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Racial/ethnic differences in clinical and biochemical type 2 diabetes mellitus risk factors in children
Michael Rosenbaum1, Ilene Fennoy, Siham Accacha
1Pediatrics Department, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York, USA.
Insights
Children exhibit racial/ethnic disparities in body fatness and type 2 diabetes risk factors, similar to adults. Adjusting body mass index (BMI) and waist circumference thresholds by race/ethnicity is recommended for accurate risk assessment in youth.
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Human Genetics
Background:
- Adults display significant racial/ethnic differences in body fatness relative to BMI and in the prevalence of type 2 diabetes (T2DM) risk factors.
- Understanding these differences in periadolescent children is crucial for early identification and intervention.
Purpose of the Study:
- To investigate racial/ethnic variations in body fatness, body composition, and T2DM risk factors among periadolescent children.
- To determine if these variations mirror those observed in adult populations.
Main Methods:
- A cohort of 994 middle school students (diverse racial/ethnic backgrounds) underwent assessment of family history, anthropometry, insulin sensitivity/secretion, lipids, and inflammatory markers.
- Body fat percentage, BMI, and waist circumference were analyzed in relation to various metabolic and inflammatory markers.
Main Results:
- South Asian children had significantly higher body fat content relative to BMI compared to other groups.
- Racial/ethnic disparities in lipid profiles, insulin secretion, insulin sensitivity, and inflammatory markers, adjusted for body fat, were observed, mirroring adult patterns.
- Family history of T2DM was linked to reduced insulin secretion, while a family history of obesity correlated with increased insulin resistance.
Conclusions:
- Periadolescent children exhibit racial/ethnic differences in T2DM risk factors, consistent with adult findings.
- Recommendations include adjusting BMI and waist circumference cutoffs for identifying at-risk children based on racial/ethnic group, birth weight, and family history.
Objective:
To examine whether periadolescent children demonstrate the significant racial/ethnic differences in body fatness relative to BMI and in the prevalence and relationship of body composition to risk factors for type 2 diabetes (T2DM) as in adults.
Design And Methods:
Family history of obesity and T2DM, anthropometry, insulin sensitivity and secretory capacity, lipids, and cytokines (IL-6, CRP, TNF-α, and adiponectin) were examined in a cohort of 994 middle school students (47% male, 53%, female; 12% African American, 14% East Asian, 13% South Asian, 9% Caucasian, 44% Hispanic, and 8% other).
Results:
Fractional body fat content was significantly greater at any BMI among South Asians. There were racial/ethnic specific differences in lipid profiles, insulin secretory capacity, insulin sensitivity, and inflammatory markers corrected for body fatness that are similar to those seen in adults. Family history of T2DM was associated with lower insulin secretory capacity while family history of obesity was more associated with insulin resistance.
Conclusions:
Children show some of the same racial/ethnic differences in risk factors for adiposity-related comorbidities as adults. BMI and waist circumference cutoffs to identify children at-risk for adiposity-related comorbidities should be adjusted by racial/ethnic group as well as other variables such as birthweight and family history.
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