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Possible To Predict Type 2 in Early Childhood

Nov 13, 2007

It may be possible to predict which kids are most likely to mature into adults with type 2 diabetes – and to nip that risk in the bud. A new study spotlights two key strategies. Researchers from the University of Cincinnati College of Medicine looked at “BMI rebound age” – the age BMI reaches its lowest point before increasing through our lifespan – in 308 children beginning at age three. The study then analyzed the children’s cardiovascular risk factors at age seven.

Healthy children began the study when they were three years old. Researchers measured their BMI every four months for the next four years. The BMI low point is between ages four and seven.

Results show earlier BMI rebound age was associated with risk factors for heart disease such as higher BMI, higher blood pressure, higher serum insulin and leptin levels, higher left ventricle mass and left arterial size.

The study divided the children into three groups depending on their age of BMI rebound – early BMI rebound age was below the 25th percentile; middle BMI rebound was between the 25th and 75th percentiles; and late BMI rebound age was above the 75th percentile.

In the 25th percentile, the report shows the BMI rebound age was 4.4 for boys and 4.2 for girls; in the 75th percentile it was 6.6 for boys and 5.7 for girls.

“The study implies that girls may have earlier BMI rebound age than boys,” senior author Thomas R. Kimball, M.D., University of Cincinnati College of Medicine, was quoted as saying. “Earlier rebound age correlates with greater likelihood to become obese adults, so girls may be more at risk to become obese adults.”

The two key strategies to prevent diabetes include, First,  Start early. Watch for type 2 diabetes risk factors beginning in childhood.

Second,  Manage weight for a lifetime.
The goal is to head off a condition called metabolic syndrome, which can lead to type 2 diabetes.

People with metabolic syndrome have at least three of these traits:

  • Large waist
  • Above-normal blood pressure
  • Above-normal blood sugar (glucose) after fasting
  • Above-normal triglycerides (a type of fat in the blood) after fasting
  • Below-normal HDL ("good") cholesterol

Weight management, which includes exercise and a healthy diet, can make all of those problems less likely.

The new study started in the 1970s and spanned a quarter of a century.  At the study’s start, 814 boys and girls (average age: 13) got their height, weight, blood pressure , glucose, triglycerides, and cholesterol measured.

Back then, about 13% were overweight or at risk for becoming overweight and 4% had metabolic syndrome.

Some 25-30 years later, the participants got another checkup. This time, a quarter of them were overweight, 26% had metabolic syndrome, and about 5% had type 2 diabetes.

Type 2 diabetes was most common among the following groups:

  • Adults who had metabolic syndrome as kids
  • Adults who had a parental history of diabetes
  • African-Americans, who were twice as likely as whites to have type 2 diabetes as adults
  • Older adults (diabetes becomes more likely with age)

At all ages, being overweight made metabolic syndrome more likely, and overweight kids often became overweight adults.

The researchers, who included John Morrison, PhD, of Cincinnati Children’s Hospital Medical Center, conclude that kids aged 5-19 should be checked for metabolic syndrome and parental history of diabetes.

Morrison’s team also emphasizes the importance of weight management to make metabolic syndrome and diabetes less likely.

The study appears online in The Journal of Pediatrics. Nov 2007



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