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The Metabolic Syndrome in Overweight Hispanic Youth and the Role of Insulin Sensitivity

Departments of Preventive Medicine (M.L.C., G.B., M.I.G.), and Physiology and Biophysics (M.I.G.), Keck School of Medicine, Department of Biokinesiology and Physical Therapy (G.Q.S.), University of Southern California, Los Angeles, California 90089; Department of Pediatrics (M.J.W.), Los Angeles County and University of Southern California Medical Center, Los Angeles, California 90033; and Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging (T.T.-K.H.), Tufts University, Boston, Massachusetts 02111

Address all correspondence and requests for reprints to: Michael I. Goran, Professor of Preventive Medicine, Physiology and Biophysics, University of Southern California, 1540 Alcazar Street, CHP Room 208-D, Los Angeles, California 90089. E-mail: goran{at}hsc.edu.

The prevalence of the metabolic syndrome is highest among Hispanic adults. However, studies exploring the metabolic syndrome in overweight Hispanic youth are lacking. Subjects were 126 overweight children (8–13 yr of age) with a family history for type 2 diabetes. The metabolic syndrome was defined as having at least three of the following: abdominal obesity, low high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, hypertension, and/or impaired glucose tolerance. Insulin sensitivity was determined by the frequently sampled iv glucose tolerance test and minimal modeling. The prevalence of abdominal obesity, low HDL cholesterol, hypertriglyceridemia, systolic and diastolic hypertension, and impaired glucose tolerance was 62, 67, 26, 22, 4, and 27%, respectively. The presence of zero, one, two, or three or more features of the metabolic syndrome was 9, 22, 38, and 30%, respectively. After controlling for body composition, insulin sensitivity was positively related to HDL cholesterol (P < 0.01) and negatively related to triglycerides (P < 0.001) and systolic (P < 0.01) and diastolic blood pressure (P < 0.05). Insulin sensitivity significantly decreased (P < 0.001) as the number of features of the metabolic syndrome increased. In conclusion, overweight Hispanic youth with a family history for type 2 diabetes are at increased risk for cardiovascular disease and type 2 diabetes, and this appears to be due to decreased insulin sensitivity. Improving insulin resistance may be crucial for the prevention of chronic disease in this at-risk population.

This work was supported by National Institutes of Health Grant R01 DK 59211 and by GCRC, National Center for Research Resources, Grant MO1 RR 00043.

Abbreviations: BMI, Body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; NHANES, National Health and Nutrition Examination Survey; VLDL, very LDL.

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