Association between age of life adversity and insulin resistance in girls with precocious puberty
-
摘要:
目的 探讨性早熟女童中早期成长逆境(ELA)与胰岛素抵抗指标甘油三酯-葡萄糖指数(TyG)的关联，为后续开展有效预防和干预措施提供科学依据。 方法 于2020年7月至2021年9月，在安徽省儿童医院儿童保健门诊招募性早熟女童，纳入有完整血液指标和问卷信息的性早熟女童150名。采用父母评估和儿童自我报告结合共同评估儿童早期成长逆境暴露情况，采集空腹血样评估TyG。根据ELA得分分类为0，1，≥2共3组，采用多元线性回归模型探索累积早期成长逆境与性早熟女童TyG指数的关联。 结果 性早熟女童主观报告的早期成长逆境暴露率高，ELA平均得分为(1.07±1.17)分，TyG平均水平为(7.99±0.49)。单一逆境关联发现，性早熟女童暴露于缺乏温暖抚育与TyG指数呈正相关(β=0.26，95%CI=0.03~0.50，P<0.05)。累积逆境关联发现，在未调整混杂因素前，与未经历早期成长逆境的女童相比，ELA≥2组的女童TyG水平增加(β=0.24，95%CI=0.04~0.43)；控制儿童年龄、母亲年龄、父亲年龄、体力活动、视屏时间、出生体重、出生方式(包括顺产和剖宫产)、自感压力，BMI标准化Z分和父母评估SDQ得分等协变量后，该关联仍有统计学意义(β=0.25，95%CI=0.04~0.46)(P值均<0.05)，且独立于BMI。 结论 性早熟女童的累积早期成长逆境与胰岛素抵抗指标TyG指数呈正相关。应尽早识别暴露于高ELA的性早熟女童，及时干预以改善其糖代谢功能。 Abstract:Objective To investigate the association between early life adversity(ELA) and the triglyceride-glucose (TyG) index for an indicator of insulin resistance among girls with precocious puberty, so as to provide scientific basis for effective prevention and intervention measures. Methods From July 2020 to September 2021, girls with precocious puberty were recruited from the children's health clinic of Anhui Provincial Children's Hospital. Among them, 150 girls with complete blood indicators and questionnaire information were included. Both parental reports and child self-reports were combined to assess ELA exposure. Fasting blood samples were collected to evaluate thetyg index. According to the ELA score classification, girls were classified into 3 groups for 0, 1 and >2, multiple linear regression analysis were conducted to examine the association between ELA exposure and TyG index in girls with precocious puberty. Results Precocious pubertal girls subjectively reported high rates of ELA exposure, with an average ELA score of (1.07±1.17) and an average TyG level of (7.99±0.49). A single adverse association was found that the exposure of girls with precocious puberty to a lack of warm nurturing was significantly positively correlated with the TyG index (β=0.26, 95%CI=0.03-0.50, P<0.05). Multiple linear regression analysis showed that girls in the ELA≥2 group had a 0.24 increase in TyG levels compared to girls who did not experience ELA (β=0.24, 95%CI=0.04-0.43). After controlling for covariates such as child age, mother's age, father's age, physical activity, screen time, birth weight, birth method (including natural and cesarean sections), perceived stress, BMI standardized Z-score, and parental assessment SDQ score, The association remained significant after controlling for covariates and was independent of BMI (β=0.25, 95%CI=0.04-0.46)(P<0.05). Conclusions Cumulative early life adversity in girls with precocious puberty is significantly positively correlated with the TyG index. It should early identify the girls exposed to high ELA for precocious puberty and timely intervent to improve their glucose metabolism function. -
Key words:
- Puberty, precocious /
- Life change events /
- Insulin resistance /
- Growth and development /
- Regression analysis /
- Child /
- Female
1) 利益冲突声明 所有作者声明无利益冲突。 -
早期成长逆境(early life adversity，ELA)暴露在全球范围内普遍存在且高度共存[1-2]，指个体在出生至成年期间经历的各种社会慢性应激，包括忽视、虐待、家庭功能失调三大类共10种逆境[3]，以及其后发展的其他逆境[4]。以生殖为导向的生命史策略提示ELA可能导致性发育提前[5-7]，性早熟女童的早期成长逆境值得关注。ELA会增加2型糖尿病的患病风险[8]，经历过4种及以上ELA的人患糖尿病的风险是未经历ELA者的2倍[3]。ELA与空腹血糖和葡萄糖耐量也密切相关[9]，并影响葡萄糖稳态和胰岛素功能[10]，导致成年早期[11]和成年后期2型糖尿病和代谢综合征发病风险升高[12-14]。胰岛素抵抗指胰岛素对葡萄糖摄取和利用的效率低于正常水平，是涵盖整个葡萄糖调节谱系的健康风险的重要指标[15]，与2型糖尿病的发病机制紧密关联[16]。甘油三酯-葡萄糖(triglyceride glucose，TyG)指数作为评估胰岛素抵抗的简单可靠的新型指标[17-18]，与金标准(高胰岛素-正葡萄糖钳夹)表现出极强的相关性，且适用于临床实践和大型流行病学研究[19-20]。本研究拟通过问卷评估性早熟女童的早期成长逆境暴露，利用TyG指数评估性早熟女童胰岛素抵抗水平，探讨性早熟女童中早期成长逆境与血糖调节紊乱的关联，为后续开展相应预防干预措施提供科学依据。
1. 对象与方法
1.1 对象
2020年7月至2021年9月，在安徽省儿童医院儿童保健科门诊招募性早熟女童，基于知情同意的原则，纳入有完整血液指标和问卷信息的性早熟女童150名。平均年龄为(8.11±1.04)岁。收集父母问卷和儿童问卷获得人口统计学资料、儿童早期出生因素、儿童早期成长逆境暴露等信息。本研究经安徽省儿童医院医学研究伦理委员会批准(批号：EYLL-2020-026)，并由儿童父母签署知情同意书。
1.2 方法
1.2.1 基本信息
儿童年龄、父母年龄、早期出生因素(出生体重、出生方式)、生活方式如体力活动、视屏时间等相关信息通过父母报告，儿童自感压力等信息由儿童自我评估。
1.2.2 体格检查
采用机械式身高坐高计测量身高，采用电子体重计测量体重，并计算儿童体质量指数(body mass index，BMI)，BMI=体重(kg)/[身高(m)]2。根据年龄分组后进行标准化，计算BMI Z分=[(实测值-均值)/标准差][21]。
1.2.3 早期成长逆境评估
本研究主要评估了8种早期成长逆境，包括严厉体罚、忽视、同伴欺凌、父母打架、父母离婚、缺乏温暖抚育、父母受教育程度低和家庭月收入低。(1)忽视经历通过改编自简明版童年期创伤量表(Childhood Trauma Questionnaire-Short Form，CTQ-SF)[22]，由儿童评估情感忽视、躯体忽视综合得到，即儿童报告经历过其中任1条目则视为经历过忽视。(2)使用自评父母养育态度与行为问卷对儿童进行访谈，评估温暖抚育状况，每个条目均使用李克特量表计分(0=没有、1=有时、2=经常、3=总是)，各条目计分之和为温暖抚育得分[23]，总分小于研究人群温暖抚育总分的P15则视为缺乏温暖抚育。(3)同伴欺凌、严厉体罚、父母离婚和父母打架情况由父母回答“是”或“否”进行报告。(4)父母的最高学历低于高中或同等学历则被归类为“父母受教育程度低”；家庭月收入<5 000元则定义为“家庭收入低”。将上述8种早期成长逆境进行“1=暴露”或“0=未暴露”二分类重编码，各类型ELA得分相加之和得到累积ELA得分，并进一步分类为“0”“1”“≥2”3个组进行后续统计分析。
1.2.4 胰岛素抵抗评估
收集患儿空腹血样，检测空腹血糖(fasting plasma glucose，FPG)和甘油三酯水平，通过公式：TyG=ln[甘油三脂(mg/dL)×血浆葡萄糖(mg/dL)÷2]计算TyG指数[17]。
1.2.5 协变量
父母版困难与长处问卷(Strengths and Diffculties Questionnaire，SDQ)采用问卷评估儿童SDQ得分，该问卷包含情绪问题、品行问题、多动问题、同伴交往问题和亲社会行为5个维度，共25个条目；采用0~2计分方法分(0=不符合、1=有点符合、2=完全符合)，总分0~50分。该问卷Cronbach α系数为0.78，重测相关系数为0.72，信、效度良好[24]。
1.3 质量控制
对医院现场病例收集调查人员进行集中培训，了解现场工作开展流程，熟悉问卷内容和填写规范，由现场调查人员进行一对一指导家长和女童的问卷填写，保证问卷填写质量。血样即采即检。问卷数据录入时认真仔细，对数据库进行系统的逻辑检查与核对并删除有明显逻辑错误的样本。
1.4 统计学方法
采用EpiData 3.1软件进行数据的双录入，使用SPSS 23.0软件与R软件进行统计分析。使用单因素方差分析比较TyG指数在不同逆境暴露组中的差异；使用零阶相关和多元线性回归分析检验特定逆境与性早熟女童TyG指数的关联，控制儿童年龄、父母年龄、体力活动、视屏时间、出生体重、出生方式、自感压力，BMI Z分和SDQ得分后，使用多元线性回归分析检验累积逆境评分(1=ELA得分为0，2=ELA得分为1，3=ELA得分≥2)与性早熟女童TyG指数的关联，所有检验均为双侧检验，以P<0.05为有统计学意义。
2. 结果
2.1 调查对象ELA和TyG基本情况
调查150名女童TyG平均水平为(7.99±0.49)，累积ELA的平均得分为(1.07±1.17)，早期成长逆境报告率高，近2/3的(91名)性早熟女童报告经历过一种及以上早期成长逆境，ELA为0，1，≥2组的女童TyG指数分别为(7.89±0.51，8.01±0.48，8.11±0.47)，差异无统计学意义(F=2.37，P > 0.05)，ELA为0与≥2组间差异有统计学意义(P=0.03)。
2.2 调查对象单一逆境与TyG指数的关联
仅缺乏温暖抚育与TyG指数间存在相关性(r=0.18，P<0.05)，其余单一逆境与TyG指数间相关均无统计学意义(P值均＞0.05)；在控制协变量后，仅缺乏温暖抚育与TyG指数存在正相关(β=0.26，95%CI=0.03~0.50，P<0.05)。见表 1，2。
表 1 未暴露组与暴露组女童TyG指数在单一早期成长逆境分组中的分布及零阶相关(x ±s)Table 1. The distribution and zero correlation of TyG index of girls in unexposed group and exposed group in single early growth adversity group(x ±s)变量 未暴露组 暴露组 r值 人数 x±s 人数 x±s 父母学历低 26 7.98±0.51 124 8.03±0.47 0.03 家庭收入低 29 7.98±0.51 121 8.04±0.45 0.05 父母离婚 11 7.98±0.49 139 8.14±0.59 0.09 父母打架 18 7.98±0.51 132 8.07±0.40 0.06 严厉体罚 17 7.99±0.50 133 8.01±0.44 0.01 忽视 7 7.98±0.50 143 8.11±0.46 0.05 同伴欺凌 31 7.97±0.50 119 8.10±0.49 0.11 缺乏温暖抚育 21 7.96±0.48 129 8.21±0.53 0.18* 注：*P<0.05。 表 2 单一早期成长逆境与TyG指数多元线性回归分析(n=150)Table 2. Multiple linear regression analysis of a single early growth adversity with a TyG index(n=150)自变量 β值(23395%CI) P值 父母学历低 0.14(-0.09~0.36) 0.23 家庭收入低 0.09(-0.12~0.31) 0.39 父母离婚 0.14(-0.17~0.46) 0.36 父母打架 0.07(-0.20~0.34) 0.62 严厉体罚 0.01(-0.26~0.28) 0.93 忽视 0.12(-0.28~0.51) 0.56 同伴欺凌 0.10(-0.12~0.31) 0.37 缺乏温暖抚育 0.26(0.03~0.50) 0.03 注：自变量缺乏温暖抚育以否为参照；多元线性回归分析调整了儿童年龄、父母年龄、体力活动、视屏时间、出生体重、出生方式、自感压力、BMI Z分和SDQ得分。 2.3 调查对象累积逆境与TyG指数的关联
在未控制协变量中，累积ELA得分与TyG指数存在正相关(β=0.08，95%CI=0.01~0.15)；控制协变量后，该关联依然存在且独立于BMI(β=0.08，95%CI=0.01~0.15)(P值均<0.05)。在未调整混杂因素模型中，与未经历早期成长逆境的女童相比，ELA≥2组的女童TyG水平增加(β=0.24，95%CI=0.04~0.43)；控制协变量后，该关联依然存在且不受BMI影响(β=0.25，95%CI=0.04~0.46)(P值均<0.05)。
3. 讨论
本研究结果表明，性早熟女童暴露于缺乏温暖抚育，且性早熟女童的累积早期成长逆境得分与TyG指数呈正相关，上述关联均独立于BMI。
研究发现，性早熟女童中累积早期逆境评分与TyG指数呈正相关，最近一项在大样本队列研究中发现ELA与成年早期的2型糖尿病患病风险升高的证据支持本研究结果[11]。一项在初级保健诊所的低收入少数患者中开展的研究结果发现，总逆境评分是2型糖尿病诊断的强有力预测因子，甚至超越年龄的影响[25]；在1 170名美国成年人中开展的研究发现，胰岛素抵抗指数与由家庭功能障碍、社会经济劣势和虐待等12种ELA评估的逆境暴露总分呈正相关[15]。Tosato等[26]研究发现，在仅经历童年期逆境和同时经历童年期逆境和近期生活压力事件的个体胰岛素水平较高；Li等[27]研究结果发现童年期逆境(通过CTQ问卷评估的总分)是糖尿病前期血糖调节紊乱。如口服葡萄糖耐量试验(oral glucose tolerance test，OGTT)曲线下葡萄糖面积高，胰岛素敏感性受损的独立危险因素。此外，本研究还发现与未经历过ELA的女童相比，经历2种及以上ELA的女童TyG水平升高，而未发现仅经历1种ELA的女童组与未经历过ELA的女童的TyG指数的显著差异。这一发现与以往多项重复逆境里程碑研究的结果一致，仅在ELA≥4组中发现了患任何糖尿病风险升高[3, 28-29]，在一项涵盖10个国家的研究中，经历1或2种ELA并不会增加患糖尿病的概率，但经历≥3种ELA组糖尿病风险会增加[30]。上述证据关注的均为健康结局，尚无研究探讨ELA与胰岛素抵抗等糖尿病前状态的阈值剂量关系，未来需要进一步探讨。
ELA作为一种慢性应激，其应激应答过程中的应激激素如糖皮质激素在维持由肝细胞介导的葡萄糖稳态中发挥着重要作用[31]，因此ELA往往会影响葡萄糖稳态和血糖调节过程[32]；ELA还会通过诱发慢性炎症[33-34]改变葡萄糖稳态和胰岛素敏感性[35-36]。与Wickrama等[37]在具有全国代表性的13 286名青少年样本中发现的BMI、抑郁症状和与压力相关健康行为共同介导早期逆境与糖尿病结局的关联不一致，本研究发现的关联独立于BMI；性早熟儿童更易出现不健康饮食行为(如饮食失调、暴饮暴食和饮食质量)和情绪障碍(如抑郁和焦虑)[38-40]，表明在性早熟女童中早期逆境与糖尿病结局更大程度上由情绪症状和健康行为介导。未来的研究需要进一步探讨早期成长逆境与心血管代谢之间的潜在机制，特别是生理机制。
本研究还发现，单一逆境中缺乏温暖抚育与TyG指数呈正相关，2015年Huang等[41]进行的一项大型综述发现在所有不同类型的童年创伤中，躯体和情感忽视而非虐待是2型糖尿病的最大风险因素。然而Zhu等[42]的荟萃分析结果显示，童年期经济逆境、虐待包括躯体性、性虐待、言语性和家庭成员监禁与糖尿病相关，忽视、情感虐待、家庭暴力、父母离婚或分居、父母死亡以及与药物滥用或精神障碍的家庭成员住在一起与糖尿病关联无统计学意义。研究之间的不一致可能是由于结局指标不一致造成的，2项Meta分析均关注健康结局，而本研究关注的是结局前期胰岛素抵抗状态。此外逆境间的共发生未被充分考虑，某些特定类型ELA的影响常会被其他更具影响ELA类型所掩盖。
此外本研究结果进一步支持了美国儿科学会的建议[43]，强调在性早熟女童的临床管理中纳入早期成长逆境筛查，同时加强相关临床工作人员对早期成长逆境的了解及其对健康的影响[44]。ELA作为一种可修饰因素，对其进行干预能及时终止逆境的生物嵌入，未来需要进一步了解早期成长逆境和胰岛素抵抗的关联，以定制干预措施。
本研究在性早熟女童中评估了胰岛素抵抗新型指标TyG指数，比胰岛素抵抗的稳态模型评估(Homeostatic Model Assessment of Insulin Resistance，HOMA-IR)指数更好地识别胰岛素抵抗[45]，通过父母自填和儿童访谈的形式评估了多种类型的ELA经历，减少了回忆偏倚；充分探讨了早期成长逆境与TyG的关系，扩展了之前的研究。本研究也存在局限性：首先，横断面分析不能确定因果关联，未来需进一步展开纵向研究；其次，研究样本量较小且研究对象大多来自安徽省，限制了结果的外推性；此外，通过回顾性自我报告和父母报告的方式获得ELA暴露信息，无法避免回忆偏倚，也未考虑逆境的时相、持续时间和严重程度，这些因素可能会影响二者的关联。综上所述，本研究结果表明，性早熟女童的累积早期成长逆境与胰岛素抵抗指标TyG指数呈正相关。本研究结果为改善性早熟女童糖代谢健康提供了新的视角，对于暴露于高ELA的个体，应尽早识别，及时干预以改善性早熟患儿的糖尿病结局。未来的研究需要进一步探讨早期成长逆境与糖代谢之间的潜在机制。
-
表 1 未暴露组与暴露组女童TyG指数在单一早期成长逆境分组中的分布及零阶相关(x ±s)
Table 1. The distribution and zero correlation of TyG index of girls in unexposed group and exposed group in single early growth adversity group(x ±s)
变量 未暴露组 暴露组 r值 人数 x±s 人数 x±s 父母学历低 26 7.98±0.51 124 8.03±0.47 0.03 家庭收入低 29 7.98±0.51 121 8.04±0.45 0.05 父母离婚 11 7.98±0.49 139 8.14±0.59 0.09 父母打架 18 7.98±0.51 132 8.07±0.40 0.06 严厉体罚 17 7.99±0.50 133 8.01±0.44 0.01 忽视 7 7.98±0.50 143 8.11±0.46 0.05 同伴欺凌 31 7.97±0.50 119 8.10±0.49 0.11 缺乏温暖抚育 21 7.96±0.48 129 8.21±0.53 0.18* 注：*P<0.05。 
下载: 导出CSV
表 2 单一早期成长逆境与TyG指数多元线性回归分析(n=150)
Table 2. Multiple linear regression analysis of a single early growth adversity with a TyG index(n=150)
自变量 β值(23395%CI) P值 父母学历低 0.14(-0.09~0.36) 0.23 家庭收入低 0.09(-0.12~0.31) 0.39 父母离婚 0.14(-0.17~0.46) 0.36 父母打架 0.07(-0.20~0.34) 0.62 严厉体罚 0.01(-0.26~0.28) 0.93 忽视 0.12(-0.28~0.51) 0.56 同伴欺凌 0.10(-0.12~0.31) 0.37 缺乏温暖抚育 0.26(0.03~0.50) 0.03 注：自变量缺乏温暖抚育以否为参照；多元线性回归分析调整了儿童年龄、父母年龄、体力活动、视屏时间、出生体重、出生方式、自感压力、BMI Z分和SDQ得分。
下载: 导出CSV
-
[1] LIN L, WANG H H, LU C, et al. Adverse childhood experiences and subsequent chronic diseases among middle-aged or older adults in China and associations with demographic and socioeconomic characteristics[J]. JAMA Netw Open, 2021, 4(10): e2130143. doi: 10.1001/jamanetworkopen.2021.30143 [2] WAN Y, CHEN R, MA S, et al. Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents[J]. Br J Psychiatry, 2019, 214(3): 146-152. doi: 10.1192/bjp.2018.263 [3] FELITTI V J, ANDA R F, NORDENBERG D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study[J]. Am J Prev Med, 1998, 14(4): 245-258. doi: 10.1016/S0749-3797(98)00017-8 [4] KOROTANA L M, DOBSON K S, PUSCH D, et al. A review of primary care interventions toimprove health outcomes in adult survivors of adverse childhood experiences[J]. Clin Psychol Rev, 2016, 46: 59-90. doi: 10.1016/j.cpr.2016.04.007 [5] KENRICK D T, GRISKEVICIUS V, NEUBERG S L, et al. Renovating the pyramid of needs: contemporary extensions built upon ancient foundations[J]. Perspect Psychol Sci, 2010, 5(3): 292-314. doi: 10.1177/1745691610369469 [6] CSATHÓ Á, BIRKÁS B. Early-life stressors, personality development, and fast lifestrategies: an evolutionary perspective on malevolent personality features[J]. Front Psychol, 2018, 9: 305. doi: 10.3389/fpsyg.2018.00305 [7] BAPTISTA A, CHAMBON V, HOERTEL N, et al. Associations between early life adversity, reproduction-oriented life strategy, and borderline personality disorder[J]. JAMA Psychiatry, 2023, 80(6): 558-566. doi: 10.1001/jamapsychiatry.2023.0694 [8] HUGHES K, BELLIS M A, HARDCASTLE K A, et al. The effect of multiple adverse childhood experiences on health: a systematic review and Meta-analysis[J]. Lancet Public Health, 2017, 2(8): e356-e366. doi: 10.1016/S2468-2667(17)30118-4 [9] MCCURLEY J L, MILLS P J, ROESCH S C, et al. Chronic stress, inflammation, and glucose regulation in U.S. Hispanics from the HCHS/SOL sociocultural ancillary study[J]. Psychophysiology, 2015, 52(8): 1071-1079. doi: 10.1111/psyp.12430 [10] BATRA A, CHEN L M, WANG Z, et al. Early life adversity and polygenic risk for high fasting insulin are associated with childhood impulsivity[J]. Front Neurosci, 2021, 15: 704785. doi: 10.3389/fnins.2021.704785 [11] ELSENBURG L K, BENGTSSON J, RIECKMANN A, et al. Childhood adversity and risk of type 2 diabetes in early adulthood: results from a population-wide cohort study of 1.2 million individuals[J]. Diabetologia, 2023, 66(7): 1218-1222. doi: 10.1007/s00125-023-05911-w [12] THOMAS C, HYPPÖNEN E, POWER C. Obesity and type 2 diabetes risk in midadult life: the role of childhood adversity[J]. Pediatrics, 2008, 121(5): e1240-e1249. doi: 10.1542/peds.2007-2403 [13] PUOLAKKA E, PAHKALA K, LAITINEN T T, et al. Childhood socioeconomic status in predicting metabolic syndrome and glucose abnormalities in adulthood: the cardiovascular risk in young finns study[J]. Diabetes Care, 2016, 39(12): 2311-2317. doi: 10.2337/dc16-1565 [14] RUTTERS F, PILZ S, KOOPMAN A D, et al. Stressful life events and incident metabolic syndrome: the Hoorn study[J]. Stress, 2015, 18(5): 507-513. doi: 10.3109/10253890.2015.1064891 [15] FULLER-ROWELL T E, HOMANDBERG L K, CURTIS D S, et al. Disparities in insulin resistance between black and white adults in the United States: the role of lifespan stress exposure[J]. Psychoneuroendocrinology, 2019, 107: 1-8. [16] 苏青, 臧丽. 胰岛素抵抗的历史、机制和管理[J]. 中华糖尿病杂志, 2023, 15(1): 6-13.SU Q, ZANG L. Insulin resistance: history, mechanisms and management[J]. Chin J Diabetes Mellitus, 2023, 15(1): 6-13. (in Chinese) [17] CHE B, ZHONG C, ZHANG R, et al. Triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio as potential cardiovascular disease risk factors: an analysis of UK biobank data[J]. Cardiovasc Diabetol, 2023, 22(1): 34. doi: 10.1186/s12933-023-01762-2 [18] 乔晶, 刘乙君, 王彦. 甘油三酯-葡萄糖指数与胰岛素抵抗相关代谢性疾病的关系[J]. 国际内分泌代谢杂志, 2022, 42(3): 223-226.QIAO J, LIU Y J, WANG Y. Relationship between triglyceride-glucose index and insulin resistance-related metabolic diseases[J]. Int J Endocrinol Metabol, 2022, 42(3): 223-226. (in Chinese) [19] GUERRERO-ROMERO F, SIMENTAL-MENDÍA L E, GONZÁLEZ-ORTIZ M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity comparison with the euglycemic-hyperinsulinemic clamp[J]. J Clin Endocrinol Metab, 2010, 95(7): 3347-3351. doi: 10.1210/jc.2010-0288 [20] GIANNINI C, SANTORO N, CAPRIO S, et al. The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds[J]. Diabetes Care, 2011, 34(8): 1869-1874. doi: 10.2337/dc10-2234 [21] 邵君, 孙毅, 尹小俭, 等. 中国日本儿童青少年体质量指数与体能指数的关系[J]. 中国学校卫生, 2019, 40(11): 1616-1619. doi: 10.16835/j.cnki.1000-9817.2019.11.005SHAO J, SUN Y, YlN X J, et al. Association between body mass index and physical fitness index in Chinese and Japanese children and adolescents[J]. Chin J Sch Health, 2019, 40(11): 1616-1619. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.11.005 [22] BERNSTEIN D P, STEIN J A, NEWCOMB M D, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire[J]. Child Abuse Negl, 2003, 27(2): 169-190. doi: 10.1016/S0145-2134(02)00541-0 [23] RAUDINO A, WOODWARD L J, FERGUSSON D M, et al. Childhood conduct problems are associated with increased partnership and parenting difficulties in adulthood[J]. J Abnorm Child Psychol, 2012, 40(2): 251-263. doi: 10.1007/s10802-011-9565-8 [24] 寇建华, 杜亚松, 夏黎明. 儿童长处和困难问卷(父母版)上海常模的信度和效度[J]. 上海精神医学, 2005, 17(1): 26-29. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI200501006.htmKOU J H, DU Y S, XIA L M. Reliabity and vaidity of Children's Strengths and Dificulties Questionnaire in Shanghai normal[J]. Shanghai Arch Psvchiatry, 2005, 17(1): 26-29. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI200501006.htm [25] LYNCH L, WAITE R, DAVEY M P. Adverse childhood experiences and diabetes in adulthood: support for a collaborative approach to primary care[J]. Contemp Fam Ther, 2013, 35(4): 639-655. doi: 10.1007/s10591-013-9262-6 [26] TOSATO S, BONETTO C, LOPIZZO N, et al. Childhood and adulthood severe stressful experiences and biomarkers related to glucose metabolism: a possible association?[J]. Front Psychiatry, 2021, 12: 629137. doi: 10.3389/fpsyt.2021.629137 [27] LI L, GARVEY W T, GOWER B A. Childhood maltreatment is an independent risk factor for prediabetic disturbances in glucose regulation[J]. Front Endocrinol (Lausanne), 2017, 8: 151. doi: 10.3389/fendo.2017.00151 [28] BELLIS M A, HUGHES K, LECKENBY N, et al. Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: a national survey[J]. J Public Health, 2015(3): 445-454. [29] ALMUNEEF M, QAYAD M, ALEISSA M, et al. Adverse childhood experiences, chronic diseases, and risky health behaviors in Saudi Arabian adults: a pilot study[J]. Child Abuse Negl, 2014, 38(11): 1787-1793. doi: 10.1016/j.chiabu.2014.06.003 [30] SCOTT K M, VON KORFF M, ANGERMEYER M C, et al. Association of childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions[J]. Arch General Psychiatry, 2011, 68(8): 838-844. doi: 10.1001/archgenpsychiatry.2011.77 [31] DE GUIA R M, ROSE A J, HERZIG S. Glucocorticoid hormones and energy homeostasis[J]. Horm Mol Biol Clin Invest, 2014, 19(2): 117-128. [32] SEAL S V, TURNER J D. The 'Jekyll and Hyde' of gluconeogenesis: early life adversity, later life stress, and metabolic disturbances[J]. Int J Mol Sci, 2021, 22(7): 3344. doi: 10.3390/ijms22073344 [33] FLOURI E, FRANCESCONI M, MIDOUHAS E, et al. Prenatal and childhood adversity and inflammation in children: a population-based longitudinal study[J]. Brain Behav Immun, 2020, 87: 524-530. doi: 10.1016/j.bbi.2020.01.024 [34] KOKOSI T, FLOURI E, MIDOUHAS E. Do upsetting life events explain the relationship between low socioeconomic status and systemic inflammation in childhood? Results from a longitudinal study[J]. Brain Behav Immun, 2020, 84: 90-96. doi: 10.1016/j.bbi.2019.11.013 [35] FACCHI J C, LIMA T A L, OLIVEIRA L R, et al. Perinatal programming of metabolic diseases: the role of glucocorticoids[J]. Metabolism, 2020, 104: 154047. doi: 10.1016/j.metabol.2019.154047 [36] ZANNAS A S, GORDON J L, HINDERLITER A L, et al. IL-6 response to psychosocial stress predicts 12-month changes in cardiometabolic biomarkers in perimenopausal women[J]. J Clin Endocrinol Metab, 2020, 105(10): e3757-e3765. doi: 10.1210/clinem/dgaa476 [37] WICKRAMA K A S, BAE D, O'NEAL C W. Explaining the association between early adversity and young adults' diabetes outcomes: physiological, psychological, and behavioral mechanisms[J]. J Youth Adolesc, 2017, 46(12): 2407-2420. doi: 10.1007/s10964-017-0639-y [38] MENDLE J, RYAN R M, MCKONE K M P. Age at menarche, depression, and antisocial behavior in adulthood[J]. Pediatrics, 2018, 141(1): e20171703. doi: 10.1542/peds.2017-1703 [39] DEARDORFF J, MARCEAU K, JOHNSON M, et al. Girls' pubertal timing and tempo and mental health: a longitudinal examination in an ethnically diverse sample[J]. J Adolesc Health, 2021, 68(6): 1197-1203. doi: 10.1016/j.jadohealth.2021.01.020 [40] CHEN C, CHEN Y, ZHANG Y, et al. Association between dietary patterns and precocious puberty in children: a population-based study[J]. Int J Endocrinol, 2018, 2018: 4528704. [41] HUANG H, YAN P, SHAN Z, et al. Adverse childhood experiences and risk of type 2 diabetes: a systematic review and Meta-analysis[J]. Metabolism, 2015, 64(11): 1408-1418. doi: 10.1016/j.metabol.2015.08.019 [42] ZHU S, SHAN S, LIU W, et al. Adverse childhood experiences and risk of diabetes: a systematic review and Meta-analysis[J]. J Glob Health, 2022, 12: 04082. doi: 10.7189/jogh.12.04082 [43] GARNER A S, SHONKOFF J P, Committee on Psychosocial Aspects of Child and Family Health, et al. Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health[J]. Pediatrics, 2012, 129(1): e224-e231. doi: 10.1542/peds.2011-2662 [44] LI J, YU Y, YUAN J, et al. Association between early life adversity and allostatic load in girls with precocious puberty[J]. Psychoneuroendocrinology, 2023, 152: 106101. doi: 10.1016/j.psyneuen.2023.106101 [45] SIMENTAL-MENDÍA L E, RODRÍGUEZ-MORÁN M, GUERRERO-ROMERO F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects[J]. Metab Syndr Relat Disord, 2008, 6(4): 299-304. doi: 10.1089/met.2008.0034 期刊类型引用(1)
1. 谢培琴，陈浩月，王红芳，向全永. 中学生超重肥胖与甘油三酯-葡萄糖指数的关系研究. 中国校医. 2025(03): 208-212 . 
百度学术其他类型引用(0)
-
下载:
点击查看大图
计量
- 文章访问数: 319
- HTML全文浏览量: 146
- PDF下载量: 18
- 被引次数: 1
