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Current Diabetes Reports
Published in: Current Diabetes Reports 2/2014

01-02-2014 | Pediatric Type 2 Diabetes (PS Zeitler, Section Editor)

Metabolic Basis of Ethnic Differences in Diabetes Risk in Overweight and Obese Youth

Authors: Tanya L. Alderete, Claudia M. Toledo-Corral, Michael I. Goran

Published in: Current Diabetes Reports | Issue 2/2014

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Abstract

The global pandemic of childhood obesity has led to increased risk for prediabetes and type 2 diabetes mellitus (T2DM). Studies have shown decreased insulin sensitivity and/or secretion with increasing adiposity and consistently observed greater risk for T2DM in obese, non-Caucasian youth. In the current review we describe recent advances in understanding how obesity and metabolic status in children and adolescents confers various risk profiles for T2DM among Latinos, African Americans, Caucasians, Asians, and Native Americans. These possible determinants include ectopic fat distribution, adipose tissue inflammation and fibrosis, and elevated plasma levels of nonesterified free fatty acids. Future work should aim to elucidate the ethnic-specific pathophysiology of T2DM in order to develop and implement appropriate prevention and treatment strategies based on different ethnic profiles of diabetes risk.
Literature
1.
Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307:483–90.PubMedCrossRef
2.
Broussard BA, Johnson A, Himes JH, et al. Prevalence of obesity in American Indians and Alaska Natives. Am J Clin Nutr. 1991;53:1535S–42.PubMed
3.
4.
Goran MI, Bergman RN, Cruz ML, Watanabe R. Insulin resistance and associated compensatory responses in African American and Hispanic children. Diabetes Care. 2002;25:2184–90.PubMedCrossRef
5.
Cowie CC, Rust KF, Ford ES, et al. Full accounting of diabetes and pre-diabetes in the U.S. population in 1988–1994 and 2005–2006. Diabetes Care. 2009;32:287–94.PubMedCrossRef
6.
Writing Group for the SEARCH for Diabetes in Youth Study Group, Dabelea D, Bell RA, et al. Incidence of diabetes in youth in the United States. JAMA. 2007;297:2716–24.PubMedCrossRef
7.•
Nsiah-Kumi PA, Lasley S, Whiting M, et al. Diabetes, pre-diabetes and insulin resistance screening in Native American children and youth. Int J Obes. 2013;37:540–5. This is the first prospective study to use an OGTT to show that diabetes risk begins early in NA youth.CrossRef
8.
Moore K. Youth-onset type 2 diabetes among american indians and alaska natives. J Public Health Manag Pract. 2010;16:388–93.PubMedCrossRef
9.•
Zeitler P, Hirst K, et al. TODAY Study Group. A clinical trial to maintain glycemic control in youth with type 2 diabetes. N Engl J Med. 2012;366:2247–56. Examined the efficacy of metformin, metformin with rosiglitazone, and lifestyle-intervention program treatments in achieving glycemic control in children and adolescents with T2DM. Metformin failure rates suggest ethnic differences in adherence/pathophysiological differences.PubMedCrossRef
10.
Li C, Ford ES, Zhao G, Mokdad AH. Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005–2006. Diabetes Care. 2009;32:342–7.PubMedCrossRef
11.
Dabelea D, DeGroat J, Sorrelman C, et al. Diabetes in Navajo youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study. Diabetes Care. 2009;32 Suppl 2:S141–7.PubMedCrossRef
12.•
Karter AJ, Schillinger D, Adams AS, et al. Elevated rates of diabetes in Pacific Islanders and Asian subgroups: the Diabetes Study of Northern California (DISTANCE). Diabetes Care. 2013;36:574–9. This is a large prospective cohort study showing that Asians have the highest prevalence and incidence of diabetes among all ethnic groups, including AAs and Latinos.
13.
Acton KJ, Burrows NR, Moore K, et al. Trends in diabetes prevalence among American Indian and Alaska native children, adolescents, and young adults. Am J Public Health. 2002;92:1485–90.PubMedCrossRef
14.
Arslanian SA, Saad R, Lewy V, et al. Hyperinsulinemia in African American children: decreased insulin clearance and increased insulin secretion and its relationship to insulin sensitivity. Diabetes. 2002;51:3014–9.PubMedCrossRef
15.
Hasson RE, Adam TC, Davis JN, et al. Ethnic differences in insulin action in obese African American and Latino adolescents. J Clin Endocrinol Metab. 2010;95:4048–51.PubMedCrossRef
16.••
Nightingale CM, Rudnicka AR, Owen CG, et al. Influence of adiposity on insulin resistance and glycemia markers among United Kingdom children of South Asian, Black African Caribbean, and White European Origin. Child Heart and Health Study in England. Diabetes Care. 2013:1–8. This is one of the few studies including Asian youth, which found that Asian children were more metabolically sensitive to fat mass percentage.
17.
Stefan N, Stumvoll M, Weyer C, et al. Exaggerated insulin secretion in Pima Indians and African Americans but higher insulin resistance in Pima Indians compared with African Americans and Caucasians. Diabet Med. 2004;21:1090–5.PubMedCrossRef
18.•
Rosenbaum M, Fennoy I, Accacha S, et al. Racial/ethnic differences in clinical and biochemical type 2 diabetes mellitus risk factors in children. Obesity. 2013;[In press]. Multi-ethnic study found differences in the prevalence of risk factors for T2DM in peri-pubertal children where fractional body fat content was higher at any BMI in Asians.
19.••
Toledo-Corral CM, Alderete TL, Hu HH, et al. Ectopic fat deposition in prediabetic overweight and obese minority adolescents. J Clin Endocrinol Metab. 2013;98:1115–21. One of the only studies examining liver and pancreatic fat in AA and Latino youth. Results suggest pancreatic fat predicts prediabetes in AAs whereas liver fat predicts prediabetes in Latino youth.
20.
Maligie M, Crume T, Scherzinger A, et al. Adiposity, fat patterning, and the metabolic syndrome among diverse youth: the EPOCH study. J Pediatr. 2012;161:875–80.PubMedCentralPubMedCrossRef
21.
Mager DR, Yap J, Rodriguez-Dimitrescu C, et al. Anthropometric measures of visceral and subcutaneous fat are important in the determination of metabolic dysregulation in boys and girls at risk for nonalcoholic fatty liver disease. Nutr Clin Pract. 2013;28:101–11.PubMedCrossRef
22.••
Bennett B, Larson-Meyer DE, Ravussin E, et al. Impaired insulin sensitivity and elevated ectopic fat in healthy obese vs nonobese prepubertal children. Obesity. 2011;20:371–5. This study directly examines the associations between IMCL, VAT, and total body fat with insulin sensitivity and resistance. Results show increased ectopic fat and insulin resistance in obese vs nonobese youth before puberty.PubMedCrossRef
23.
Singh GK, Bernadette VE, Holland MR, et al. Alterations in ventricular structure and function in obese adolescents with nonalcoholic fatty liver disease. J Pediatr. 2013;162:1160–8.PubMedCrossRef
24.
Indulekha K, Anjana RM, Surendar J, Mohan V. Association of visceral and subcutaneous fat with glucose intolerance, insulin resistance, adipocytokines and inflammatory markers in Asian Indians (CURES-113). Clin Biochem. 2011;44:281–7.PubMedCrossRef
25.
Hasson RE, Adam TC, Davis JN, et al. Randomized controlled trial to improve adiposity, inflammation, and insulin resistance in obese African American and Latino youth. Obesity. 2012;20:811–8.PubMedCentralPubMedCrossRef
26.
Staiano AE, Katzmarzyk PT. Ethnic and sex differences in body fat and visceral and subcutaneous adiposity in children and adolescents. Int J Obes. 2012;36:1261–9.CrossRef
27.
Gautier J-F, Milner MR, Elam E, et al. Visceral adipose tissue is not increased in Pima Indians compared with equally obese Caucasians and is not related to insulin action or secretion. Diabetologia. 1999;42:28–34.PubMedCrossRef
28.
Cruz ML, Bergman RN, Goran MI. Unique effect of visceral fat on insulin sensitivity in obese Hispanic children with a family history of type 2 diabetes. Diabetes Care. 2002;25:1631–6.PubMedCrossRef
29.
Going SB, Lohman TG, Cussler EC, et al. Percent body fat and chronic disease risk factors in U.S. children and youth. Am J Prev Med. 2011;41:S77–86.PubMedCrossRef
30.
Abate N, Chandalia M. Role of subcutaneous adipose tissue in metabolic complications of obesity. Metab Syndr Relat Disord. 2012;10:319–20.PubMedCrossRef
31.
McLaughlin T, Lamendola C, Liu A, Abbasi F. Preferential fat deposition in subcutaneous vs visceral depots is associated with insulin sensitivity. J Clin Endocrinol Metab. 2011;96:E1756–60.PubMedCrossRef
32.
33.
Kelley DE, Thaete FL, Troost F, et al. Subdivisions of subcutaneous abdominal adipose tissue and insulin resistance. Am J Physiol Endocrinol Metab. 2011;278:E941–8.
34.
Tordjman J, Divoux A, Prifti E, et al. Structural and inflammatory heterogeneity in subcutaneous adipose tissue: relation with liver histopathology in morbid obesity. J Hepatol. 2012;56:1152–8.PubMedCrossRef
35.
Kohli S, Lear SA. Differences in subcutaneous abdominal adiposity regions in four ethnic groups. Obesity. 2012;[In press].
36.
Nazare J-A, Smith JD, Borel A-L, et al. Ethnic influences on the relations between abdominal subcutaneous and visceral adiposity, liver fat, and cardiometabolic risk profile: the International Study of Prediction of Intra-Abdominal Adiposity and its Relationship with Cardiometabolic Risk/Intra-Abdominal Adiposity. Am J Clin Nutr. 2012;96:714–26.PubMedCrossRef
37.
Kohli S, Sniderman AD, Tchernof A, Lear SA. Ethnic-specific differences in abdominal subcutaneous adipose tissue compartments. Obesity. 2010;18:2177–83.PubMedCrossRef
38.
Anand SS, Tarnopolsky MA, Rashid S, et al. Adipocyte hypertrophy, fatty liver and metabolic risk factors in South Asians: the Molecular Study of Health and Risk in Ethnic Groups (mol-SHARE). PLoS One. 2011;6:e22112.PubMedCentralPubMedCrossRef
39.•
Saukkonen T, Heikkinen S, Hakkarainen A, et al. Association of intramyocellular, intraperitoneal and liver fat with glucose tolerance in severely obese adolescents. Eur J Endocrinol. 2010;163:413–9. The results from this study suggest that IMCL, and not liver fat, is associated with impaired glucose tolerance in obese adolescents.PubMedCrossRef
40.
Forouhi NG, Jenkinson G, Thomas EL, et al. Relation of triglyceride stores in skeletal muscle cells to central obesity and insulin sensitivity in European and South Asian men. Diabetologia. 1999;42:932–5.PubMedCrossRef
41.
Lee S, Kim Y, White DA, et al. Relationships between insulin sensitivity, skeletal muscle mass and muscle quality in obese adolescent boys. Eur J Clin Nutr. 2012;66:1366–8.PubMedCrossRef
42.•
Brumbaugh DE, Crume TL, Nadeau K, et al. Intramyocellular lipid is associated with visceral adiposity, markers of insulin resistance, and cardiovascular risk in prepubertal children: the EPOCH Study. J Clin Endocrinol Metab. 2012;97:E1099–105. The results from this analysis show a positive relationship between IMCL and VAT. This is the largest studying examining the relationships between IMCL, VAT, and markers of insulin resistance in children.PubMedCrossRef
43.
Koska J, Stefan N, Permana PA, et al. Increased fat accumulation in liver may link insulin resistance with subcutaneous abdominal adipocyte enlargement, visceral adiposity, and hypoadiponectinemia in obese individuals. Am J Clin Nutr. 2008;87:295–302.PubMed
44.
45.
Targher G, Rossi AP, Zamboni GA, et al. Pancreatic fat accumulation and its relationship with liver fat content and other fat depots in obese individuals. J Endocrinol Investig. 2012;35:748–53.
46.
Szczepaniak LS, Victor RG, Mathur R, et al. Pancreatic steatosis and its relationship to β-cell dysfunction in humans: racial and ethnic variations. Diabetes Care. 2012;35:2377–83.PubMedCrossRef
47.•
Lê K-A, Ventura EE, Fisher JQ, et al. Ethnic differences in pancreatic fat accumulation and its relationship with other fat depots and inflammatory markers. Diabetes Care. 2011;34:485–90. This is one of the first studies to document ethnic differences in pancreatic fat accumulation in overweight/obese AA and Latino adolescents and young adults. This study shows that pancreatic fat was positively correlated with VAT and that pancreatic fat was higher in Latinos than AAs.
48.
Wittmeier KDM, Wicklow BA, MacIntosh AC, et al. Hepatic steatosis and low cardiorespiratory fitness in youth with type 2 diabetes. Obesity. 2012;20:1034–40.PubMedCrossRef
49.•
Kim JS, Lê KA, Mahurkar S, et al. Influence of elevated liver fat on circulating adipocytokines and insulin resistance in obese Hispanic adolescents. Pediatr Obes. 2012;7:158–64. This study found that obese Latinos with high liver fat had significantly higher plasma levels of adipocytokines and insulin resistance compared with obese adolescents with low liver fat but similar amounts of total fat mass, SAT, and VAT.PubMedCentralPubMedCrossRef
50.•
Wicklow BA, Wittmeier KDM, MacIntosh AC, et al. Metabolic consequences of hepatic steatosis in overweight and obese adolescents. Diabetes Care. 2012;35:905–10. This study included lean, overweight, and obese adolescents with and without hepatic steatosis. The results demonstrate that hepatic steatosis is associated with risk factors for T2DM (e.g., lower insulin sensitivity, metabolic syndrome) independent of VAT.PubMedCrossRef
51.
Goran MI. Ethnic-specific pathways to obesity-related disease: the Hispanic vs African American paradox. Obesity. 2008;16:2561–5.PubMedCrossRef
52.
Jakobsen M, Berentzen T, Sorensen T, Overvad K. Abdominal obesity and fatty liver. Epidemiol Rev. 2007;29:77–87.PubMedCrossRef
53.
Korenblat KM, Fabbrini E, Mohammed BS, Klein S. Liver, muscle, and adipose tissue insulin action is directly related to intrahepatic triglyceride content in obese subjects. Gastroenterology. 2008;134:1369–75.PubMedCentralPubMedCrossRef
54.
American Diabetes Association: diagnosis and classification of diabetes mellitus. Diabetes Care. 2004:S5–10.
55.••
Alderete TL, Toledo-Corral CM, Desai P, et al. Liver Fat has a stronger association with risk factors for type 2 diabetes in African American compared with Hispanic adolescents. J Clin Endocrinol Metab. 2013;[In press]. This study found that liver fat, not VAT, was inversely associated with insulin sensitivity and the effect of high liver fat compared with low liver fat was more pronounced in AAs compared with Latinos.
56.
International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327–34.CrossRef
57.•
Maggio ABR, Mueller P, Wacker J, et al. Increased pancreatic fat fraction is present in obese adolescents with metabolic syndrome. J Pediatr Gastroenterol Nutr. 2012;54:720–6. This study found that pancreatic fat was higher in obese compared with lean adolescents and was associated with VAT and metabolic syndrome.PubMedCrossRef
58.•
Spruijt-Metz D, Adar Emken B, Spruijt MR, et al. CRP Is related to higher leptin levels in minority peripubertal females regardless of adiposity levels. Obesity. 2011;20:512–6. This study found that inflammation was related to levels of adiposity in Latino and AA females.PubMedCentralPubMedCrossRef
59.•
Utsal L, Tillmann V, Zilmer M, et al. Elevated serum IL-6, IL-8, MCP-1, CRP, and IFN-γ levels in 10- to 11-year-old boys with increased BMI. Horm Res Paediatr. 2012;78:31–9. This is a recent study in non-minority boys showing clear association between BMI and plasma markers of inflammation.
60.
Balas-Nakash M, Perichart-Perera O. [Asociación entre adiposidad, inflamación y factores de riesgo cardiovascular en un grupo de escolares mexicanos]. Gac Méd de Méx. 2013:196–203.
61.
Stolzman S, Bement MH. Inflammatory markers in pediatric obesity: health and physical activity implications. ICAN. 2012;4:297–302.
62.
Whincup PH, Nightingale CM, Owen CG, et al. Early emergence of ethnic differences in type 2 diabetes precursors in the UK: the Child Heart and Health Study in England (CHASE Study). PLoS Med. 2010;7:e1000263.PubMedCentralPubMedCrossRef
63.
McArdle MA, Finucane OM, Connaughton RM, et al. Mechanisms of obesity-induced inflammation and insulin resistance: insights into the emerging role of nutritional strategies. Front Endocrinol (Lausanne). 2013;4:52.
64.
Kyrgios I, Galli-Tsinopoulou A, Stylianou C, et al. Elevated circulating levels of the serum acute-phase protein YKL-40 (chitinase 3-like protein 1) are a marker of obesity and insulin resistance in prepubertal children. Metab Clin Exp. 2012;61:562–8.PubMedCrossRef
65.
Retnakaran R, Hanley A, Connelly PW, et al. Elevated C‐reactive protein in Native Canadian children: an ominous early complication of childhood obesity. Diabetes Obes Metab. 2006;8:483–91.PubMedCrossRef
66.
Lê K-A, Mahurkar S, Alderete TL, et al. Subcutaneous adipose tissue macrophage infiltration is associated with hepatic and visceral fat deposition, hyperinsulinemia, and stimulation of NF-κB stress pathway. Diabetes. 2011;60:2802–9.PubMedCrossRef
67.
Fabbrini E, Cella M, McCartney SA, et al. Association between specific adipose tissue CD4 + T-Cell populations and insulin resistance in obese people. YGAST. 2013:1–37.
68.
He J, Le DS, Xu X, et al. Circulating white blood cell count and measures of adipose tissue inflammation predict higher 24-hour energy expenditure. Eur J Endocrinol. 2010;162:275–80.PubMedCrossRef
69.
Spencer M, Unal R, Zhu B, et al. Adipose tissue extracellular matrix and vascular abnormalities in obesity and insulin resistance. J Clin Endocrinol Metab. 2011;96:E1990–8.PubMedCrossRef
70.
Sbarbati A. Obesity and inflammation: evidence for an elementary lesion. Pediatrics. 2006;117:220–3.PubMedCrossRef
71.•
Tam CS, Tordjman J, Divoux A, et al. Adipose tissue remodeling in children: the link between collagen deposition and age-related adipocyte growth. J Clin Endocrinol Metab. 2012;97:1320–7. One of few studies examining abdominal SAT biopsies from children. This study documented extracellular matrix remodeling and the presence of immune cells in SAT biopsies at an early age.PubMedCrossRef
72.
Heilbronn L, Smith SR, Ravussin E. Failure of fat cell proliferation, mitochondrial function and fat oxidation results in ectopic fat storage, insulin resistance and type II diabetes mellitus. Int J Obes Relat Metab Disord. 2004;28 Suppl 4:S12–21.PubMedCrossRef
73.•
Kelsey MM, Forster JE, Van Pelt RE, et al. Adipose tissue insulin resistance in adolescents with and without type 2 diabetes. Pediatr Obes. 2013;[In press]. This is the first study to show that some obese youth with and without T2DM have impaired suppression of lipolysis, demonstrating that adipose tissue insulin resistance occurs in obese adolescents.
74.
Gaggini M, Morelli M, Buzzigoli E, et al. Non-Alcoholic Fatty Liver Disease (NAFLD) and its connection with insulin resistance, dyslipidemia, atherosclerosis and coronary heart disease. Nutrients. 2013;5:1544–60.PubMedCentralPubMedCrossRef
75.
Bays H, Mandarino L, DeFronzo RA. Role of the adipocyte, free fatty acids, and ectopic fat in pathogenesis of type 2 diabetes mellitus: peroxisomal proliferator-activated receptor agonists provide a rational therapeutic approach. J Clin Endocrinol Metab. 2004;89:463–78.PubMedCrossRef
76.
Manteiga S, Choi K, Jayaraman A, Lee K. Systems biology of adipose tissue metabolism: regulation of growth, signaling and inflammation. Wiley Interdiscip Rev Syst Biol Med. 2013;5:425–47.PubMedCrossRef
77.
78.•
Salgin B, Ong KK, Thankamony A, et al. Higher fasting plasma free fatty acid levels are associated with lower insulin secretion in children and adults and a higher incidence of type 2 diabetes. J Clin Endocrinol Metab. 2012;97:3302–9. This is reported data from a large longitudinal study where higher fasting NEFA were associated with a lower insulin secretion following a 30-minute oral glucose challenge in children with normal glucose tolerance.PubMedCrossRef
79.
Burns SF, Kelsey SF, Arslanian SA. Effects of an intravenous lipid challenge and free fatty acid elevation on in vivo insulin sensitivity in African American vs Caucasian adolescents. Diabetes Care. 2009;32:355–60.PubMedCrossRef
80.
Goree LLT, Darnell BE, Oster RA, et al. Associations of free fatty acids with insulin secretion and action among African American and European-American girls and women. Obesity. 2009;18:247–53.PubMedCentralPubMedCrossRef
81.••
Michaliszyn SF, Bonadonna RC, Sjaarda LA, et al. β-cell lipotoxicity in response to free fatty acid elevation in youth: African American vs Caucasian contrast. Diabetes. 2013;[In press]. This study found that AA and Caucasian youth show a decline in β-cell function relative to insulin sensitivity during intralipid infusion. The authors observed a greater decline in Caucasians, suggesting AAs are hypersensitive to FFA stimulation of β-cell insulin secretion.
82.•
Toledo-Corral CM, Sequeria P, Moua K, et al. Elevated free fatty acids as a risk factor for type 2 diabetes in overweight Latino youth. Diabetes. 2012;61(S1):A337. This is the first study to show that elevated free fatty acids are a risk factor for T2DM in overweight Latino youth.
83.••
Toledo-Corral CM, Vargas LG, Goran MI, Weigensberg MJ. Hemoglobin A1c above threshold level is associated with decreased β-cell function in overweight Latino youth. J Pediatr. 2012;160:751–6. The first study in children to examine the relationship between International Expert Committee and the American Diabetes Association A1c thresholds to β-cell function. The study was conducted exclusively in Latino overweight children.PubMedCentralPubMedCrossRef
84.••
Sjaarda LA, Michaliszyn SF, Lee S, et al. HbA(1c) diagnostic categories and β-cell function relative to insulin sensitivity in overweight/obese adolescents. Diabetes Care. 2012;35:2559–63. This study found that overweight Caucasian and AA adolescents with A1c in the at-risk/prediabetes category demonstrate impaired β-cell function relative to insulin sensitivity. No differences by ethnicity were reported.
85.•
Amed S, Hamilton JK, Sellers EAC, et al. Differing clinical features in Aboriginal vs non-Aboriginal children presenting with type 2 diabetes. Pediatr Diabetes. 2012;13:470–5. This study found that clinical features, including A1c, differ across Caucasian and NA children with newly diagnosed T2DM.PubMedCrossRef
86.
Bacha F, Gungor N, Lee S, Arslanian SA. Type 2 diabetes in youth: are there racial differences in β-cell responsiveness relative to insulin sensitivity? Pediatr Diabetes. 2012;13:259–65.PubMedCentralPubMedCrossRef
87.•
Tfayli H, Lee S, Arslanian S. Declining beta-cell function relative to insulin sensitivity with increasing fasting glucose levels in the nondiabetic range in children. Diabetes Care. 2010;33:2024–30. This study found impairment in β-cell function relative to insulin sensitivity even in children with fasting blood glucose levels in the nondiabetic range (90–99 mg/dl).PubMedCrossRef
88.
Tfayli H, Lee S, Bacha F, Arslanian S. One-hour plasma glucose concentration during the OGTT: what does it tell about β-cell function relative to insulin sensitivity in overweight/obese children? Pediatr Diabetes. 2011;12:572–9.PubMedCentralPubMed
89.••
Kim JY, Goran MI, Toledo-Corral CM, et al. One-hour glucose during an oral glucose challenge prospectively predicts β-cell deterioration and prediabetes in obese Hispanic youth. Diabetes Care. 2013;36:1681–6. Only longitudinal study in children to show that baseline 1-hour glucose of ≥ 155 mg/dL predicted a decline in β-Cell function over an 8-year period.PubMedCrossRef
90.
Manco M, Miraglia Del Giudice E, Spreghini MR, et al. One-hour plasma glucose in obese youth. Acta Diabetol. 2012;49:435–43.PubMedCrossRef
91.
Burns SF, Bacha F, Lee SJ, et al. Declining β-cell function relative to insulin sensitivity with escalating OGTT 2-hour glucose concentrations in the nondiabetic through the diabetic range in overweight youth. Diabetes Care. 2011;34:2033–40.PubMedCrossRef
92.••
Giannini C, Weiss R, Cali A, et al. Evidence for early defects in insulin sensitivity and secretion before the onset of glucose dysregulation in obese youths: a longitudinal study. Diabetes. 2012;61:606–14. Longitudinal study that showed normal glucose tolerant obese adolescents (100–139 mg/dL) had significant impairments in β-cell function relative to insulin sensitivity over time.PubMedCrossRef
93.•
Kim JY, Coletta DK, Mandarino LJ, Shaibi GQ. Glucose response curve and type 2 diabetes risk in Latino adolescents. Diabetes Care. 2012;35:1925–30. First study in children to show a biphasic glucose curve during an oral glucose tolerance test was related to lower β-Cell function when compared with those with a monophasic glucose curve.PubMedCrossRef
94.
Goff LM, Griffin BA, Lovegrove JA, et al. Ethnic differences in beta-cell function, dietary intake and expression of the metabolic syndrome among UK adults of South Asian, Black African-Caribbean and White-European origin at high risk of metabolic syndrome. Diab Vasc Dis Res. 2013;10:315–23.PubMedCrossRef
95.
Lee S, Boesch C, Kuk JL, Arslanian S. Effects of an overnight intravenous lipid infusion on intramyocellular lipid content and insulin sensitivity in African American vs Caucasian adolescents. Metab Clin Exp. 2013;62:417–23.PubMedCrossRef
Metadata
Title
Metabolic Basis of Ethnic Differences in Diabetes Risk in Overweight and Obese Youth
Authors
Tanya L. Alderete
Claudia M. Toledo-Corral
Michael I. Goran
Publication date
01-02-2014
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 2/2014
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-013-0455-z

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