Racial/ethnic discrepancies in the metabolic syndrome begin in childhood and persist after adjustment for environmental factors

Walker, S.E.; Gurka, Matthew J.; Oliver, M. Norman; Johns, D W; DeBoer, Mark D.

doi:10.1016/j.numecd.2010.05.006

Cited by 103 publications

(122 citation statements)

References 35 publications

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“…[9][10][11][12][13][14] This is a concern because non-Hispanic-black individuals have higher rates of T2DM and CVD despite low rates of ATP-III MetS diagnosis. [15][16][17][18][19] The recently developed MetS Severity Score (MetS z score) calculator addresses the epidemiologic limitations of the ATP-III criteria. 20,21 This tool accounts for differences in MetS by race/ethnicity and gender.…”

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confidence: 99%

Trends in Metabolic Syndrome Severity and Lifestyle Factors Among Adolescents

2016

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Trends in Metabolic Syndrome Severity and Lifestyle Factors Among Adolescents

2016

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“…17 However, racial/ethnic discrepancies in MetS may affect its relationship to NAFLD. Non-Hispanic black adolescents have a lower prevalence of MetS [24][25][26][27]18,[28][29][30] despite having more IR. 26,[31][32][33][34][35] Conversely, Hispanics have a higher prevalence of NAFLD despite similar rates of MetS.…”

Section: E718mentioning

confidence: 99%

“…26,[31][32][33][34][35] Conversely, Hispanics have a higher prevalence of NAFLD despite similar rates of MetS. 5,7,13,18,24,25 Given these intergroup differences, our goal was to assess relationships among MetS, IR, and NAFLD between racial/ ethnic groups. We evaluated adolescents from the NHANES for unexplained elevations in ALT as a potential marker for NAFLD.…”

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Ethnic Differences in the Link Between Insulin Resistance and Elevated ALT

DeBoer

Wiener²,

Barnes

et al. 2013

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Evaluating for elevations in alanine aminotransferase (ALT) is a common screening test for the presence of nonalcoholic fatty liver disease (NAFLD). NAFLD is less common among non-Hispanic blacks. Better predictors of NAFLD are needed to identify individuals in most need of screening. WHAT THIS STUDY ADDS:Relative to other ethnicities, metabolic syndrome and insulin resistance performed poorly at identifying non-Hispanic black adolescents with ALT elevations. The presence of metabolic syndrome may therefore not be an adequate trigger for NAFLD screening. Triglyceride elevations performed similarly between groups in identifying ALT elevations. abstract BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) exhibits tight links with insulin resistance (IR) and the metabolic syndrome (MetS), a cluster of cardiovascular risk factors. Compared with non-Hispanic whites, non-Hispanic black adolescents have more IR but a lower prevalence of NAFLD and MetS. Our hypothesis was that IR would be a better predictor of alanine aminotransferase (ALT) elevations than is MetS among non-Hispanic blacks. METHODS:We analyzed data from 4124 adolescents aged 12 to 19 years in the 1999 to 2010 NHANES, using unexplained elevations in ALT (.30 U/L) to characterize presumed NAFLD and using a pediatric adaptation of the Adult Treatment Panel III definition of MetS. RESULTS:Prevalence of elevated ALT varied by race/ethnicity (Hispanics 13.7%, non-Hispanic white 8.6%, non-Hispanic blacks 5.4%, P , .0001). Among non-Hispanic whites and Hispanics, a classification of MetS performed well in identifying adolescents with elevated ALT (odds ratios [ORs] 9.53 and 5.56, respectively), as did MetS-related indices. However, among non-Hispanic blacks, the association between MetS and ALT elevations was smaller in magnitude and technically nonsignificant (OR = 3.24, P = .051). Furthermore, among non-Hispanic blacks, the presence of IR and elevated waist circumference performed more poorly at identifying ALT elevations (ORs 3.93 and 2.28, respectively: significantly smaller than ORs for non-Hispanic whites, P , .05), with triglyceride elevations being a better predictor (OR = 4.44).CONCLUSIONS: Non-Hispanic black adolescents exhibit a lower relationship between IR and elevated ALT, supporting racial/ethnic differences in the link between MetS and NAFLD. These data may have implications regarding triggers for screening for NAFLD among nonHispanic black adolescents, focusing particularly on those with triglyceride elevations. Pediatrics 2013;132:e718-e726 KEY WORDS metabolic syndrome, visceral obesity, inflammation, racial/ethnic difference ABBREVIATIONS ALT-alanine aminotransferase BP-blood pressure GGT-g-glutamyl transferase HDL-C-high-density lipoprotein cholesterol HOMA-IR-homeostasis model of insulin resistance hsCRP-high-sensitivity C-reactive protein IR-insulin resistance MetS-metabolic syndrome NAFLD-nonalcoholic fatty liver disease OR-odds ratio WC-waist circumference Drs DeBoer, Wiener, and Barnes were involved in th...

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“…In humans, loss of homeostatic control can lead to toxic levels of blood glucose and the development of obesity and type 2 diabetes, diseases characterized by decreased ability to respond to and metabolize glucose. Twin, family, and epidemiological studies have demonstrated a significant genetic component for diseases of glucose toxicity (reviewed in Vimaleswaran and Loos 2010;Walker et al 2010). Genetic background can be thought of as setting a threshold for glucose toxicity, and environmental factors such as diet and physical activity determine whether an individual crosses that threshold.…”

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O-Linked-N-Acetylglucosamine Cycling and Insulin Signaling Are Required for the Glucose Stress Response inCaenorhabditis elegans

et al. 2011

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In a variety of organisms, including worms, flies, and mammals, glucose homeostasis is maintained by insulin-like signaling in a robust network of opposing and complementary signaling pathways. The hexosamine signaling pathway, terminating in O-linked-N-acetylglucosamine (O-GlcNAc) cycling, is a key sensor of nutrient status and has been genetically linked to the regulation of insulin signaling in Caenorhabditis elegans. Here we demonstrate that O-GlcNAc cycling and insulin signaling are both essential components of the C. elegans response to glucose stress. A number of insulin-dependent processes were found to be sensitive to glucose stress, including fertility, reproductive timing, and dauer formation, yet each of these differed in their threshold of sensitivity to glucose excess. Our findings suggest that O-GlcNAc cycling and insulin signaling are both required for a robust and adaptable response to glucose stress, but these two pathways show complex and interdependent roles in the maintenance of glucose-insulin homeostasis.

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Racial/ethnic discrepancies in the metabolic syndrome begin in childhood and persist after adjustment for environmental factors

Cited by 103 publications

References 35 publications

Trends in Metabolic Syndrome Severity and Lifestyle Factors Among Adolescents

Trends in Metabolic Syndrome Severity and Lifestyle Factors Among Adolescents

Ethnic Differences in the Link Between Insulin Resistance and Elevated ALT

O-Linked-N-Acetylglucosamine Cycling and Insulin Signaling Are Required for the Glucose Stress Response inCaenorhabditis elegans

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