Evaluation of the insulin resistance syndrome in 5- to 10-year-old overweight/obese African-American children.
OBJECTIVE
To characterize the insulin sensitivity of overweight and obese 5- to 10-year-old (Tanner stage 1-3) African-American children screened for participation in a diabetes prevention study and to identify the association of insulin sensitivity with obesity, hyperlipidemia, and hypertension.


METHODS
Measures of insulin resistance (homeostasis model assessment) and insulin sensitivity (Matsuda and DeFronzo's whole-body insulin sensitivity) were calculated from a 2-h oral glucose tolerance test in 137 African-American children recruited into a diabetes prevention study. Measures of lipids (LDL, HDL, total cholesterol, and triglycerides), blood pressure, and body composition were obtained for a subset of the children.


RESULTS
In response to a glucose challenge, girls and older and heavier children produced significantly more insulin. As BMI increased, there was a statistically significant decrease in insulin sensitivity, particularly in girls. Insulin sensitivity was inversely correlated with increases in blood pressure, triglycerides, subcutaneous fat, the percentage of total body fat, and Tanner stage, but it was not correlated with LDL and HDL.


CONCLUSIONS
Reduced insulin sensitivity and the cluster of risk factors known as the insulin resistance syndrome (IRS) are already apparent in these overweight African-American children. Young African-American girls, in particular, already show evidence of hyperinsulinemia in response to a glucose load, suggesting that the early stages of metabolic decompensation that lead to type 2 diabetes are already occurring. Monitoring of those risk factors known to be part of IRS should become part of routine medical care for overweight or obese African-American children.
Young-Hyman
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Department of Pediatric Endocrinology, University of Maryland School of Medicine, Baltimore, Maryland, USA. dyoung@umaryland.edu
Schlundt
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Herman
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De Luca
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Counts
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D000273:Adipose Tissue / Q000033:anatomy & histology; D001741:Black or African American; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D001823:Body Composition; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003920:Diabetes Mellitus / Q000517:prevention & control*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008403:Mass Screening; D009765:Obesity / Q000503:physiopathology*; D010808:Physical Examination; D012044:Regression Analysis; D012885:Skinfold Thickness; D013714:Tennessee; D014280:Triglycerides / Q000097:blood; D014481:United States
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol