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Insulinemia in children at low and high risk of NIDDM
D J Pettitt1, P P Moll, W C Knowler
1Diabetes and Arthritis Epidemiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona 85014.
Insights
Pima Indian children exhibit higher fasting insulin levels than Caucasian children, indicating early susceptibility to non-insulin-dependent diabetes mellitus (NIDDM). This early hyperinsulinemia is a key predictor of future NIDDM development.
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Diabetes Research
Background:
- Fasting hyperinsulinemia with normoglycemia often signifies insulin resistance and heightened risk for non-insulin-dependent diabetes mellitus (NIDDM).
- Pima Indians have a high incidence of NIDDM, and hyperinsulinemia predicts its development in this population.
- Previous studies have not reported insulin concentrations in children with varying NIDDM risks.
Purpose of the Study:
- To compare fasting insulin concentrations in Pima Indian and Caucasian children.
- To investigate early indicators of NIDDM susceptibility in pediatric populations.
Main Methods:
- A comparative study of nondiabetic children aged 6-19 years.
- Fasting insulin concentrations were measured in Pima Indian children from Arizona and Caucasian children from Minnesota.
Main Results:
- Insulin levels varied significantly by age, sex, glucose concentration, and relative weight.
- Pima Indian children, both males and females, demonstrated significantly higher mean fasting insulin concentrations compared to Caucasian children, even after controlling for other factors (P < 0.001).
Conclusions:
- Pima Indian children present with elevated fasting insulin levels from a young age compared to their Caucasian peers.
- These findings suggest that susceptibility to NIDDM is evident in childhood through fasting hyperinsulinemia, serving as an early marker for the disease.
Objective:
Fasting hyperinsulinemia in the presence of normoglycemia usually indicates insulin resistance and is characteristic of populations at high risk for developing NIDDM. Hyperinsulinemia predicts the development of impaired glucose tolerance and NIDDM in Pima Indians, a population with a high incidence of NIDDM. Insulin concentrations in population-based samples of children who have different risks of developing NIDDM later in life have not been reported previously.
Research Design And Methods:
We compared fasting insulin concentrations in two populations of nondiabetic children, 6-19 yr of age: Pima Indians from southern Arizona and Caucasians from Minnesota.
Results:
Insulin concentration varied with age, sex, glucose concentration, and relative weight. Mean fasting insulin concentration was 140.3 pM in Pima Indian males, 94.4 pM in Caucasian males, 171.5 pM in Pima Indian females, and 107.1 pM in Caucasian females. For each sex, the mean fasting insulin concentration, controlled for age, glucose, and relative weight, was significantly higher in the Pima Indians than in the Caucasians (P < 0.001).
Conclusions:
From a young age, Pima Indian children have higher fasting insulin concentrations than Caucasian children. As hyperinsulinemia predicts subsequent NIDDM, these data suggest that the susceptibility to NIDDM is manifest at a young age as fasting hyperinsulinemia.