Session: SAT 677-696-Obesity Physiology & Epidemiology
Poster Board SAT-690
Subjects and Methods: This was a retrospective, cross sectional study on obese children between the ages of 10-20 years that attended the pediatric endocrinology or weight management clinics at Children’s of Alabama between the years 2000-2012. Exclusion criteria included low-density lipoprotein (LDL) >190 mg/dL, triglycerides (TG) >500 mg/dL, weight >205 kg, body mass index (BMI)>50 kg/m2, thyroid stimulating hormone > 10 miu/L and total cholesterol (TC) >300 mg/dL. Subjects were classified by glycosylated hemoglobin (HbA1c) as having simple obesity (<5.7%), pre-diabetes (5.7-6.4%), or type 2-diabetes (T2DM, >6.4%).
Results: 489 obese children (AA= 333, EA =158) were included in the study. Mean age was 13.3 ± 3.0 years. There was no significant difference in the BMI, weight, or gender between diabetes classification groups (simple obesity vs. pre-diabetes vs. T2DM) or ethnic groups. Children with T2DM were older (P= <0.0001), had higher systolic blood pressure (P= <0.001), and had higher TC (161.6±32.2 vs. 162.2±30.5 vs. 178.8±43.3 mg/dl , P= <0.0001), non high-density lipoprotein (HDL) cholesterol (nHDLC, 119.0±30.8 vs. 119.0±31.0 vs. 136.6±42.1 mg/dl, P= <0.0001), LDL (P= <0.005) and TC/HDL ratios (4.0±1.1 vs. 4.0±1.2 vs. 4.5±1.4, P= <0.0001) than those with simple obesity or pre-diabetes. There was no significant difference in age between African American (AA) and European Americans (EA). AA had a higher prevalence of pre-diabetes and T2DM with a higher mean HbA1c (P= 0.0002) than EA. EA had a higher mean nHDLC (129.6±36.2 vs. 122.5±37.5 mg/dl, P= 0.05) and lower HDL (40.4±10.4 vs. 44.3±11.9 mg/dl, P= 0.0005) than AA. HbA1c was the most significant determinant of CV risk and was strongly predictive of both TC and nHDLC (P<0.0001) but not of HDL (P=0.7296).
Conclusion: This study demonstrates that obese children with T2DM have more CV risk factors than equally obese children with simple obesity or pre-diabetes. African American obese children are more likely to develop T2DM than equally obese European American children. CV disease prevention efforts are especially important in these highest-risk groups.
Nothing to Disclose: CWC, CMH, RLG, JEJ, APL, CBS, APA
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