin resistance.Methods Based on Beijing Child and Adolescent Metabolic Syndrome(BCAMS) study with BMI,waist circumference(WC) and blood pressure measured,the overweight and obese children were screened and fasting plasma glucose(FPG) and insulin(FPI),serum high-density lipoprotein cholesterol(HDL-C) and triglyceride(TG) were examined.HOMA-IR index was calculated for estimating individual insulin resistance.Results The prevalence rates of AN among overweight and obesity groups were 12.7% and 26.3%,respectively,and their WC,FPI,TG and blood pressure were significantly higher than those without AN,but HDL-C in obesity group with AN was significantly lower than that without AN.The geometric means(P25～P75) of HOMA-IR index among overweight and obese children with AN were 2.81(2.13～4.12)mU/L and 3.69(2.53～5.34)mU/L,respectively,significantly higher than those without AN [2.03(1.45～3.01)mU/L;2.45(1.72～3.61)mU/L](P<0.001).Conclusion More than one quarter of Beijing obese children suffer from AN.Acanthosis nigricans,as the skin feature of insulin resistance,can provide clinical clues for screening insulin resistance in overweight and obese children.更多还原