title: Diabetes Status and Race are Associated with Cardiovascular Risk Markers in Obese Adolescents.
abstract: OBJECTIVE
  The objective of this study was to evaluate differences in cardiovascular disease (CVD) risk markers in obese adolescents based on diabetes status and race in order to improve risk-reduction intervention strategies.
  
  
  METHODS
  This was a retrospective, cross-sectional study of obese adolescents, age 10 to 21 years, who were evaluated at Children's of Alabama between 2000 and 2012. Subjects were classified by glycated hemoglobin (HbA1c) as having normoglycemia, prediabetes, or type 2 diabetes mellitus (T2DM).
  
  
  RESULTS
  There were a total of 491 African American (AA) or Caucasian American (CA) subjects. Body mass index was not different between HbA1c and racial groups. Compared to subjects with normoglycemia or prediabetes, subjects with T2DM had higher levels of total cholesterol (TC) (178.6 ± 43.8 mg/dL vs. 161.5 ± 32.5 mg/dL vs. 162.4 ± 30.6 mg/dL; P<.0001) and low-density-lipoprotein cholesterol (107.4 ± 39.2 mg/dL vs. 97.0 ± 31.0 mg/dL vs. 97.5 ± 26.9 mg/dL; P = .0073). Compared with AA subjects, CA subjects had lower high-density-lipoprotein cholesterol (HDL-C) levels (40.4 ± 10.4 mg/dL vs. 44.3 ± 11.9 mg/dL; P = .0005) and higher non-HDL-C levels (129.6 ± 36.2 mg/dL vs. 122.5 ± 37.5 mg/dL; P = .0490). Of the characteristics studied, HbA1c had the most significant positive association with dyslipidemia and was strongly correlated with both TC (β, 4.21; P<.0001) and non-HDL-C (β, 4.3; P<.0001).
  
  
  CONCLUSIONS
  Obese adolescents with T2DM have more abnormal lipoprotein profiles than those with normoglycemia or prediabetes. Obese CA adolescents have more abnormal lipids than obese AA adolescents. HbA1c was the characteristic most highly associated with abnormal lipoprotein profiles in our subjects. Our results show that CVD risk markers in obese adolescents vary by race and HbA1c concentration.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama.
authors.forename: Caroline W
authors.initials: CW
authors.lastname: Colvin
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama.
authors.forename: Ambika P
authors.initials: AP
authors.lastname: Ashraf
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Russell L
authors.initials: RL
authors.lastname: Griffin
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama.
authors.forename: Benjamin Tuanama
authors.initials: BT
authors.lastname: Diaz
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama.
authors.forename: Govardhana Rao
authors.initials: GR
authors.lastname: Yannam
authors.affiliation: University of Alabama School of Medicine, Birmingham, Alabama.
authors.forename: Joffre E
authors.initials: JE
authors.lastname: Johnson
authors.affiliation: University of Alabama School of Medicine, Birmingham, Alabama.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Lucas
authors.affiliation: Ross University School of Medicine, Dominica, West Indies.
authors.forename: Matthew
authors.initials: M
authors.lastname: Propst
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama.
authors.forename: Carroll M
authors.initials: CM
authors.lastname: Harmon
mesh_terms: D000293:Adolescent; D001741:Black or African American; D002318:Cardiovascular Diseases / Q000209:etiology*; D002648:Child; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000208:ethnology; D012189:Retrospective Studies; D044465:White People; D055815:Young Adult
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human