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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Ximena Urrutia-Rojas, RN, DrPH1, Naveed Ahmad, MD2, Walter McConathy, PhD3, John A Menchaca, MD4, Craig Spellman, PhD, DO5, Andras Lacko, PhD6, Wendy Wadley, MPH7, Bhalchandra Kudchodkar, PhD5, and George Kudolo, MD8. (1) Department of Social and Behavioral Sciences, University of North Texas Health Science Center School of Public Health, 3500 Camp Bowie Blvd, Fort Worth, TX 76107-2699, 817-735-0325, xurrutia@hsc.unt.edu, (2) Biostatistics, University of North Texas Health Science Center School of Public Health, 3500 Camp Bowie Blvd, Fort Worth, TX 76107-2699, (3) Internal Medicine, University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, (4) Cook Children's Network, 709 West Leuda, Fort Worth, TX 76104, (5) University of N. Texas, Health Science Center at Fort Worth, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, (6) University ofN. Texas, Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, (7) Community Health, University of North Texas Health Science Center School of Public Health, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, (8) University of Texas Health Science Center, San Antonio, San Antonio, TX 78229
Children at risk for T2DM, using ADA screening criteria, and their siblings, were evaluated by physical exam, family history of T2DM, and fasting serum parameters. ADA screening criteria (BMI>85 percentile, and 2 of the following: diabetes family history, minority race/ethnicity, and signs/conditions associated with insulin resistance -AN, hypertension, dyslipidemia, PCOS. Children with AN (thick and darkened skin, usually around the neck, highly associated with hyperinsulinemia), AN+, n=85 and AN-, n=80 were compared. The prevalence of overweight/obesity was 69.4% for AN+ while only 15.4% for AN- (p<0.0001). BMI. Waist/hip ratio (p<0.0001), systolic/diastolic BP (p<0.002) were significantly higher in AN+ vs AN-. Fasting serum glucose was normal for all children while insulin was elevated in AN+ vs AN- (28.8±15.6 micro units/ml vs 14.7±8.4, mean±SD, p<0.0001). LDL-C and serum cholesterol were higher among the AN+. But not significant (p>0.15), while HDL-C was significantly lower (5.7mg/dl) in the AN+ group (p<0.001). The lower HDL-C in AN+ was associated with elevated triglycerides and a higher TC/HDL-C ratio compared to the AN- values (134.4±62.3 mg/dl vs 94.3 ± 53.9, p=0.0001; 4.1 ± 1.2 vs 3.4 ± 1.0, p<0.0001). The pattern of altered metabolic parameters observed in AN+ children in this study is similar to that seen in adults with metabolic syndrome, a condition with increased risk for both T2DM and CVD. The use of ADA screening criteria to identify children at risk for T2DM may be useful in identifying children at increased risk for CVD and point to a urgent need to screen children with AN.
Learning Objectives:
Keywords: Obesity, Children
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.