title: Early emergence of ethnic differences in type 2 diabetes precursors in the UK: the Child Heart and Health Study in England (CHASE Study).
abstract: BACKGROUND
  Adults of South Asian origin living in the United Kingdom have high risks of type 2 diabetes and central obesity; raised circulating insulin, triglyceride, and C-reactive protein concentrations; and low HDL-cholesterol when compared with white Europeans. Adults of African-Caribbean origin living in the UK have smaller increases in type 2 diabetes risk, raised circulating insulin and HDL-cholesterol, and low triglyceride and C-reactive protein concentrations. We examined whether corresponding ethnic differences were apparent in childhood.
  
  
  RESULTS
  We performed a cross-sectional survey of 4,796 children aged 9-10 y in three UK cities who had anthropometric measurements (68% response) and provided blood samples (58% response); ethnicity was based on parental definition. In age-adjusted comparisons with white Europeans (n = 1,153), South Asian children (n = 1,306) had higher glycated haemoglobin (HbA1c) (% difference: 2.1, 95% CI 1.6 to 2.7), fasting insulin (% difference 30.0, 95% CI 23.4 to 36.9), triglyceride (% difference 12.9, 95% CI 9.4 to 16.5), and C-reactive protein (% difference 43.3, 95% CI 28.6 to 59.7), and lower HDL-cholesterol (% difference -2.9, 95% CI -4.5 to -1.3). Higher adiposity levels among South Asians (based on skinfolds and bioimpedance) did not account for these patterns. Black African-Caribbean children (n = 1,215) had higher levels of HbA1c, insulin, and C-reactive protein than white Europeans, though the ethnic differences were not as marked as in South Asians. Black African-Caribbean children had higher HDL-cholesterol and lower triglyceride levels than white Europeans; adiposity markers were not increased.
  
  
  CONCLUSIONS
  Ethnic differences in type 2 diabetes precursors, mostly following adult patterns, are apparent in UK children in the first decade. Some key determinants operate before adult life and may provide scope for early prevention.
authors.affiliation: Division of Community Health Sciences, St George's, University of London, London, United Kingdom. p.whincup@sgul.ac.uk
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
authors.forename: Claire M
authors.initials: CM
authors.lastname: Nightingale
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Owen
authors.forename: Alicja R
authors.initials: AR
authors.lastname: Rudnicka
authors.forename: Ian
authors.initials: I
authors.lastname: Gibb
authors.forename: Catherine M
authors.initials: CM
authors.lastname: McKay
authors.forename: Angela S
authors.initials: AS
authors.lastname: Donin
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.forename: K George M M
authors.initials: KG
authors.lastname: Alberti
authors.forename: Derek G
authors.initials: DG
authors.lastname: Cook
mesh_terms: D044466:Asian People; D044383:Black People; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology* / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000378:metabolism; D014280:Triglycerides / Q000378:metabolism; D006113:United Kingdom; D044465:White People
chemical_list: D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D007328:Insulin; D014280:Triglycerides