Persistence of the Metabolic Syndrome Over 3 Annual Visits in Overweight Hispanic Children: Association with Progressive Risk for Type 2 Diabetes

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

AIR, Acute insulin response to glucose, ANCOVA, Analysis of covariance, ANOVA, Analysis of variance, AUC, Area under the curve, BMI, Body mass index, DEXA, Dual-energy x-ray absorptiometry, DI, Disposition index, FSIVGTT, Frequently sampled intravenous glucose tolerance test, HDL, High-density lipoprotein, IAAT, Intra-abdominal adipose tissue, IAUC, Incremental area under the curve, MetS, Metabolic syndrome, MRI, Magnetic resonance imaging, OGGT, Oral glucose tolerance test, SAAT, Subcutaneous abdominal adipose tissue, SI, Insulin sensitivity, SOLAR, Study of Latino Adolescents at Risk for Diabetes