全球精选文摘 - 青少年体力活动、体脂与胰岛素抵抗（稳态模式评估）之间的关系：欧洲青年人心脏研究

Associations between physical activity, body fat, and insulin resistance (homeostasis model assessment) in adolescents: The European Youth Heart Study

Rizzo NS, Ruiz JR, Oja L 2009/5/27 10:49:03

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Am J Clin Nutr, 2008,

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Abstract
Background:
More and better data are needed to understand the action of physical activity (PA) on insulin resistance and the concomitant relation with body fat in adolescence.

Objective:
We examined the relation between total PA and intensity levels with insulin resistance under special consideration of waist circumference and skinfold thickness.

Design:
This was a cross-sectional study of 613 adolescents (352 girls, 261 boys) with a mean (±SD) age of 15.5±0.5y from Sweden and Estonia. Total, low, moderate, and vigorous PA was measured by accelerometry. Body fat estimators included waist circumference and the sum of 5 skinfold thicknesses. Fasting insulin and glucose were measured, and insulin resistance was calculated according to the homeostasis model assessment (HOMA). Linear regression analysis and analysis of covariance were used to determine the association between PA and insulin resistance while considering body fat. All estimates were adjusted for sex, country, pubertal status, and indicators of body fat when applicable.

Results:
Total, moderate, and vigorous PA were inversely correlated with HOMA. Body fat estimators were positively correlated with HOMA. Significant contrasts in HOMA concentrations were seen when comparing the lower 2 tertiles with the upper tertile of PA indicators. Repeating the analysis with body fat estimators showed significant contrasts in HOMA concentrations when comparing the lower tertiles with the upper tertile.

Conclusion:
In view of an increase in obesity in young people, the results accentuate the role of PA in sustaining metabolic balance in adolescence and the potential benefit of an increase of time spent at higher PA levels for youth with relatively elevated amounts of body fat.

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高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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