Issue 153 Item 9 Children Of Diabetics Show Increased Adiposity, Rapidly Progres

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.