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The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 1 207-212
Copyright © 2004 by The Endocrine Society

Impaired Glucose Tolerance and Reduced ß-Cell Function in Overweight Latino Children with a Positive Family History for Type 2 Diabetes

Michael I. Goran, Richard N. Bergman, Quintilia Avila, Michael Watkins, Geoff D. C. Ball, Gabriel Q. Shaibi, Marc J. Weigensberg and Martha L. Cruz

Departments of Preventive Medicine and Physiology & Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, California 90033

Address all correspondence and requests for reprints to: Michael I. Goran, Ph.D., 1540 Alcazar Street, Room 208-D, Department of Preventive Medicine, University of Southern California, Los Angeles, California 90033. E-mail: goran{at}usc.edu.

The objective of this study was to examine relationships between impaired glucose tolerance (IGT) and body composition and insulin-related phenotypes in 150 overweight Latino children with a family history of type 2 diabetes. Glucose tolerance was assessed by an oral glucose challenge. Body composition was assessed by dual energy x-ray absorptiometry and magnetic resonance imaging. Insulin sensitivity, the acute insulin response, and the disposition index (DI), as an index of ß-cell function, were determined by an iv glucose tolerance test and compared between normal glucose-tolerant and IGT children. IGT was present in 28% of children, and was similar across obesity groups, but higher in children exposed to gestational diabetes mellitus (41% IGT). There were no significant differences in body composition, fat distribution, insulin sensitivity, or acute insulin response, but DI was significantly lower in IGT children by 16% (P < 0.02), and DI was inversely related to age. In conclusion, IGT is present in 28% of overweight Latino children with a family history of type 2 diabetes, is not influenced by obesity, is more prevalent in children exposed to gestational diabetes mellitus, and is related to poor ß-cell function, which shows signs of deterioration with age in this population.

This work was supported by the National Institutes of Health (Grant R01 DK 59211), and in part by the General Clinical Research Center, National Center for Research Resources (Grant MO1 RR 00043).

Abbreviations: AIR, Acute insulin response; BCF, ß-cell function; BMI, body mass index; CDC, Centers for Disease Control and Prevention; DEXA, dual energy x-ray absorptiometry; DI, disposition index; FH, family history; GCRC, General Clinical Research Center; GDM, gestational diabetes mellitus; IGT, impaired glucose tolerance/tolerant; MRI, magnetic resonance imaging; NGT, normal glucose tolerance/tolerant; SI, insulin sensitivity; SOLAR, Study of Latino Adolescents at Risk.




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