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J Pediatr. 2009 Oct;155(4):535-41. doi: 10.1016/j.jpeds.2009.04.008. Epub 2009 Jun 24.

Persistence of the metabolic syndrome over 3 annual visits in overweight Hispanic children: association with progressive risk for type 2 diabetes.

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1
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Abstract

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.

PMID:
19555970
PMCID:
PMC3709847
DOI:
10.1016/j.jpeds.2009.04.008
[Indexed for MEDLINE]
Free PMC Article
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