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Longitudinal Changes in Body Fat in African American and Caucasian Children: Influence of Fasting Insulin and Insulin Sensitivity¹

Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, University of Southern California (M.S.J., T.T.-K.H., J.H.D., M.I.G.), Los Angeles, CA 90033; and Mead Johnson Nutritionals (R.F.-C.), Evansville, Indiana 47721

Address all correspondence and requests for reprints to: Dr. Michael I. Goran, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, University of Southern California, 1540 Alcazar Street, Room 208, Los Angeles, California 90033. E-mail: goran{at}hsc.usc.edu

Abstract

Obesity is associated with hyperinsulinemia and reduced insulin sensitivity, both risk factors for type 2 diabetes. However, it is not clear whether these risk factors occur as a result of obesity or whether they contribute to the development of obesity. The aims of this study were to determine whether baseline (first visit) or changes in insulin measures over time were associated with longitudinal changes in body fat mass during growth in children. The study group consisted of 137 children (83 Caucasian and 54 African American) with a mean age of 8.1 yr at baseline. The children returned for 3–6 annual visits for measurement of fasting insulin, insulin sensitivity (Si), and acute insulin response (AIR) from the tolbutamide-modified frequent sampling iv glucose tolerance test and for determination of body composition by dual energy x-ray absorptiometry. Data were analyzed using SAS Proc mixed growth models. Total fat mass increased with time by 15.6%/yr (P = 0.013), but the rate of increase was not significantly influenced by race, sex, or Tanner stage. However, fasting insulin (positive effect), Si (negative effect), and AIR (positive effect) were significantly associated with the rate of increase in fat mass. In conclusion, in this cohort of children, growth-related increases in body fat were significantly associated with increases in fasting insulin and AIR and decreases in Si.

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