Fasting plasma glucose and insulin levels and their relationship to cardiovascular risk factors in children: Bogalusa Heart Study

Burke, Gregory L.; Webber, Larry S.; Srinivasan, Sathanur R.; Radhakrishnamurthy, B.; Freedman, David S.; Berenson, Gerald S.

doi:10.1016/0026-0495(86)90135-6

Cited by 131 publications

(54 citation statements)

References 20 publications

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“…The Bogalusa Heart Study was the first to show evidence of increased insulin resistance in African-American children compared with Caucasian children, based on measures of fasting insulin. 30 Goran et al 31 compared Caucasian, AfricanAmerican, and Hispanic children, and showed that Hispanic children are more insulin resistant than Caucasian children, independent of adiposity.…”

Section: Discussionmentioning

confidence: 99%

Insulin resistance and impaired glucose tolerance in obese children and adolescents referred to a tertiary-care center in Israel

et al. 2005

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OBJECTIVE:To establish the prevalence of insulin resistance and impaired glucose tolerance (IGT) and their determinants in a cohort of obese children and adolescents. METHODS: A retrospective design was used. The study group included 234 patients with a body mass index (BMI) greater than the 95th percentile for age and gender and 22 patients with a BMI between the 85th and 95th percentile for age and gender referred for evaluation to a major tertiary-care center in Israel. Ages ranged from 5 to 22 y. Estimates of insulin resistance (homeostatic model assessment (HOMA-IR)); insulin sensitivity (ratio of fasting glucose (GF) to fasting insulin (IF) (GF/IF), the quantitative insulin sensitivity check index (QUICKI)), and pancreatic b-cell function (HOMA-derived b-cell function (HOMA %B)) were derived from fasting measurements. An oral glucose tolerance test (OGTT) was performed in 192 patients to determine the presence of IGT. RESULTS: Insulin resistance was detected in 81.2% of the patients, IGT in 13.5%, and silent diabetes in one adolescent girl. Only two patients with IGT also had impaired fasting glucose (IFG). The prevalence of IGT was higher in adolescents than prepubertal children (14.7 vs 8.6%). GF/IF and QUICKI decreased significantly during puberty (Po0.005), whereas HOMA-IR and HOMA %B did not. Insulin resistance and insulin sensitivity indexes were not associated with ethnicity, presence of acanthosis nigricans or family history of type 2 diabetes. Patients with obesity complications had lower insulin sensitivity indexes than those without (P ¼ 0.05). Compared with subjects with normal glucose tolerance (NGT), patients with IGT had significantly higher fasting blood glucose (85.976.5 vs 89.2710.6 mg/dl, Po0.05), higher 2-h post-OGGT insulin levels (101.2774.0 vs 207.67129.7 mU/ml, Po0.001), a lower QUICKI (0.32370.031 vs 0.30970.022, Po0.05), and higher fasting triglyceride levels (117.4753.1 vs 156.9768.9, P ¼ 0.002). However, several of the fasting indexes except QUICKI failed to predict IGT. There was no difference between the group with IGT and the group with NGT in fasting insulin, HOMA-IR, HOMA %B or the male-to-female ratio, age, BMI-SDS, presence of acanthosis nigricans, ethnicity, and family history of type 2 diabetes. CONCLUSIONS: Insulin resistance is highly prevalent in obese children and adolescents. The onset of IGT is associated with the development of severe hyperinsulinemia as there are no predictive cutpoint values of insulin resistance or insulin sensitivity indexes for IGT, and neither fasting blood glucose nor insulin levels nor HOMA-IR or HOMA %B are effective screening tools; an OGTT is required in all subjects at high risk. Longitudinal studies are needed to identify the metabolic precursors and the natural history of the development of type 2 diabetes in these patients.

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Section: Discussionmentioning

confidence: 99%

Insulin resistance and impaired glucose tolerance in obese children and adolescents referred to a tertiary-care center in Israel

et al. 2005

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“…All variables except height, body weight and WHR showed some skewness in their distribution, and therefore logarithmic transformation was performed on them. A small constant (0.01) was added to the percentage of coronary plaques and macrophagesamm 2 …”

Section: Discussionmentioning

confidence: 99%

Visceral fat and coronary pathology in male adolescents

Kortelainen

Särkioja

2001

Int J Obes

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OBJECTIVE: To ®nd out whether coronary atherosclerotic lesions and their precursors in male adolescents are associated with the amount of mesenteric and omental fat. SUBJECTS: A series of 40 forensic autopsy cases of ante-mortem healthy boys of 13 ± 19 y of age were investigated. METHODS: Body height and weight, waist and hip circumferences and the thickness of the abdominal subcutaneous fat were measured, the body mass index (BMI) and waist-to-hip ratio (WHR) were calculated, and omental and mesenteric fat deposits were weighed. The intimal surface of the coronary arteries covered by lesions was measured by planimetry, and the thickness of the intima was measured by computerized image analysis. Intimal macrophage foam cells and smooth muscle cells were detected by immunohistochemisty, and macrophages were quanti®ed. RESULTS: The intima thickness of the left anterior descending artery (LAD) and in the thickest lesion varied signi®cantly across the tertiles of visceral fat when adjusted for age, being highest when the sum weight of omental and mesenteric fat exceeded 358 g. The intima thickness of the circum¯ex artery (CX) varied signi®cantly across the tertiles of waist circumference when adjusted for age. No statistically signi®cant associations with other indicators of obesity were found. Macrophage foam cells were present in the lesions and their maximal densityamm 2 correlated signi®cantly with intima thickness in the LAD and CX. The maximal density of macrophages in CX and the right coronary artery (RCA) and in the thickest lesion varied signi®cantly across the tertiles of visceral fat when adjusted for age, being highest when the amount of fat exceeded 358 g. The macrophage density also varied signi®cantly across the tertiles of waist circumference in all vessels. CONCLUSIONS:The results indicate that early macrophage-rich coronary lesions are associated with increased amounts of visceral fat in adolescent male individuals. This emphasizes the importance of effective prevention of weight gain in individuals with a tendency to accumulate visceral fat at an early age.

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“…16 The same group has more recently found in a biracial sample of 2856 boys and girls that fasting glucose and insulin were both simply correlated with systolic and diastolic BPs. 17 However, in their analysis limited to older children (ages 12-17 years), after adjusting for age and weight, only the correlation between systolic BP and fasting glucose remained statistically significant (partial correlation coefficient = 0.10, p<0.0001). Our Atlanta results based on only 32 black girls similarly demonstrate that systolic BP is more strongly correlated with fasting glucose than with fasting insulin.…”

Section: Discussionmentioning

confidence: 93%

Vertex-corrected blood pressure in black girls. Relation to obesity, glucose, and cations.

Kahn¹,

Bain²

1987

Hypertension

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SUMMARY Correlates of resting blood pressure (BP) were explored among 32 inner-city, black girls, ages 11.7 to 13.9 years, a sample drawn from the second and fourth quartiles of the BP distribution in an earlier school survey. Customary BP measurements in the seated position were corrected for the height of the arterial column extending from the BP cuff to the top (vertex) of each girl's head. This vertex correction procedure has previously been shown to eliminate the childhood association between mean arterial pressure and age. Vertex-corrected systolic BP was correlated individually (p<0.03) with serum fasting glucose, ionized calcium, sodium, and calculated osmolality. The BP association with serum glucose did not persist after an oral sucrose challenge. Vertexcorrected diastolic BP was correlated individually (jo<0.02) with serum ionized calcium and four indices of obesity, the best correlated of which was the subscapular skinfold (r = 0.66, p = 0.0001). Vertex-corrected BPs generally provided stronger correlations than customary (uncorrected) BPs with the variables of interest. Correlations with seated BPs were generally stronger than those with supine BPs. By multiple regression analysis, seated vertex-corrected systolic BP was related directly to serum fasting glucose and ionized calcium and inversely to pulse rate (Jt 2 = 0.53). Seated vertexcorrected diastolic BP was related directly to subscapular skinfold and calculated osmolality (R 2 = 0.54). Vertex correction may facilitate clinical or epidemiological studies of early hypertension. O UR interest in the childhood origins of primary hypertension led us to a cross-sectional, clinical study of 32 black girls ranging in age from 11.7 to 13.9 years. We systematically chose our sample from participants in a previous blood pressure (BP) survey of black schoolchildren in Atlanta, excluding subjects from the lowest quartile of their community's BP distribution. The resulting study population was considered likely to yield a substantial number of hypertensive adults in subsequent years.In this clinical study we explored correlations between the girls' average resting BPs and various measures of their obesity, glucose metabolism, and catFrom the Departments of Community Health (H.S. Kahn) and Biometry (R.P. Bain), Emory University School of Medicine, Atlanta, Georgia.Supported by grants from the Georgia Affiliate of the American Heart Association, the Emory University Research Fund, and the Clinical Research Center Program of the National Institutes of Health, U.S. Public Health Service (Grant 2-M01-RR00O39).Address for reprints: H.S. Kahn, M.D., 735 Gatewood Road, Emory University School of Medicine, Atlanta, GA 30322.Received May 6, 1986; accepted October 28, 1986. ions. We also probed the utility within this age range of correcting customary systolic and diastolic BP measurements for the height of the arterial column extending from the BP cuff to the top (vertex) of each subject's head. In the large school-based survey from which these girls were drawn (...

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Fasting plasma glucose and insulin levels and their relationship to cardiovascular risk factors in children: Bogalusa Heart Study

Cited by 131 publications

References 20 publications

Insulin resistance and impaired glucose tolerance in obese children and adolescents referred to a tertiary-care center in Israel

Insulin resistance and impaired glucose tolerance in obese children and adolescents referred to a tertiary-care center in Israel

Visceral fat and coronary pathology in male adolescents

Vertex-corrected blood pressure in black girls. Relation to obesity, glucose, and cations.

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