title: A longitudinal study of serum insulin and insulin resistance as predictors of weight and body fat gain in African American and Caucasian children.
abstract: The influence of insulin and insulin resistance (IR) on children's weight and fat gain is unclear.
  
  
  
  To evaluate insulin and IR as predictors of weight and body fat gain in children at high risk for adult obesity. We hypothesized that baseline IR would be positively associated with follow-up body mass index (BMI) and fat mass.
  
  
  
  Two hundred and forty-nine healthy African American and Caucasian children aged 6-12 years at high risk for adult obesity because of early-onset childhood overweight and/or parental overweight were followed for up to 15 years with repeated BMI and fat mass measurements. We examined baseline serum insulin and homeostasis model of assessment-IR (HOMA-IR) as predictors of follow-up BMI Z-score and fat mass by dual-energy X-ray absorptiometry in mixed model longitudinal analyses accounting for baseline body composition, pubertal stage, sociodemographic factors and follow-up interval.
  
  
  
  At baseline, 39% were obese (BMI⩾95th percentile for age/sex). Data from 1335 annual visits were examined. Children were followed for an average of 7.2±4.3 years, with a maximum follow-up of 15 years. After accounting for covariates, neither baseline insulin nor HOMA-IR was significantly associated with follow-up BMI (Ps>0.26), BMIz score (Ps>0.22), fat mass (Ps>0.78) or fat mass percentage (Ps>0.71). In all models, baseline BMI (P<0.0001), body fat mass (P<0.0001) and percentage of fat (P<0.001) were strong positive predictors for change in BMI and fat mass. In models restricted to children without obesity at baseline, some but not all models had significant interaction terms between body adiposity and insulinemia/HOMA-IR that suggested less gain in mass among those with greater insulin or IR. The opposite was found in some models restricted to children with obesity at baseline.
  
  
  
  In middle childhood, BMI and fat mass, but not insulin or IR, are strong predictors of children's gains in BMI and fat mass during adolescence.
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
authors.forename: N M
authors.initials: NM
authors.lastname: Sedaka
authors.affiliation: Biostatistics Consulting Center, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Olsen
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Yannai
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
authors.forename: W E
authors.initials: WE
authors.lastname: Stutzman
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Krause
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
authors.forename: R
authors.initials: R
authors.lastname: Sherafat-Kazemzadeh
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Condarco
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Brady
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
authors.forename: A P
authors.initials: AP
authors.lastname: Demidowich
authors.affiliation: Nuclear Medicine Department, Hatfield Clinical Research Center, NIH, Bethesda, MD, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Reynolds
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.|Nutritional Sciences Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA.
authors.forename: S Z
authors.initials: SZ
authors.lastname: Yanovski
authors.affiliation: Nutritional Sciences Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA.|Division of Nutrition Research Coordination, NIH, Bethesda, MD, USA.
authors.forename: V S
authors.initials: VS
authors.lastname: Hubbard
authors.affiliation: Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Yanovski
mesh_terms: D000273:Adipose Tissue / Q000502:physiology*; D050154:Adiposity / Q000208:ethnology / Q000502:physiology*; D001741:Black or African American; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D015430:Weight Gain / Q000502:physiology*; D044465:White People
chemical_list: D007328:Insulin