TY - JOUR
T1 - Cardiovascular risk factors in Mexican-American children at risk for type 2 diabetes mellitus (T2DM)
AU - Urrutia-Rojas, Ximena
AU - Menchaca, John
AU - Wadley, Wendy
AU - Ahmad, Naveed
AU - Lacko, Andras
AU - Bae, Sejong
AU - Spellman, Craig
AU - Kudchodkar, Bhalchandra
AU - Kudolo, George
AU - McConathy, Walter
N1 - Funding Information:
We appreciate the technical support of Sulabha Paranjape. Funds to support this study were provided in part by funds of the UNTHSC and Bristol Myers Squibb.
PY - 2004/4
Y1 - 2004/4
N2 - Purpose To assess risk factors for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) with the hypothesis that risk for T2DM in children would be associated with an increase in risk factors for CVD. Methods Subjects from a group of Mexican-American school children (aged 10-12 years) identified to be at risk for T2DM, and their siblings, were selected for this study. There were 68 children with acanthosis nigricans (AN+), and 71 without AN (AN-). Both AN+ and AN- children were assessed for T2DM and CVD risk factors. Probands and siblings were evaluated by physical examination, family history, and fasting serum parameters: glucose, insulin, body mass index (BMI), serum lipoproteins, and oxidized lipids. Data were analyzed by descriptive, univariate, and multivariate procedures. Results BMI, waist/hip ratio, systolic and diastolic blood pressure were all significantly higher (p < .002) in AN+, whereas Tanner stages were similar in both groups. Fasting serum glucose was in the normal range, whereas insulin was elevated in AN+ compared with AN- (30.0 ± 1.9 μU/mL vs. 14.8 ± 1.0 p < .0001). Insulin resistance as assessed by the homeostasis assessment model (HOMA-IR) was elevated in both groups, although higher among AN+ (p < .0001). High-density lipoprotein-cholesterol (HDL-C) was lower (6.2 mg/dL) in the AN+ group (p < .003). The lower HDL-C in AN+ was associated with elevated triglycerides and a higher serum total cholesterol TC/HDL-C ratio when contrasted with the AN- values (145.9 ± 7.6 mg/dL vs. 97.1 ± 0.07, p < .0001; 4.1 ± 0.2 vs. 3.4 ± 0.1, p < .0001, respectively). In addition to the high prevalence of overweight/obesity (BMI > 85th percentile) in this population (76.3%, 106/139), elevated insulin (59.7% >15 μU/mL), low HDL-C (27.3% <40 mg/dL), and elevated low-density lipoprotein cholesterol (LDL-C) (41.0% >100 mg/dL) were also detected. Conclusions: The altered metabolic pattern observed in this group of Mexican-American children is characteristic of metabolic syndrome, a condition associated with obesity and increased risk for both T2DM and CVD in adults. This study points to the value of BMI and acanthosis nigricans as easily accessible markers for children and nuclear families at increased risk for developing T2DM and CVD.
AB - Purpose To assess risk factors for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) with the hypothesis that risk for T2DM in children would be associated with an increase in risk factors for CVD. Methods Subjects from a group of Mexican-American school children (aged 10-12 years) identified to be at risk for T2DM, and their siblings, were selected for this study. There were 68 children with acanthosis nigricans (AN+), and 71 without AN (AN-). Both AN+ and AN- children were assessed for T2DM and CVD risk factors. Probands and siblings were evaluated by physical examination, family history, and fasting serum parameters: glucose, insulin, body mass index (BMI), serum lipoproteins, and oxidized lipids. Data were analyzed by descriptive, univariate, and multivariate procedures. Results BMI, waist/hip ratio, systolic and diastolic blood pressure were all significantly higher (p < .002) in AN+, whereas Tanner stages were similar in both groups. Fasting serum glucose was in the normal range, whereas insulin was elevated in AN+ compared with AN- (30.0 ± 1.9 μU/mL vs. 14.8 ± 1.0 p < .0001). Insulin resistance as assessed by the homeostasis assessment model (HOMA-IR) was elevated in both groups, although higher among AN+ (p < .0001). High-density lipoprotein-cholesterol (HDL-C) was lower (6.2 mg/dL) in the AN+ group (p < .003). The lower HDL-C in AN+ was associated with elevated triglycerides and a higher serum total cholesterol TC/HDL-C ratio when contrasted with the AN- values (145.9 ± 7.6 mg/dL vs. 97.1 ± 0.07, p < .0001; 4.1 ± 0.2 vs. 3.4 ± 0.1, p < .0001, respectively). In addition to the high prevalence of overweight/obesity (BMI > 85th percentile) in this population (76.3%, 106/139), elevated insulin (59.7% >15 μU/mL), low HDL-C (27.3% <40 mg/dL), and elevated low-density lipoprotein cholesterol (LDL-C) (41.0% >100 mg/dL) were also detected. Conclusions: The altered metabolic pattern observed in this group of Mexican-American children is characteristic of metabolic syndrome, a condition associated with obesity and increased risk for both T2DM and CVD in adults. This study points to the value of BMI and acanthosis nigricans as easily accessible markers for children and nuclear families at increased risk for developing T2DM and CVD.
KW - Acanthosis nigricans
KW - Body mass index
KW - Metabolic syndrome
KW - Prediabetic
UR - http://www.scopus.com/inward/record.url?scp=12144289112&partnerID=8YFLogxK
U2 - 10.1016/j.jadohealth.2003.07.005
DO - 10.1016/j.jadohealth.2003.07.005
M3 - Article
C2 - 15040998
AN - SCOPUS:12144289112
SN - 1054-139X
VL - 34
SP - 290
EP - 299
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 4
ER -