MedWire News: Children with persistent metabolic syndrome have accelerated fat gain, increased insulin response to oral glucose, and decreased insulin sensitivity and beta-cell function, all indicators of progressively greater risk for Type 2 diabetes, researchers show.
The metabolic syndrome is a strong indicator for Type 2 diabetes in adults, but there are few data on the epidemiology of metabolic syndrome in children who are not routinely screened for the syndrome.
Emily Ventura (University of Southern California, Los Angeles, USA) and colleagues examined whether the persistence of metabolic syndrome is associated with changes in risk factors for Type 2 diabetes in overweight Hispanic children, a population at high risk for this form of diabetes.
The 73 study participants were a subset from a longitudinal cohort study tracking the incidence of Type 2 diabetes. Children were aged 8 to 13 years, of Hispanic origin, and without a diagnosis of diabetes but with a family history of the disease in at least one grandparent, parent, or sibling.
The researchers used whole-body dual-energy X-ray absorptiometry to measure participants’ body composition and magnetic resonance imaging to assess central fat distribution, and performed 2-hour glucose tolerance and frequently sampled intravenous glucose tolerance tests to determine blood glucose levels, insulin sensitivity, acute insulin response to glucose, and disposition index, an indicator of the compensatory adaptation to insulin resistance.
Children were classified into three metabolic syndrome groups based on data from all three annual study visits: never (negative for metabolic syndrome at all visits), intermittent (positive for metabolic syndrome at one or two visits), and persistent (positive for metabolic syndrome at all visits).
Reporting in the Journal of Pediatrics, the authors say that 35 (48%) children did not exhibit metabolic syndrome at any of the three annual visits, while 24 (33%) were classified as intermittent, and 14 (19%) were classified as persistent.
“This study is the first to show that progressive risk for Type 2 diabetes is evident with persistent metabolic syndrome over just three consecutive annual measurements during childhood,” write the authors.
Compared with the never group, the persistent group had increased adiposity (20% vs 15% gain from baseline), an increased insulin response to oral glucose, had maintained a 43% lower insulin sensitivity, and by the second visit had a 25% lower disposition index, indicating an impaired ability of pancreatic beta cells to compensate by increasing insulin secretion.
“Our findings indicate that assessing overweight Hispanic children for metabolic syndrome on a yearly basis can help identify those at particular risk for Type 2 diabetes,” conclude Ventura et al.
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