Children Of Diabetics Show Increased Adiposity,
Rapidly Progressing Insulin Resistance
Fifteen percent of the children of parents with diabetes
showed hyperinsulinemia indicating insulin resistance
compared to 8% of controls.
The researchers, from Tulane University Health
Sciences Center, New Orleans, United States,
enrolled 303
children aged between 4 and 17 years whose parents
showed type 2 diabetes, as well as 1,136 controls
without a family history of diabetes. The children
were followed for a mean of 15 years.
The children of parents with diabetes showed increased
generalized and truncal adiposity, body mass index
(BMI), and subscapular skin fold thickness compared
to controls. The increase adiposity emerged during
childhood.
Moreover, the offspring of diabetics showed increased
fasting insulin and glucose levels as well as higher
values on the homeostasis model assessment index
of insulin resistance (HOMA-IR). These differences
emerged during adolescence. As adults, these children
expressed higher concentrations of low-density lipoprotein
(LDL) cholesterol and triglycerides as well as lower
levels of high-density lipoprotein (HDL) cholesterol.
Many of these risk factors worsened more rapidly
in the offspring of diabetics.
In multivariate analysis, parental diabetes independently
predicted changes in adiposity, glucose, insulin,
HOM-IR, systolic and diastolic blood pressure, and
LDL cholesterol in the children. These associations
remained regardless of race and gender. As young
adults, offspring of diabetic parents were more likely
to show generalized and visceral obesity than controls.
So 36 and 15% of the offspring of diabetic parents
showed BMI over 30 and waist over 100 cm respectively.
Among controls the proportions were 16 and 6% respectively.
Fifteen percent of the children of parents with
diabetes showed hyperinsulinemia indicating insulin
resistance compared to 8% of controls. Moreover,
2 and 0.5% respectively showed hyperglycaemia. Eleven,
40 and 23% of the offspring of diabetic parents showed
high LDL cholesterol, low HDL cholesterol and high
triglycerides respectively. This compared to 7, 31
and 15% respectively among controls. Finally, 11%
of the children of parents with diabetes showed hypertension
compared to 6% of controls. Metabolism 2003;52:4:443-450.
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