Persistence of pre-diabetes in overweight and obese Hispanic children: association with progressive insulin resistance, poor beta-cell function, and increasing visceral fat.
Persistence of pre-diabetes in overweight and obese Hispanic children: association with progressive insulin resistance, poor beta-cell function, and increasing visceral fat.
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DOI：
10.2337/db08-0445
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发表时间：
2008-11
期刊：
影响因子：
7.7
通讯作者：
Weigensberg MJ
中科院分区：
文献类型：
--
作者：
Goran MI;Lane C;Toledo-Corral C;Weigensberg MJ
目的：研究超重和肥胖西班牙裔2型糖尿病高危儿童危险因素的变化。研究设计和方法：我们招募了128名超重/肥胖的西班牙裔儿童，主要来自东洛杉矶的诊所，有2型糖尿病家族史。采用美国糖尿病协会定义糖尿病和前驱糖尿病的标准，每年对儿童进行口服葡萄糖耐量试验，持续4年。通过频繁取样的静脉葡萄糖耐量试验确定胰岛素敏感性（Si）、急性胰岛素反应（AIR）和β细胞功能（BCF），并在第1、2和4年通过双能x线吸收仪评估全身脂肪，通过磁共振成像评估腹腔内和皮下脂肪组织（IAAT和SAAT）。结果：没有受试者发展为2型糖尿病，40%从未有过糖尿病前期，47%有间歇性糖尿病前期，没有明确的模式，13%有持续性糖尿病前期。基线时，持续性糖尿病前期患者BCF较低，IAAT较高。在重复测量中，无论是否患有糖尿病前期，Si都出现恶化，糖尿病前期对AIR（糖尿病前期降低42%，P = 0.01）和处置指数（糖尿病前期降低34%，P = 0.021）有显著影响，糖尿病前期和时间对IAAT有显著的相互作用（糖尿病前期患者随时间增加较多，P = 0.034）。结论：在这组西班牙裔2型糖尿病高危儿童中，1)糖尿病前期每年变化很大；2)持续3年以上的糖尿病前期患病率为13%；3)由于较低的AIR和随着时间的推移内脏脂肪增加，持续性糖尿病前期儿童BCF较低。
OBJECTIVE—To examine changes in risk factors in overweight and obese Hispanic children at high risk of developing type 2 diabetes. RESEARCH DESIGN AND METHODS—We recruited 128 overweight/obese Hispanic children with a family history of type 2 diabetes primarily from clinics in East Los Angeles. Children were evaluated annually for 4 years with an oral glucose tolerance test, applying American Diabetes Association criteria to define diabetes and pre-diabetes. Insulin sensitivity (Si), acute insulin response (AIR) to glucose, and β-cell function (BCF) were determined from frequently sampled intravenous glucose tolerance tests, and total body fat by dual-energy X-ray absorptiometry and intra-abdominal and subcutaneous abdominal adipose tissue (IAAT and SAAT) by magnetic resonance imaging were assessed in years 1, 2, and 4. RESULTS—No subjects developed type 2 diabetes, 40% never had pre-diabetes, 47% had intermittent pre-diabetes with no clear pattern over time, and 13% had persistent pre-diabetes. At baseline, those with persistent pre-diabetes had lower BCF and higher IAAT. In repeated measures, Si deteriorated regardless of pre-diabetes, and there was a significant effect of pre-diabetes on AIR (42% lower in pre-diabetes; P = 0.01) and disposition index (34% lower in pre-diabetes; P = 0.021) and a significant interaction of pre-diabetes and time on IAAT (greater increase over time in those with pre-diabetes; P = 0.034). CONCLUSIONS—In this group of Hispanic children at high risk of type 2 diabetes, 1) pre-diabetes is highly variable from year to year; 2) the prevalence of persistent pre-diabetes over 3 years is 13%; and 3) children with persistent pre-diabetes have lower BCF, due to a lower AIR, and increasing visceral fat over time.
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影响因子：
7.7
作者：
Bergman, RN;Ader, M;Van Citters, G
通讯作者：
Van Citters, G
影响因子：
7.7
作者：
Marchesini, G;Brizi, M;Melchionda, N
通讯作者：
Melchionda, N
影响因子：
--
作者：
Goran, Michael I.;Shaibi, Gabriel Q.;Cruz, Martha L.
通讯作者：
Cruz, Martha L.
影响因子：
5.8
作者：
Seppälä-Lindroos, A;Vehkavaara, S;Yki-Järvinen, H
通讯作者：
Yki-Järvinen, H
影响因子：
5.1
作者：
BALDRIDGE, AD;PEREZATAYDE, AR;LAVINE, JE
通讯作者：
LAVINE, JE