Racial/Ethnic differences in clinical and biochemical type 2 diabetes mellitus risk factors in children
Disclosure: None of the authors have any conflict of interest related to this study.Michael Rosenbaum and Ilene Fennoy contributed equally to the preparation of this manuscript.
*Contributed equally to the preparation of this mauscript. †Dr. Shelov was at the Pediatrics, Infant's and Children's Hospital of Brooklyn at Maimonides at the time that he participated in these studies. He is currently at Winthrop University Hospital Children's Medical Center.
Funding agencies: The development and piloting of this project was supported by AMDeC, the Hannah and Ryan Barry Memorial Foundation, the Naomi Berrie Diabetes Research Center, Columbia Diabetes and Endocrinology Research Center (DERC, NIH P30 DK63068), Columbia University's; CTSA grant No. UL1TR000040; NCATS/NIH, Pediatric Endocrine grant NIH, NIDDK 5T 32DK 06552-07, New York State, and the Starr Foundation.
To examine whether periadolescent children demonstrate the significant racial/ethnic differences in body fatness relative to BMI and in the prevalence and relationship of body composition to risk factors for type 2 diabetes (T2DM) as in adults.
Design and Methods
Family history of obesity and T2DM, anthropometry, insulin sensitivity and secretory capacity, lipids, and cytokines (IL-6, CRP, TNF-α, and adiponectin) were examined in a cohort of 994 middle school students (47% male, 53%, female; 12% African American, 14% East Asian, 13% South Asian, 9% Caucasian, 44% Hispanic, and 8% other).
Fractional body fat content was significantly greater at any BMI among South Asians. There were racial/ethnic specific differences in lipid profiles, insulin secretory capacity, insulin sensitivity, and inflammatory markers corrected for body fatness that are similar to those seen in adults. Family history of T2DM was associated with lower insulin secretory capacity while family history of obesity was more associated with insulin resistance.
Children show some of the same racial/ethnic differences in risk factors for adiposity-related comorbidities as adults. BMI and waist circumference cutoffs to identify children at-risk for adiposity-related comorbidities should be adjusted by racial/ethnic group as well as other variables such as birthweight and family history.