Diabetes Care：肌肉心肺耐力可测胰岛素抵抗

　　《糖尿病护理》（Diabetes Care）杂志2013年4月11日在线发表的一项研究指出，对于青年人群胰岛素抵抗与β细胞功能受损的一级预防，肌肉耐力与心肺耐力（CRF）水平或可作为靶向观测指标。

　　研究者在317例来自欧洲青年心脏研究（European Youth Heart Study）的受试者中，分别评估其腹、背部等长肌肉力量以及CRF与葡萄糖代谢的各自独立相关性，以及肌肉耐力+ CRF与葡萄糖代谢的联合相关性。

　　研究者以应变测力计检测受试者等长背部舒张与腹部前屈时的最大自主收缩，以蹬车运动试验极限值评估CRF水平，以青少年至成年早期随访记录的空腹血浆胰岛素水平与空腹血糖水平预估胰岛素抵抗与β细胞功能。

　　结果显示，等长肌力每1个标准差（0.16N/kg）的改变，空腹胰岛素水平、HOMA-IR(胰岛素稳态评估模型)、HOMA-B（β细胞功能稳态评估模型）在青少年人群中的改变分别达到−11.3%、−12.2%和−8.9%（经CRF与个体化生活方式、统计学因素校正）。CRF结果与之类似，经全身或腹部肥胖校正后相关程度亦无改变。肌肉耐力+ CRF与空腹胰岛素水平、HOMA-IR、HOMA-B的联合相关性两者叠加。男女两性等长肌肉力量、CRF水平最高三分位者血糖水平最低。 

与胰岛素抵抗相关的拓展阅读：

• LRP16基因对胰岛素分泌和胰岛素抵抗的影响
• Diabetes Care：支链和芳香化氨基酸预测年轻人胰岛素抵抗
• Diabetes Care：胰岛素抵抗或致老年痴呆灰质萎缩和认知障碍
• AIM：睡眠不足可诱发脂肪细胞胰岛素抵抗
• Diabetes:高浓度硬脂酸导致胰岛素抵抗 更多信息请点击：有关胰岛素抵抗更多资讯

Independent and Combined Association of Muscle Strength and Cardiorespiratory Fitness in Youth With Insulin Resistance and β-Cell Function in Young Adulthood
OBJECTIVE
To examine the independent and combined association of isometric muscle strength of the abdomen and back and cardiorespiratory fitness (CRF) in youth with indices of glucose metabolism in young adulthood among boys and girls from the European Youth Heart Study.
RESEARCH DESIGN AND METHODS
We used data from a population-based prospective cohort study among youth followed-up for up to 12 years (n = 317). In youth, maximal voluntary contractions during isometric back extension and abdominal flexion were determined using a strain-gauge dynamometer and CRF was obtained from a maximal cycle ergometer test. Insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR]) and β-cell function (homeostasis model assessment of β-cell function [HOMA-B]) were estimated from fasting serum insulin and glucose that were obtained in youth and at follow-up in young adulthood.
RESULTS
For each 1-SD difference in isometric muscle strength (0.16 N/kg) in youth, fasting insulin, HOMA-IR, and HOMA-B in young adulthood changed with −11.3% (95% CI, −17.0 to −5.2), −12.2% (−18.2 to −5.7), and −8.9% (−14.4 to −3.0), respectively, in young adulthood after adjustment for CRF and personal lifestyle and demographic factors. Results for CRF were very similar in magnitude, and the magnitude of associations for both exposures was unchanged with additional adjustment for general or abdominal adiposity in youth. Combined associations of muscle strength and CRF with fasting insulin, HOMA-IR, and HOMA-B were additive, and adolescents in the highest sex-specific tertile for both isometric muscle strength and CRF had the lowest levels of these glucose metabolism outcomes.
CONCLUSIONS
Increasing muscle strength and CRF should be targets in youth primordial prevention strategies of insulin resistance and β-cell dysfunction.