Persistence of the Metabolic Syndrome Over 3 Annual Visits in Overweight Hispanic Children: Association with Progressive Risk for Type 2 Diabetes
Received 6 December 2008; received in revised form 10 March 2009; accepted 3 April 2009. published online 25 June 2009.
Refers to article:
Prevalence and Trends of Metabolic Syndrome Among Korean Adolescents: From the Korean NHANES Survey, 1998-2005
, 25 June 2009
Mi Jung Park, Bruce A. Boston, Minkyoung Oh, Sun Ha Jee
The Journal of Pediatrics
October 2009 (Vol. 155, Issue 4, Pages 529-534.e1) Abstract |
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Objective
To examine an association between persistent metabolic syndrome (MetS) and the risk for type 2 diabetes in overweight Hispanic children.
Study design
A total of 73 subjects (mean age, 11.0 ± 1.7 years) from a longitudinal study were classified as Never (negative for MetS at all 3 annual visits), Intermittent (positive for MetS at 1 or 2 visits), or Persistent (positive for MetS at all 3 visits). Measures included dual-energy x-ray absorptiometry, magnetic resonance imaging, the 2-hour oral glucose tolerance test, and the frequently sampled intravenous glucose tolerance test.
Results
The Persistent group had a faster rate of fat mass gain than the Never group (20% vs 15% gain of baseline value; P < .05 for time∗group interaction [time = visit]). Independent of body composition, the Persistent group increased by 70% in insulin incremental area under the curve, whereas the other groups decreased (P < .05 for time∗group interaction). Despite no time∗group interactions for insulin sensitivity, acute insulin response, or disposition index, the Persistent group maintained 43% lower insulin sensitivity (P < .01) and by visit 2 had a 25% lower disposition index (P < .05) compared with the Never group.
Conclusions
Patients with persistent MetS had accelerated fat gain, increased insulin response to oral glucose, and decreased sensitivity and beta cell function, indicators of progressively greater risk for type 2 diabetes
aDepartment of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
bDepartment of Pediatrics, LAC + USC Medical Center, Los Angeles, CA
Reprint requests: Michael I. Goran, 2250 Alcazar Street, CSC 212, Los Angeles, CA 90089-2211.
Supported by grants from the National Institutes of Health (R01 DK 59211), the General Clinical Research Center's National Center for Research Resources (MO1 RR 00043), and the National Cancer Institute's Center for Transdisciplinary Research on Energetics and Cancer (U54 CA 116848).
ABSTRACT