Prevalence of the metabolic syndrome among a racially/ethnically diverse group of U.S. eighth-grade adolescents and associations with fasting insulin and homeostasis model assessment of insulin resistance levels

Studies to Treat or Prevent Pediatric Type 2 Diabetes Prevention Study Group, R Jago, T Baranowski, J Buse, S Edelstein, P Galassetti, J Harrell, F Kaufman, B Linder, T Pham, F R Kaufman, T Baranowski, J Baranowski, A Canada, K Cullen, R Jago, M Missaghian, D Thompson, V Thompson, B Walker, D M Cooper, S Bassin, K Blackler, F Culler, D Ford, P Galassetti, J Harrell, R G McMurray, J Buse, M A Morris, K Kirby, K Hirst, S Edelstein, L El ghormli, S Grau, T Pham, L Pyle, B Linder, M Goran, K Resnicow, Studies to Treat or Prevent Pediatric Type 2 Diabetes Prevention Study Group, R Jago, T Baranowski, J Buse, S Edelstein, P Galassetti, J Harrell, F Kaufman, B Linder, T Pham, F R Kaufman, T Baranowski, J Baranowski, A Canada, K Cullen, R Jago, M Missaghian, D Thompson, V Thompson, B Walker, D M Cooper, S Bassin, K Blackler, F Culler, D Ford, P Galassetti, J Harrell, R G McMurray, J Buse, M A Morris, K Kirby, K Hirst, S Edelstein, L El ghormli, S Grau, T Pham, L Pyle, B Linder, M Goran, K Resnicow

Abstract

Objective: The purpose of this study was to report the prevalence of the International Diabetes Federation (IDF)-defined metabolic syndrome and its components among a cross-sectional sample of racially/ethnically diverse eighth grade youths and examine the association between the presence of the syndrome and participant fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) levels.

Research design and methods: Data were from a cross-sectional study with 1,453 racially/ethnically diverse eighth grade students from 12 middle schools in three U.S. states (Texas, North Carolina, and California). Height, weight, waist circumference, and blood pressure were recorded. Fasting blood samples were analyzed for triglycerides, HDL cholesterol, glucose, and insulin; HOMA-IR was calculated. Sex, race/ethnicity, and pubertal stage were self-reported. IDF criteria were used to determine the prevalence of the metabolic syndrome. The odds ratio for being classified with the syndrome was calculated by quintiles of fasting insulin and HOMA-IR.

Results: Of the sample, 138 students (9.5%) were classified with metabolic syndrome. Hispanics were more likely to have high abdominal adiposity and high triglycerides. Male adolescents were more likely to have high triglycerides, low HDL cholesterol, high blood pressure, and high fasting glucose. Participants in the highest insulin quintile were almost 200 times more likely to be classified with the syndrome than participants in the lowest quintile with comparable associations for HOMA-IR quintiles.

Conclusions: In a racially/ethnically diverse sample of U.S. adolescents, 9.5% of participants were identified with the metabolic syndrome using the IDF criteria. The likelihood of metabolic syndrome classification significantly increased with higher insulin and HOMA-IR values.

References

    1. Laaksonen DE, Lakka HM, Niskanen LK, Kaplan GA, Salonen JT, Lakka TA: Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol 156:1070–1077, 2002
    1. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288:2709–2716, 2002
    1. Kahn R, Buse J, Ferrannini E, Stern M: The metabolic syndrome: time for a critical appraisal. Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 48:1684–1699, 2005
    1. Morrison JA, Friedman LA, Wang P, Glueck CJ: Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later. J Pediatr 152:201–206, 2008
    1. Huang TT, Nansel TR, Belsheim AR, Morrison JA: Sensitivity, specificity, and predictive values of pediatric metabolic syndrome components in relation to adult metabolic syndrome: the Princeton LRC follow-up study. J Pediatr 152:185–190, 2008
    1. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH: Prevalence of a metabolic syndrome phenotype in adolescents: findings from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 157:821–827, 2003
    1. Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI: The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab 89:108–113, 2004
    1. de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N: Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 110:2494–2497, 2004
    1. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S: Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350:2362–2374, 2004
    1. Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S: The metabolic syndrome in children and adolescents. Lancet 369:2059–2061, 2007
    1. Ford ES, Li C, Zhao G, Pearson WS, Mokdad AH: Prevalence of the metabolic syndrome among U.S. adolescents using the definition from the International Diabetes Federation. Diabetes Care 31:587–589, 2008
    1. Stern MP, Haffner SM: Body fat distribution and hyperinsulinemia as risk factors for diabetes and cardiovascular disease. Arteriosclerosis 6:123–130, 1986
    1. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419, 1985
    1. STOPP-T2D Prevention Study Group: Presence of diabetes risk factors in a large U.S. eighth-grade cohort. Diabetes Care 29:212–217, 2006
    1. Petersen AC, Crockett L, Richards M, Boxer A: A self-report measure of pubertal status: reliability, validity, and initial norms. Youth Adol 17:117–133, 1988
    1. Greenbaum CJ, Sears KL, Kahn SE, Palmer JP: Relationship of β-cell function and autoantibodies to progression and nonprogression of subclinical type 1 diabetes: follow-up of the Seattle Family Study. Diabetes 48:170–175, 1999
    1. Fernandez JR, Redden DT, Pietrobelli A, Allison DB: Waist circumference percentiles in nationally representative samples of African-American, European-American and Mexican-American children and adolescents. J Pediatr 145:439–444, 2004
    1. Lee S, Bacha F, Gungor N, Arslanian S: Comparison of different definitions of pediatric metabolic syndrome: relation to abdominal adiposity, insulin resistance, adiponectin, and inflammatory biomarkers. J Pediatr 152:177–184, 2008
    1. Sharp TA, Grunwald GK, Giltinan KE, King DL, Jatkauskas CJ, Hill JO: Association of anthropometric measures with risk of diabetes and cardiovascular disease in Hispanic and Caucasian adolescents. Prev Med 37:611–616, 2003
    1. Cook S, Auinger P, Li C, Ford ES: Metabolic syndrome rates in United States adolescents, from the National Health and Nutrition Examination Survey, 1999–2002. J Pediatr 152:165–170, 2008
    1. Goran MI, Gower BA: Longitudinal study on pubertal insulin resistance. Diabetes 50:2444–2450, 2001
    1. Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, Kitzmiller J, Knowler WC, Lebovitz H, Lernmark A, Nathan D, Palmer J, Rizza R, Saudek C, Shaw J, Steffes M, Stern M, Tuomilehto J, Zimmet P: Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 26:3160–3167, 2003
    1. Robbins DC, Andersen L, Bowsher R, Chance R, Dinesen B, Frank B, Gingerich R, Goldstein D, Widemeyer HM, Haffner S, Hales CN, Jarett L, Polonsky K, Porte D, Skyler J, Webb G, Gallagher K: Report of the American Diabetes Association's Task Force on standardization of the insulin assay. Diabetes 45:242–256, 1996
    1. Mooy JM, Grootenhuis PA, de Vries H, Kostense PJ, Popp-Snijders C, Bouter LM, Heine RJ: Intra-individual variation of glucose, specific insulin and proinsulin concentrations: the Hoorn Study. Diabetologia 39:298–305, 1996

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